II 

109TH CONGRESS 

2D SESSION S. 3529 

To ensure that new mothers and their families are educated about postpartum 

depression, screened for symptoms, and provided with essential services, 

and to increase research at the National Institutes of Health on 

postpartum depression. 

IN THE SENATE OF THE UNITED STATES 

JUNE 15, 2006 

Mr. MENENDEZ (for himself and Mr. DURBIN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To ensure that new mothers and their families are educated 

about postpartum depression, screened for symptoms, 

and provided with essential services, and to increase research at the National Institutes of Health on 

postpartum depression. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Mom’s Opportunity 

5 to Access Health, Education, Research, and Support for 

6 Postpartum Depression Act’’ or the ‘‘MOTHERS Act’’. 


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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) Postpartum depression is a devastating 

4 mood disorder which strikes many women during 

5 and after pregnancy. 

6 (2) Postpartum mood changes are common and 

7 can be broken into three subgroups: ‘‘baby blues,’’ 

8 which is an extremely common and the less severe 

9 form of postpartum depression; postpartum mood 

10 and anxiety disorders, which are more severe than 

11 baby blues and can occur during pregnancy and any12 time within the first year of the infant’s birth; and 

13 postpartum psychosis, which is the most extreme 

14 form of postpartum depression and can occur during 

15 pregnancy and up to twelve months after delivery. 

16 (3) ‘‘Baby blues’’ is characterized by mood 

17 swings, feelings of being overwhelmed, tearfulness, 

18 irritability, poor sleep, mood changes, and a sense of 

19 vulnerability that usually starts in the first week and 

20 resolves without treatment by the end of the second 

21 week postpartum. 

22 (4) The symptoms of postpartum mood and 

23 anxiety disorders are as defined in the latest edition 

24 of Diagnostic and Statistical Manual of Mental Dis25 orders (DSM), as published by American Psycho26 logical Association. 


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1 (5) The symptoms of postpartum psychosis in2 clude losing touch with reality, distorted thinking, 

3 delusions, auditory hallucinations, paranoia, hyper4 activity, and rapid speech or mania. 

5 (6) Baby blues afflicts up to 80 percent of new 

6 mothers, postpartum depression occurs in 10 to 20 

7 percent of new mothers, and postpartum psychosis 

8 strikes 1 in 1,000 new mothers. 

9 (7) The causes of postpartum depression are 

10 complex and unknown at this time; however, contrib11 uting factors include: a steep and rapid drop in hor12 mone levels after childbirth; difficulty during labor 

13 or pregnancy; a premature birth; a miscarriage; feel14 ing overwhelmed, uncertain, frustrated or anxious 

15 about one’s new role as a mother; a lack of support 

16 from one’s spouse, friends or family; marital strife; 

17 stressful events in life such as death of a loved one, 

18 financial problems, or physical or mental abuse; a 

19 family history of depression or mood disorders; a 

20 previous history of major depression or anxiety; or 

21 a prior postpartum depression. 

22 (8) Postpartum depression is a treatable dis23 order if promptly diagnosed by a trained provider 

24 and attended to with a personalized regimen of care 


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1 including social support, therapy, medication, and 

2 when necessary hospitalization. 

3 (9) All too often postpartum depression goes 

4 undiagnosed or untreated due to the social stigma 

5 surrounding depression and mental illness, the ro6 manticization of motherhood, the new mother’s in7 ability to self-diagnose her condition, the new moth8 er’s shame or embarrassment over discussing her de9 pression so near to the birth of her child, the lack 

10 of understanding in society and the medical commu11 nity of the complexity of postpartum depression, and 

12 economic pressures placed on hospitals and pro13 viders. 

14 (10) Untreated, postpartum depression can lead 

15 to further depression, substance abuse, loss of em16 ployment, divorce and further social alienation, self17 destructive behavior, or even suicide. 

18 (11) Untreated, postpartum depression impacts 

19 society through its effect on the infant’s physical 

20 and psychological and cognitive development, child 

21 abuse, neglect or death of the infant or other sib22 lings, and the disruption of the family. 

23 (12) This Act shares the goals of the Melanie 

24 Blocker-Stokes Postpartum Depression Research 


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1 and Care Act and will help new mothers who are 

2 battling with postpartum conditions. 

3 TITLE I—DELIVERY OF SERV4 ICES REGARDING 

5 POSTPARTUM DEPRESSION 

6 AND PSYCHOSIS 

7 SEC. 101. DELIVERY OF SERVICES REGARDING 

8 POSTPARTUM DEPRESSION AND PSYCHOSIS. 

9 Subpart 3 of part B of title V of the Public Health 

10 Service Act (42 U.S.C. 290bb–31 et seq.) is amended— 

11 (1) by inserting after the subpart heading the 

12 following: 

13 ‘‘CHAPTER I—GENERAL PROVISIONS’’; 

14 and 

15 (2) by adding at the end thereof the following: 

16 ‘‘CHAPTER II—DELIVERY OF SERVICES 

17 REGARDING POSTPARTUM DEPRES18 SION AND PSYCHOSIS 

19 ‘‘SEC. 520K. ESTABLISHMENT OF PROGRAM OF GRANTS. 

20 ‘‘(a) IN GENERAL.—The Secretary shall in accord21 ance with this chapter make grants to provide for projects 

22 for the establishment, operation, and coordination of effec23 tive and cost-efficient systems to— 

24 ‘‘(1) provide education to women who have re25 cently given birth, and their families, concerning 


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1 postpartum depression, postpartum mood and anx2 iety disorders, and postpartum psychosis (referred to 

3 in this chapter as ‘postpartum conditions’) before 

4 such women leave their birthing centers and to 

5 screen new mothers for postpartum conditions dur6 ing their first year of postnatal checkup visits, in7 cluding the standard 6-week postnatal checkup visit; 

8 and 

9 ‘‘(2) provide for the delivery of essential serv10 ices to individuals with postpartum conditions and 

11 their families. 

12 ‘‘(b) RECIPIENTS OF GRANTS.—A grant under sub13 section (a) may be made to an entity only if the entity— 

14 ‘‘(1) is— 

15 ‘‘(A) in the case of a grant to carry out the 

16 activities described in subsection (c)(1), a State; 

17 and 

18 ‘‘(B) in the case of a grant to carry out 

19 the activities described in subsection (c)(2), a 

20 public or nonprofit private entity, which may in21 clude a State or local government; a public or 

22 nonprofit private hospital, community-based or23 ganization, hospice, ambulatory care facility, 

24 community health center, migrant health cen25 ter, tribal government or territory, or homeless 


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1 health center; or other appropriate public or 

2 nonprofit private entity; and 

3 ‘‘(2) submits to the Secretary an application at 

4 such time, in such manner, and containing such in5 formation as the Secretary may require. 

6 ‘‘(c) CERTAIN ACTIVITIES.— 

7 ‘‘(1) EDUCATION.— 

8 ‘‘(A) IN GENERAL.—To the extent prac9 ticable and appropriate, the Secretary shall en10 sure that projects under subsection (a)(1) de11 velop policies and procedures to ensure that 

12 education concerning postpartum conditions is 

13 provided to women in accordance with subpara14 graph (B), that training programs regarding 

15 such education are carried out at health facili16 ties within the State, and that screening and re17 ferral is provided in accordance with subpara18 graph (C). 

19 ‘‘(B) REQUIREMENTS.—A State that re20 ceives a grant or contract under subsection 

21 (a)(1) shall ensure that postpartum condition 

22 education complies with the following: 

23 ‘‘(i) Physicians, certified nurse mid24 wives, certified midwives, nurses, and other 

25 licensed health care professionals within 


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1 the State who provide prenatal and post2 natal care to women shall also provide edu3 cation to women and their families con4 cerning postpartum conditions to promote 

5 earlier diagnosis and treatment. 

6 ‘‘(ii) All birthing facilities in the State 

7 shall provide new mothers and fathers, and 

8 other family members as appropriate, with 

9 complete information concerning 

10 postpartum conditions, including its symp11 toms, methods of coping with the illness, 

12 and treatment resources prior to such 

13 mothers leaving the birthing facility after a 

14 birth. 

15 ‘‘(iii) Physicians, certified nurse mid16 wives, certified midwives, nurses, and other 

17 licensed health care professionals within 

18 the State who provide prenatal and post19 natal care to women shall include fathers 

20 and other family members, as appropriate, 

21 in both the education and treatment proc22 esses to help them better understand the 

23 nature and causes of postpartum condi24 tions. 


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1 ‘‘(C) SCREENING AND REFERRAL.—A 

2 State that receives a grant or contract under 

3 subsection (a)(1) shall ensure that new moth4 ers, during visits to a physician, certified nurse 

5 midwife, certified midwife, nurse, or licensed 

6 healthcare professional who is licensed or cer7 tified by the State, within the first year after 

8 the birth of their child, are offered screenings 

9 for postpartum conditions by using the Edin10 burgh Postnatal Depression Scale (EPDS), or 

11 other appropriate tests. If the results of such 

12 screening provide warning signs for postpartum 

13 conditions, the new mother shall be referred to 

14 an appropriate mental healthcare provider. 

15 ‘‘(D) SUBGRANTS.—A State that receives a 

16 grant or contract under subsection (a)(1) to 

17 carry out activities under this paragraph may 

18 award subgrants to entities described in sub19 section (b)(1)(B) to enable such entities to pro20 vide education of this type described in sub21 paragraph (B). 

22 ‘‘(2) SERVICES.—To the extent practicable and 

23 appropriate, the Secretary shall ensure that projects 

24 under subsection (a)(2) provide services for the diag25 nosis and management of postpartum conditions. 


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1 Activities that the Secretary may authorize for such 

2 projects may also include the following: 

3 ‘‘(A) Delivering or enhancing outpatient 

4 and home-based health and support services, in5 cluding case management, screening and com6 prehensive treatment services for individuals 

7 with or at risk for postpartum conditions, and 

8 delivering or enhancing support services for 

9 their families. 

10 ‘‘(B) Delivering or enhancing inpatient 

11 care management services that ensure the well 

12 being of the mother and family and the future 

13 development of the infant. 

14 ‘‘(C) Improving the quality, availability, 

15 and organization of health care and support 

16 services (including transportation services, at17 tendant care, homemaker services, day or res18 pite care, and providing counseling on financial 

19 assistance and insurance) for individuals with 

20 postpartum conditions and support services for 

21 their families. 

22 ‘‘(d) INTEGRATION WITH OTHER PROGRAMS.—To 

23 the extent practicable and appropriate, the Secretary shall 

24 integrate the program under this title with other grant 


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1 programs carried out by the Secretary, including the pro2 gram under section 330. 

3 ‘‘SEC. 520L. TECHNICAL ASSISTANCE. 

4 ‘‘The Secretary may provide technical assistance to 

5 assist entities in complying with the requirements of this 

6 chapter in order to make such entities eligible to receive 

7 grants under section 520K. 

8 ‘‘SEC. 520M. AUTHORIZATION OF APPROPRIATIONS. 

9 ‘‘For the purpose of carrying out this chapter, there 

10 are authorized to be appropriated such sums as may be 

11 necessary for each of the fiscal years 2007 through 

12 2009.’’. 

13 TITLE II—RESEARCH ON 

14 POSTPARTUM DEPRESSION 

15 AND PSYCHOSIS 

16 SEC. 201. CONSENSUS RESEARCH CONFERENCE AND PLAN 

17 CONCERNING POSTPARTUM DEPRESSION 

18 AND PSYCHOSIS. 

19 Part B of title IV of the Public Health Service Act 

20 (42 U.S.C. 284 et seq.) is amended by adding at the end 

21 the following: 


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1 ‘‘SEC. 409J. CONSENSUS RESEARCH CONFERENCE AND 

2 PLAN CONCERNING POSTPARTUM DEPRES3 SION AND PSYCHOSIS. 

4 ‘‘(a) CONSENSUS RESEARCH CONFERENCE AND

5 PLAN.— 

6 ‘‘(1) CONFERENCE.—The Secretary, acting 

7 through the Director of NIH, the Administrator of 

8 the Substance Abuse and Mental Health Services 

9 Administration, and the heads of other Federal 

10 agencies that administer Federal health programs 

11 including the Centers for Disease Control and Pre12 vention, shall organize a series of national meetings 

13 that are designed to develop a research plan for 

14 postpartum depression and psychosis (referred to in 

15 this section as ‘postpartum condition’). 

16 ‘‘(2) PLAN.—The Secretary, taking into ac17 count the findings of the research conference under 

18 paragraph (1), shall develop a research plan relating 

19 to postpartum conditions. Such plan shall include— 

20 ‘‘(A) basic research concerning the etiology 

21 and causes of postpartum conditions; 

22 ‘‘(B) epidemiological studies to address the 

23 frequency and natural history of postpartum 

24 conditions and the differences among racial and 

25 ethnic groups with respect to such conditions; 


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1 ‘‘(C) the development of improved diag2 nostic techniques relating to postpartum condi3 tions; and 

4 ‘‘(D) clinical research for the development 

5 and evaluation of new treatments for 

6 postpartum conditions, including new biological 

7 agents. 

8 ‘‘(3) REPORT.—Not later than 2 years after the 

9 date of enactment of this section, the Secretary shall 

10 prepare and submit to the appropriate committees of 

11 Congress a report concerning the research plan 

12 under paragraph (2). 

13 ‘‘(b) ACTIVITY RELATING TO RESEARCH PLAN.— 

14 ‘‘(1) IN GENERAL.—After the development of 

15 the research plan under subsection (a)(1), the Sec16 retary, acting through the Director of NIH shall ex17 pand and intensify research and related activities of 

18 the Institutes relating to postpartum conditions in a 

19 manner appropriate to carry out such plan, and in 

20 particular shall direct research efforts to carry out 

21 such plan. 

22 ‘‘(2) REPORT.—Not later than 1 year after the 

23 development of the research plan under subsection 

24 (a)(1), and annually thereafter, the Secretary shall 

25 prepare and submit to the appropriate committees of 


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1 Congress a report on the progress made with respect 

2 to such plan and the status of ongoing activities re3 garding postpartum conditions at the National Insti4 tutes of Health.’’. 

Æ 


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