I 

110TH CONGRESS 

1ST SESSION H. R. 20 

To provide for research on, and services for individuals with, postpartum 

depression and psychosis. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 4, 2007 

Mr. RUSH introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To provide for research on, and services for individuals with, 

postpartum depression and psychosis. 

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 ‘‘Melanie Blocker5 Stokes Postpartum Depression Research and Care Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) Postpartum depression is a devastating 

9 mood disorder which strikes many women during 

10 and after pregnancy. 


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1 (2) Postpartum mood changes are common and 

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

3 which is an extremely common and the less severe 

4 form of postpartum depression; postpartum mood 

5 and anxiety disorders, which are more severe than 

6 baby blues and can occur during pregnancy and any7 time within the first year of the infant’s birth; and 

8 postpartum psychosis, which is the most extreme 

9 form of postpartum depression and can occur during 

10 pregnancy and up to twelve months after delivery. 

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

12 swings, feelings of being overwhelmed, tearfulness, 

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

14 vulnerability. 

15 (4) The symptoms of postpartum mood and 

16 anxiety disorders are the worsening and the continu17 ation of the baby blues beyond the first days or 

18 weeks after delivery. 

19 (5) The symptoms of postpartum psychosis in20 clude losing touch with reality, distorted thinking, 

21 delusions, auditory hallucinations, paranoia, hyper22 activity, and rapid speech or mania. 

23 (6) Each year over 400,000 women suffer from 

24 postpartum mood changes, with baby blues afflicting 

25 up to 80 percent of new mothers; postpartum mood 


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1 and anxiety disorders impairing around 10–20 per2 cent of new mothers; and postpartum psychosis 

3 striking 1 in 1,000 new mothers. 

4 (7) The causes of postpartum depression are 

5 complex and unknown at this time; however, theories 

6 include a steep and rapid drop in hormone levels 

7 after childbirth; difficulty during labor or pregnancy; 

8 a premature birth; a miscarriage; feeling over9 whelmed, uncertain, frustrated or anxious about 

10 one’s new role as a mother; a lack of support from 

11 one’s spouse, friends or family; marital strife; stress12 ful events in life such as death of a loved one, finan13 cial problems, or physical or mental abuse; a family 

14 history of depression or mood disorders; a previous 

15 history of major depression or anxiety; or a prior 

16 postpartum depression. 

17 (8) Postpartum depression is a treatable dis18 order if promptly diagnosed by a trained provider 

19 and attended to with a personalized regimen of care 

20 including social support, therapy, medication, and 

21 when necessary hospitalization. 

22 (9) All too often postpartum depression goes 

23 undiagnosed or untreated due to the social stigma 

24 surrounding depression and mental illness, the myth 

25 of motherhood, the new mother’s inability to self-diVerDate Aug 31 2005 07:19 Jan 09, 2007 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H20.IH H20

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1 agnose her condition, the new mother’s shame or 

2 embarrassment over discussing her depression so 

3 near to the birth of her child, the lack of under4 standing in society and the medical community of 

5 the complexity of postpartum depression, and eco6 nomic pressures placed on hospitals and providers. 

7 (10) Untreated, postpartum depression can lead 

8 to further depression, substance abuse, loss of em9 ployment, divorce and further social alienation, self10 destructive behavior, or even suicide. 

11 (11) Untreated, postpartum depression impacts 

12 society through its affect on the infant’s physical 

13 and psychological development, child abuse, neglect 

14 or death of the infant or other siblings, and the dis15 ruption of the family. 

16 TITLE I—RESEARCH ON 

17 POSTPARTUM DEPRESSION 

18 AND PSYCHOSIS 

19 SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI20 TIES OF NATIONAL INSTITUTE OF MENTAL 

21 HEALTH. 

22 (a) IN GENERAL.—The Secretary of Health and 

23 Human Services, acting through the Director of NIH and 

24 the Director of the National Institute of Mental Health 

25 (in this section referred to as the ‘‘Institute’’), shall exVerDate Aug 31 2005 07:19 Jan 09, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H20.IH H20

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1 pand and intensify research and related activities of the 

2 Institute with respect to postpartum depression and 

3 postpartum psychosis (in this section referred to as 

4 ‘‘postpartum conditions’’). 

5 (b) COORDINATION WITH OTHER INSTITUTES.—The 

6 Director of the Institute shall coordinate the activities of 

7 the Director under subsection (a) with similar activities 

8 conducted by the other national research institutes and 

9 agencies of the National Institutes of Health to the extent 

10 that such Institutes and agencies have responsibilities that 

11 are related to postpartum conditions. 

12 (c) PROGRAMS FOR POSTPARTUM CONDITIONS.—In 

13 carrying out subsection (a), the Director of the Institute 

14 shall conduct or support research to expand the under15 standing of the causes of, and to find a cure for, 

16 postpartum conditions. Activities under such subsection 

17 shall include conducting and supporting the following: 

18 (1) Basic research concerning the etiology and 

19 causes of the conditions. 

20 (2) Epidemiological studies to address the fre21 quency and natural history of the conditions and the 

22 differences among racial and ethnic groups with re23 spect to the conditions. 

24 (3) The development of improved diagnostic 

25 techniques. 


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1 (4) Clinical research for the development and 

2 evaluation of new treatments, including new biologi3 cal agents. 

4 (5) Information and education programs for 

5 health care professionals and the public. 

6 (d) AUTHORIZATION OF APPROPRIATIONS.—For the 

7 purpose of carrying out this section, there are authorized 

8 to be appropriated such sums as may be necessary for 

9 each of the fiscal years 2008 through 2010. 

10 TITLE II—DELIVERY OF SERV11 ICES REGARDING 

12 POSTPARTUM DEPRESSION 

13 AND PSYCHOSIS 

14 SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 

15 (a) IN GENERAL.—The Secretary of Health and 

16 Human Services (in this title referred to as the ‘‘Sec17 retary’’) shall in accordance with this title make grants 

18 to provide for projects for the establishment, operation, 

19 and coordination of effective and cost-efficient systems for 

20 the delivery of essential services to individuals with 

21 postpartum depression or postpartum psychosis (referred 

22 to in this section as a ‘‘postpartum condition) and their 

23 families. 

24 (b) RECIPIENTS OF GRANTS.—A grant under sub25 section (a) may be made to an entity only if the entity 


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1 is a public or nonprofit private entity, which may include 

2 a State or local government; a public or nonprofit private 

3 hospital, community-based organization, hospice, ambula4 tory care facility, community health center, migrant health 

5 center, or homeless health center; or other appropriate 

6 public or nonprofit private entity. 

7 (c) CERTAIN ACTIVITIES.—To the extent practicable 

8 and appropriate, the Secretary shall ensure that projects 

9 under subsection (a) provide services for the diagnosis and 

10 management of postpartum conditions. Activities that the 

11 Secretary may authorize for such projects may also in12 clude the following: 

13 (1) Delivering or enhancing outpatient and 

14 home-based health and support services, including 

15 case management, screening and comprehensive 

16 treatment services for individuals with or at risk for 

17 postpartum conditions; and delivering or enhancing 

18 support services for their families. 

19 (2) Delivering or enhancing inpatient care man20 agement services that ensure the well being of the 

21 mother and family and the future development of 

22 the infant. 

23 (3) Improving the quality, availability, and or24 ganization of health care and support services (in25 cluding transportation services, attendant care, 


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1 homemaker services, day or respite care, and pro2 viding counseling on financial assistance and insur3 ance) for individuals with postpartum conditions and 

4 support services for their families. 

5 (d) INTEGRATION WITH OTHER PROGRAMS.—To the 

6 extent practicable and appropriate, the Secretary shall in7 tegrate the program under this title with other grant pro8 grams carried out by the Secretary, including the program 

9 under section 330 of the Public Health Service Act. 

10 SEC. 202. CERTAIN REQUIREMENTS. 

11 A grant may be made under section 201 only if the 

12 applicant involved makes the following agreements: 

13 (1) Not more than 5 percent of the grant will 

14 be used for administration, accounting, reporting, 

15 and program oversight functions. 

16 (2) The grant will be used to supplement and 

17 not supplant funds from other sources related to the 

18 treatment of postpartum conditions. 

19 (3) The applicant will abide by any limitations 

20 deemed appropriate by the Secretary on any charges 

21 to individuals receiving services pursuant to the 

22 grant. As deemed appropriate by the Secretary, such 

23 limitations on charges may vary based on the finan24 cial circumstances of the individual receiving serv25 ices. 


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1 (4) The grant will not be expended to make 

2 payment for services authorized under section 

3 201(a) to the extent that payment has been made, 

4 or can reasonably be expected to be made, with re5 spect to such services— 

6 (A) under any State compensation pro7 gram, under an insurance policy, or under any 

8 Federal or State health benefits program; or 

9 (B) by an entity that provides health serv10 ices on a prepaid basis. 

11 (5) The applicant will, at each site at which the 

12 applicant provides services under section 201(a), 

13 post a conspicuous notice informing individuals who 

14 receive the services of any Federal policies that 

15 apply to the applicant with respect to the imposition 

16 of charges on such individuals. 

17 SEC. 203. TECHNICAL ASSISTANCE. 

18 The Secretary may provide technical assistance to as19 sist entities in complying with the requirements of this 

20 title in order to make such entities eligible to receive 

21 grants under section 201. 


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1 SEC. 204. AUTHORIZATION OF APPROPRIATIONS. 

2 For the purpose of carrying out this title, there are 

3 authorized to be appropriated such sums as may be nec4 essary for each of the fiscal years 2008 through 2010. 

Æ 


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