IIB 

110TH CONGRESS 

1ST SESSION H. R. 20 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 16, 2007 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Melanie Blocker3 Stokes Postpartum Depression Research and Care Act’’. 

4 SEC. 2. FINDINGS. 

5 The Congress finds as follows: 

6 (1) Postpartum depression is a devastating 

7 mood disorder which strikes many women during 

8 and after pregnancy. 

9 (2) Postpartum mood changes are common and 

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

11 which is an extremely common and the less severe 

12 form of postpartum depression; postpartum mood 

13 and anxiety disorders, which are more severe than 

14 baby blues and can occur during pregnancy and any15 time within the first year of the infant’s birth; and 

16 postpartum psychosis, which is the most extreme 

17 form of postpartum depression and can occur during 

18 pregnancy and up to 12 months after delivery. 

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

20 swings, feelings of being overwhelmed, tearfulness, 

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

22 vulnerability. 

23 (4) The symptoms of postpartum mood and 

24 anxiety disorders are the worsening and the continu25 ation of the baby blues beyond the first days or 

26 weeks after delivery. 


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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) Each year over 400,000 women suffer from 

6 postpartum mood changes, with baby blues afflicting 

7 up to 80 percent of new mothers; postpartum mood 

8 and anxiety disorders impairing around 10 to 20 

9 percent of new mothers; and postpartum psychosis 

10 striking 1 in 1,000 new mothers. 

11 (7) Postpartum depression is a treatable dis12 order if promptly diagnosed by a trained provider 

13 and attended to with a personalized regimen of care 

14 including social support, therapy, medication, and 

15 when necessary hospitalization. 

16 (8) All too often postpartum depression goes 

17 undiagnosed or untreated due to the social stigma 

18 surrounding depression and mental illness, the myth 

19 of motherhood, the new mother’s inability to self-di20 agnose her condition, the new mother’s shame or 

21 embarrassment over discussing her depression so 

22 near to the birth of her child, the lack of under23 standing in society and the medical community of 

24 the complexity of postpartum depression, and eco25 nomic pressures placed on hospitals and providers. 


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1 (9) Untreated, postpartum depression can lead 

2 to further depression, substance abuse, loss of em3 ployment, divorce and further social alienation, self4 destructive behavior, or even suicide. 

5 (10) Untreated, postpartum depression impacts 

6 society through its effect on the infant’s physical 

7 and psychological development, child abuse, neglect, 

8 or death of the infant or other siblings, and the dis9 ruption of the family. 

10 TITLE I—RESEARCH ON 

11 POSTPARTUM DEPRESSION 

12 AND PSYCHOSIS 

13 SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI14 TIES. 

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

16 Human Services, acting through the Director of the Na17 tional Institutes of Health and the Director of the Na18 tional Institute of Mental Health (in this title referred to 

19 as the ‘‘Institute’’), is encouraged to continue aggressive 

20 work on postpartum depression and postpartum psychosis. 

21 (b) COORDINATION WITH OTHER INSTITUTES.—The 

22 Director of the Institute should continue to coordinate ac23 tivities of the Director under subsection (a) with similar 

24 activities conducted by the other national research insti25 tutes and agencies of the National Institutes of Health 


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1 to the extent that such Institutes and agencies have re2 sponsibilities that are related to postpartum conditions. 

3 (c) PROGRAMS FOR POSTPARTUM CONDITIONS.—In 

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

5 is encouraged to continue research to expand the under6 standing of the causes of, and to find a cure for, 

7 postpartum conditions. Activities under such subsection 

8 shall include conducting and supporting the following: 

9 (1) Basic research concerning the etiology and 

10 causes of the conditions. 

11 (2) Epidemiological studies to address the fre12 quency and natural history of the conditions and the 

13 differences among racial and ethnic groups with re14 spect to the conditions. 

15 (3) The development of improved screening and 

16 diagnostic techniques. 

17 (4) Clinical research for the development and 

18 evaluation of new treatments, including new biologi19 cal agents. 

20 (5) Information and education programs for 

21 health care professionals and the public. 

22 SEC. 102. NATIONAL PUBLIC AWARENESS CAMPAIGN. 

23 (a) IN GENERAL.—The Director of the National In24 stitutes of Health and the Administrator of the Health 

25 Resources and Services Administration are encouraged to 


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1 carry out a coordinated national campaign to increase the 

2 awareness and knowledge of postpartum depression and 

3 postpartum psychosis. 

4 (b) PUBLIC SERVICE ANNOUNCEMENTS.—Activities 

5 under the national campaign under subsection (a) may in6 clude public service announcements through television, 

7 radio, and other means. 

8 SEC. 103. BIENNIAL REPORTING. 

9 Section 403(a)(5) of the Public Health Service Act 

10 (42 U.S.C. 283(a)(5)) is amended— 

11 (1) by redesignating subparagraph (L) as sub12 paragraph (M); and 

13 (2) by inserting after subparagraph (K) the fol14 lowing: 

15 ‘‘(L) Depression.’’. 

16 SEC. 104. LONGITUDINAL STUDY OF RELATIVE MENTAL 

17 HEALTH CONSEQUENCES FOR WOMEN OF RE18 SOLVING A PREGNANCY. 

19 (a) SENSE OF CONGRESS.—It is the sense of Con20 gress that the Director of the Institute may conduct a na21 tionally representative longitudinal study (during the pe22 riod of fiscal years 2008 through 2018) of the relative 

23 mental health consequences for women of resolving a preg24 nancy (intended and unintended) in various ways, includ25 ing carrying the pregnancy to term and parenting the 


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1 child, carrying the pregnancy to term and placing the child 

2 for adoption, miscarriage, and having an abortion. This 

3 study may assess the incidence, timing, magnitude, and 

4 duration of the immediate and long-term mental health 

5 consequences (positive or negative) of these pregnancy 

6 outcomes. 

7 (b) REPORT.—Beginning not later than 3 years after 

8 the date of the enactment of this Act, and periodically 

9 thereafter for the duration of the study under subsection 

10 (a), the Director of the Institute should prepare and sub11 mit to the Congress reports on the findings of the study. 

12 TITLE II—DELIVERY OF SERV13 ICES REGARDING 

14 POSTPARTUM DEPRESSION 

15 AND PSYCHOSIS 

16 SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 

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

18 Human Services (in this title referred to as the ‘‘Sec19 retary’’) should in accordance with this title make grants 

20 to provide for projects for the establishment, operation, 

21 and coordination of effective and cost-efficient systems for 

22 the delivery of essential services to individuals with 

23 postpartum depression or postpartum psychosis (referred 

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

25 families. 


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1 (b) RECIPIENTS OF GRANTS.—A grant under sub2 section (a) may be made to an entity only if the entity 

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

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

5 hospital, community-based organization, hospice, ambula6 tory care facility, community health center, migrant health 

7 center, or homeless health center; or any other appropriate 

8 public or nonprofit private entity. 

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

10 and appropriate, the Secretary shall ensure that projects 

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

12 management of postpartum conditions. Activities that the 

13 Secretary may authorize for such projects may also in14 clude the following: 

15 (1) Delivering or enhancing outpatient and 

16 home-based health and support services, including 

17 case management, screening, and comprehensive 

18 treatment services for individuals with or at risk for 

19 postpartum conditions; and delivering or enhancing 

20 support services for their families. 

21 (2) Delivering or enhancing inpatient care man22 agement services that ensure the well-being of the 

23 mother and family and the future development of 

24 the infant. 


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1 (3) Improving the quality, availability, and or2 ganization of health care and support services (in3 cluding transportation services, attendant care, 

4 homemaker services, day or respite care, and pro5 viding counseling on financial assistance and insur6 ance) for individuals with postpartum conditions and 

7 support services for their families. 

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

9 extent practicable and appropriate, the Secretary should 

10 integrate the program under this title with other grant 

11 programs carried out by the Secretary, including the pro12 gram under section 330 of the Public Health Service Act. 

13 SEC. 202. CERTAIN REQUIREMENTS. 

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

15 applicant involved makes the following agreements: 

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

17 be used for administration, accounting, reporting, 

18 and program oversight functions. 

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

20 not supplant funds from other sources related to the 

21 treatment of postpartum conditions. 

22 (3) The applicant will abide by any limitations 

23 deemed appropriate by the Secretary on any charges 

24 to individuals receiving services pursuant to the 

25 grant. As deemed appropriate by the Secretary, such 


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1 limitations on charges may vary based on the finan2 cial circumstances of the individual receiving serv3 ices. 

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

5 payment for services authorized under section 

6 201(a) to the extent that payment has been made, 

7 or can reasonably be expected to be made, with re8 spect to such services— 

9 (A) under any State compensation pro10 gram, under an insurance policy, or under any 

11 Federal or State health benefits program; or 

12 (B) by an entity that provides health serv13 ices on a prepaid basis. 

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

15 applicant provides services under section 201(a), 

16 post a conspicuous notice informing individuals who 

17 receive the services of any Federal policies that 

18 apply to the applicant with respect to the imposition 

19 of charges on such individuals. 

20 SEC. 203. TECHNICAL ASSISTANCE. 

21 The Secretary may provide technical assistance to as22 sist entities in complying with the requirements of this 

23 title in order to make such entities eligible to receive 

24 grants under section 201. 


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1 TITLE III—GENERAL 

2 PROVISIONS 

3 SEC. 301. AUTHORIZATION OF APPROPRIATIONS. 

4 To carry out this Act and the amendments made by 

5 this Act, there are authorized to be appropriated— 

6 (1) $3,000,000 for fiscal year 2008; and 

7 (2) such sums as may be necessary for fiscal 

8 years 2009 and 2010. 

Passed the House of Representatives October 15, 

2007. 

Attest: LORRAINE C. MILLER, 

Clerk. 


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