IB 

Union Calendar No. 232 

110TH CONGRESS 

1ST SESSION H. R. 20 

[Report No. 110–375] 

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 

OCTOBER 15, 2007 

Additional sponsors: Mr. JINDAL, Mr. ROTHMAN, Mr. ALLEN, Mrs. CAPPS, 

Mr. MORAN of Virginia, Mr. CUMMINGS, Mrs. CHRISTENSEN, Ms. 

SCHAKOWSKY, Ms. ESHOO, Ms. CORRINE BROWN of Florida, Mr. 

WEXLER, Mrs. DAVIS of California, Mr. DAVIS of Illinois, Ms. MOORE

of Wisconsin, Mr. CONYERS, Ms. NORTON, Mr. GRIJALVA, Mr. PICKERING, Mr. BURGESS, Mr. WAXMAN, Ms. BORDALLO, Mr. AL GREEN of 

Texas, Mr. FRANK of Massachusetts, Ms. SOLIS, Mrs. EMERSON, Mr. 

TOWNS, Mr. DAVIS of Alabama, Mr. CLAY, Ms. CLARKE, Mr. CLEAVER, 

Mr. CLYBURN, Mr. GONZALEZ, Mr. LEWIS of Georgia, Mr. RAHALL, Mr. 

PASTOR, Mr. BECERRA, Ms. LORETTA SANCHEZ of California, Mr. BOSWELL, Ms. WATSON, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. 

MEEKS of New York, Mr. WYNN, Ms. KILPATRICK of Michigan, Ms. 

VELA ́ZQUEZ, Mr. SERRANO, Mr. JOHNSON of Georgia, Ms. WASSERMAN

SCHULTZ, Mrs. MCCARTHY of New York, Mr. GUTIERREZ, Mr. GENE

GREEN of Texas, Mr. ELLISON, Mr. REYES, Mr. DONNELLY, Mr. JEFFERSON, Mr. SKELTON, Ms. LEE, Mr. THOMPSON of Mississippi, Mr. 

MCNULTY, Mr. MICHAUD, Ms. JACKSON-LEE of Texas, Mr. KILDEE, Mr. 

PAYNE, Mr. STUPAK, Ms. SLAUGHTER, Mr. GORDON of Tennessee, Mr. 

BARTON of Texas, Mr. SHIMKUS, Mr. UPTON, Mrs. BONO, Mr. MACK, 

Ms. BALDWIN, Mr. HINCHEY, Mr. BOUCHER, Mr. SCOTT of Virginia, Mr. 

DEAL of Georgia, Ms. HARMAN, Ms. HERSETH SANDLIN, Mr. ROSS, Mr. 

ENGEL, Mr. BAIRD, Mr. BUTTERFIELD, Mr. MURPHY of Connecticut, 

Ms. MATSUI, Mr. WALZ of Minnesota, Mrs. JONES of Ohio, Mr. COHEN, 

Ms. WOOLSEY, Mr. HASTINGS of Florida, Mr. MCGOVERN, Mr. BISHOP


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of Georgia, Ms. WATERS, Mr. DINGELL, Mr. SCOTT of Georgia, Mr. 

MEEK of Florida, Mr. WATT, Mr. RANGEL, Ms. CARSON, Mr. STARK, 

Mrs. BIGGERT, Mr. RODRIGUEZ, Ms. HOOLEY, Ms. DEGETTE, Mr. 

WEINER, Mr. MATHESON, Mr. BRALEY of Iowa, Mr. PALLONE, Mr. 

PERLMUTTER, Mr. HINOJOSA, Mr. GEORGE MILLER of California, Mr. 

HARE, Mr. BOOZMAN, Ms. SHEA-PORTER, Mrs. NAPOLITANO, Mr. FARR, 

Mr. SIRES, Mr. MARKEY, Mr. LIPINSKI, Mr. JACKSON of Illinois, Mr. 

COSTELLO, Mr. EMANUEL, Mr. KENNEDY, Mrs. BOYDA of Kansas, Mr. 

TIERNEY, Ms. BEAN, Mr. PITTS, Mr. MEEHAN, Ms. ROYBAL-ALLARD, 

Ms. SUTTON, Mr. HONDA, and Mr. MANZULLO

OCTOBER 15, 2007 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on January 4, 2007] 

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 Blocker-Stokes 

5 Postpartum Depression Research and Care Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) Postpartum depression is a devastating mood 

9 disorder which strikes many women during and after 

10 pregnancy. 

11 (2) Postpartum mood changes are common and 

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


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1 which is an extremely common and the less severe 

2 form of postpartum depression; postpartum mood and 

3 anxiety disorders, which are more severe than baby 

4 blues and can occur during pregnancy and anytime 

5 within the first year of the infant’s birth; and 

6 postpartum psychosis, which is the most extreme form 

7 of postpartum depression and can occur during preg8 nancy and up to 12 months after delivery. 

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

10 swings, feelings of being overwhelmed, tearfulness, ir11 ritability, poor sleep, mood changes, and a sense of 

12 vulnerability. 

13 (4) The symptoms of postpartum mood and anx14 iety disorders are the worsening and the continuation 

15 of the baby blues beyond the first days or weeks after 

16 delivery. 

17 (5) The symptoms of postpartum psychosis in18 clude losing touch with reality, distorted thinking, de19 lusions, auditory hallucinations, paranoia, hyper20 activity, and rapid speech or mania. 

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

22 postpartum mood changes, with baby blues afflicting 

23 up to 80 percent of new mothers; postpartum mood 

24 and anxiety disorders impairing around 10 to 20 


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1 percent of new mothers; and postpartum psychosis 

2 striking 1 in 1,000 new mothers. 

3 (7) Postpartum depression is a treatable disorder 

4 if promptly diagnosed by a trained provider and at5 tended to with a personalized regimen of care includ6 ing social support, therapy, medication, and when 

7 necessary hospitalization. 

8 (8) All too often postpartum depression goes 

9 undiagnosed or untreated due to the social stigma 

10 surrounding depression and mental illness, the myth 

11 of motherhood, the new mother’s inability to self-diag12 nose her condition, the new mother’s shame or embar13 rassment over discussing her depression so near to the 

14 birth of her child, the lack of understanding in society 

15 and the medical community of the complexity of 

16 postpartum depression, and economic pressures placed 

17 on hospitals and providers. 

18 (9) Untreated, postpartum depression can lead to 

19 further depression, substance abuse, loss of employ20 ment, divorce and further social alienation, self-de21 structive behavior, or even suicide. 

22 (10) Untreated, postpartum depression impacts 

23 society through its effect on the infant’s physical and 

24 psychological development, child abuse, neglect, or 


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1 death of the infant or other siblings, and the disrup2 tion of the family. 

3 TITLE I—RESEARCH ON 

4 POSTPARTUM DEPRESSION 

5 AND PSYCHOSIS 

6 SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI7 TIES. 

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

9 Human Services, acting through the Director of the Na10 tional Institutes of Health and the Director of the National 

11 Institute of Mental Health (in this title referred to as the 

12 ‘‘Institute’’), is encouraged to continue aggressive work on 

13 postpartum depression and postpartum psychosis. 

14 (b) COORDINATION WITH OTHER INSTITUTES.—The 

15 Director of the Institute should continue to coordinate ac16 tivities of the Director under subsection (a) with similar 

17 activities conducted by the other national research institutes 

18 and agencies of the National Institutes of Health to the ex19 tent that such Institutes and agencies have responsibilities 

20 that are related to postpartum conditions. 

21 (c) PROGRAMS FOR POSTPARTUM CONDITIONS.—In 

22 carrying out subsection (a), the Director of the Institute is 

23 encouraged to continue research to expand the under24 standing of the causes of, and to find a cure for, postpartum 


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1 conditions. Activities under such subsection shall include 

2 conducting and supporting the following: 

3 (1) Basic research concerning the etiology and 

4 causes of the conditions. 

5 (2) Epidemiological studies to address the fre6 quency and natural history of the conditions and the 

7 differences among racial and ethnic groups with re8 spect to the conditions. 

9 (3) The development of improved screening and 

10 diagnostic techniques. 

11 (4) Clinical research for the development and 

12 evaluation of new treatments, including new biologi13 cal agents. 

14 (5) Information and education programs for 

15 health care professionals and the public. 

16 SEC. 102. NATIONAL PUBLIC AWARENESS CAMPAIGN. 

17 (a) IN GENERAL.—The Director of the National Insti18 tutes of Health and the Administrator of the Health Re19 sources and Services Administration are encouraged to 

20 carry out a coordinated national campaign to increase the 

21 awareness and knowledge of postpartum depression and 

22 postpartum psychosis. 

23 (b) PUBLIC SERVICE ANNOUNCEMENTS.—Activities 

24 under the national campaign under subsection (a) may inVerDate Aug 31 2005 00:05 Oct 16, 2007 Jkt 069200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\H20.RH H20

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1 clude public service announcements through television, 

2 radio, and other means. 

3 SEC. 103. BIENNIAL REPORTING. 

4 Section 403(a)(5) of the Public Health Service Act (42 

5 U.S.C. 283(a)(5)) is amended— 

6 (1) by redesignating subparagraph (L) as sub7 paragraph (M); and 

8 (2) by inserting after subparagraph (K) the fol9 lowing: 

10 ‘‘(L) Depression.’’. 

11 SEC. 104. LONGITUDINAL STUDY OF RELATIVE MENTAL 

12 HEALTH CONSEQUENCES FOR WOMEN OF RE13 SOLVING A PREGNANCY. 

14 (a) SENSE OF CONGRESS.—It is the sense of Congress 

15 that the Director of the Institute may conduct a nationally 

16 representative longitudinal study (during the period of fis17 cal years 2008 through 2018) of the relative mental health 

18 consequences for women of resolving a pregnancy (intended 

19 and unintended) in various ways, including carrying the 

20 pregnancy to term and parenting the child, carrying the 

21 pregnancy to term and placing the child for adoption, mis22 carriage, and having an abortion. This study may assess 

23 the incidence, timing, magnitude, and duration of the im24 mediate and long-term mental health consequences (positive 

25 or negative) of these pregnancy outcomes. 


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

2 the date of the enactment of this Act, and periodically there3 after for the duration of the study under subsection (a), the 

4 Director of the Institute should prepare and submit to the 

5 Congress reports on the findings of the study. 

6 TITLE II—DELIVERY OF SERV7 ICES REGARDING 

8 POSTPARTUM DEPRESSION 

9 AND PSYCHOSIS 

10 SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 

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

12 Human Services (in this title referred to as the ‘‘Sec13 retary’’) should in accordance with this title make grants 

14 to provide for projects for the establishment, operation, and 

15 coordination of effective and cost-efficient systems for the 

16 delivery of essential services to individuals with postpartum 

17 depression or postpartum psychosis (referred to in this sec18 tion as a ‘‘postpartum condition’’) and their families. 

19 (b) RECIPIENTS OF GRANTS.—A grant under sub20 section (a) may be made to an entity only if the entity 

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

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

23 hospital, community-based organization, hospice, ambula24 tory care facility, community health center, migrant health 


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

2 public or nonprofit private entity. 

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

4 and appropriate, the Secretary shall ensure that projects 

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

6 management of postpartum conditions. Activities that the 

7 Secretary may authorize for such projects may also include 

8 the following: 

9 (1) Delivering or enhancing outpatient and 

10 home-based health and support services, including 

11 case management, screening, and comprehensive treat12 ment services for individuals with or at risk for 

13 postpartum conditions; and delivering or enhancing 

14 support services for their families. 

15 (2) Delivering or enhancing inpatient care man16 agement services that ensure the well-being of the 

17 mother and family and the future development of the 

18 infant. 

19 (3) Improving the quality, availability, and or20 ganization of health care and support services (in21 cluding transportation services, attendant care, home22 maker services, day or respite care, and providing 

23 counseling on financial assistance and insurance) for 

24 individuals with postpartum conditions and support 

25 services for their families. 


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

2 extent practicable and appropriate, the Secretary should in3 tegrate the program under this title with other grant pro4 grams carried out by the Secretary, including the program 

5 under section 330 of the Public Health Service Act. 

6 SEC. 202. CERTAIN REQUIREMENTS. 

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

8 applicant involved makes the following agreements: 

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

10 used for administration, accounting, reporting, and 

11 program oversight functions. 

12 (2) The grant will be used to supplement and not 

13 supplant funds from other sources related to the treat14 ment of postpartum conditions. 

15 (3) The applicant will abide by any limitations 

16 deemed appropriate by the Secretary on any charges 

17 to individuals receiving services pursuant to the 

18 grant. As deemed appropriate by the Secretary, such 

19 limitations on charges may vary based on the finan20 cial circumstances of the individual receiving services. 

21 (4) The grant will not be expended to make pay22 ment for services authorized under section 201(a) to 

23 the extent that payment has been made, or can rea24 sonably be expected to be made, with respect to such 

25 services— 


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1 (A) under any State compensation pro2 gram, under an insurance policy, or under any 

3 Federal or State health benefits program; or 

4 (B) by an entity that provides health serv5 ices on a prepaid basis. 

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

7 applicant provides services under section 201(a), post 

8 a conspicuous notice informing individuals who re9 ceive the services of any Federal policies that apply 

10 to the applicant with respect to the imposition of 

11 charges on such individuals. 

12 SEC. 203. TECHNICAL ASSISTANCE. 

13 The Secretary may provide technical assistance to as14 sist entities in complying with the requirements of this title 

15 in order to make such entities eligible to receive grants 

16 under section 201. 

17 TITLE III—GENERAL 

18 PROVISIONS 

19 SEC. 301. AUTHORIZATION OF APPROPRIATIONS. 

20 To carry out this Act and the amendments made by 

21 this Act, there are authorized to be appropriated— 

22 (1) $3,000,000 for fiscal year 2008; and 

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

24 years 2009 and 2010. 


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Union Calendar No. 232 

110TH CONGRESS 

1ST SESSION H. R. 20 

[Report No. 110

–375] 

A BILL 

To provide for research on, and services for individuals with, postpartum depression and psychosis. 

OCTOBER 15, 2007 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


bajohnson on PROD1PC69 with BILLS