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All new mothers need to be screened for postpartum depression

Posted by Marjorie Pritchard  January 25, 2012 12:21 PM

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By Ellen Story

Postpartum depression hits approximately 15 percent of new moms during the first year of their babies' lives, and is often marked by severe despair, guilt, anxiety, and fears of hurting oneself or one's baby. Although awareness of postpartum depression is improving, the illness is often hidden by new moms' successful covering-up of these painful symptoms for fear of being deemed a "bad mother." The illness is also frequently missed by health care providers who feel unprepared to deal with the consequences of digging deeper into moms' mental health. Fortunately, however, if addressed early, this depression is eminently treatable, and any adverse consequences it has had on children can be successfully remedied.

Many states are addressing this issue through various new screening protocols, public and professional education programs, and innovative pilot programs. Massachusetts should match these efforts.

As I began to work on a state bill that addresses postpartum depression, I discovered outsanding work that was already being done here. I met Dr. Howard King, a pediatrician from Newton ,who has found innovative solutions to addressing the illness and developed a training program to help other pediatricians see mental health issues in a more holistic, family-oriented way. I learned about regional nonprofits like MotherWoman in Western Mass., the North Shore Postpartum Depression Task Force, and the Cape and Islands Maternal Depression Task Force, that are working locally to get women the treatment they need. I got to know the state Department of Public Health's Maternal and Infant Mental Health Project, focusing on prevention and treatment of postpartum depression through home-visiting and other programs for at-risk moms. I learned that the nation's pioneering work on the safe use of antidepressants and other psychiatric medications sometimes necessary for pregnant and nursing women is being done right here at Mass. General's Center for Women's Mental Health.

Wanting to build on the good work of these leaders and many others, I brought together health care providers, activists, mothers, and policymakers in both small and large groups to learn from each other, prioritize top issues, and finally, to draft a bill.

What I learned from these experts was that an effective solution to postpartum depression must be comprehensive: all women must be screened. Moreover, it's useless to screen if you have nowhere to refer women for treatment. Also doctors and families need a better understanding of the illness to be able to identify and support suffering moms. The bill, called "An Act Relative to Postpartum Depression,'' addressed all these areas.

In January 2010 our bill received a hearing before the Legislature's Joint Committee on Financial Services. Doctors, child psychiatrists, survivors, spouses, and many others offered powerful testimony about the painful effects of postpartum depression on moms, babies, and families -- and also about how it can be treated. With strong momentum from this hearing, the legislation passed in August 2010.

As the bill made its way through the legislative process, however, it was changed. The heart of the bill, universal screening, raised concerns for insurers and doctors. And funds for the bill's other provisions, such as public education, were nearly nonexistent. Fortunately, the law that passed does take important steps forward. It calls on the state Department of Public Health, a strong partner throughout the process, to issue regulations on best practices and data collection for screening. They are making excellent progress.

The law also created a diverse 34-person Commission, including health care providers, insurance representatives, survivors, legislators and state agency representatives, and many others, charged with advancing best practices in screening, referrals, treatment, and public and professional education.

I am co-chair of this commission, which held its first meeting in mid-December. I am hopeful about the group'ss ability to develop systemic solutions to postpartum depression like the ones in our original bill, and to be sure those solutions are really working to get women and their families successful treatment. If we succeed, we will all benefit.

Ellen Story is a Democratic state representative from Amherst.

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