I 

111TH CONGRESS 

1ST SESSION H. R. 1350 

To provide for research on, and services for individuals with, post-abortion 

depression and psychosis. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 5, 2009 

Mr. PITTS (for himself, Mr. AKIN, Mr. PENCE, Mr. CANTOR, Mr. LAMBORN, 

Mr. BARTLETT, Mr. FORTENBERRY, Mr. FRANKS of Arizona, Mr. BURTON of Indiana, Mr. RYAN of Wisconsin, Mr. MANZULLO, Ms. FALLIN, 

Mr. BRADY of Texas, Mr. BISHOP of Utah, Mr. FLEMING, Mr. 

NEUGEBAUER, Mr. SHIMKUS, Mr. HENSARLING, Mr. CONAWAY, Mrs. 

BACHMANN, Mr. KINGSTON, Mr. MCHENRY, Mr. WAMP, Mr. BROWN of 

South Carolina, and Mr. SMITH of New Jersey) 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, 

post-abortion 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 ‘‘Post-Abortion Depres5 sion Research and Care Act of 2009’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 


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1 (1) About 3,000,000 women per year in the 

2 United States have an unplanned or unwanted preg3 nancy, and approximately 1,186,000 of these preg4 nancies end in elective abortion. 

5 (2) Abortion can have severe and long-term ef6 fects on the mental and emotional well-being of 

7 women. Women often experience sadness and guilt 

8 following abortions with no one to console them. 

9 They may have difficulty in bonding with new ba10 bies, become overprotective parents or develop prob11 lems in their relationship with their spouses. Prob12 lems such as eating disorders, depression, and sui13 cide attempts have also been traced to past abor14 tions. 

15 (3) The symptoms of post-abortion depression 

16 include bouts of crying, guilt, intense grief or sad17 ness, emotional numbness, eating disorders, drug 

18 and alcohol abuse, suicidal urges, anxiety and panic 

19 attacks, anger or rage, sexual problems or promis20 cuity, lowered self esteem, nightmares and sleep dis21 turbance, flashbacks, and difficulty with relation22 ships. 

23 (4) Women who aborted a first pregnancy are 

24 four times more likely to report substance abuse 

25 compared to those who suffered a natural loss of 


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1 their first pregnancy, and they are five times more 

2 likely to report subsequent substance abuse than 

3 women who carried to term. 

4 (5) Greater thought suppression is associated 

5 with experiencing more intrusive thoughts of the 

6 abortion. Both suppression and intrusive thoughts, 

7 in turn, are positively related to increases in psycho8 logical distress over time. 

9 (6) Women who experience decisionmaking dif10 ficulties and may lack social support may experience 

11 more negative emotional consequences to induced 

12 abortion. 

13 (7) Post-abortion depression often relates to the 

14 lack of understanding in society and the medical 

15 community of the complexity of post-abortion de16 pression, and economic pressures placed on hospitals 

17 and providers are contributing factors. 

18 (8) Social pressure to have an abortion can be 

19 directly related to higher levels of immediate regret 

20 and more mental undoing over subsequent years. 

21 (9) Post-abortion depression is a treatable dis22 order if promptly diagnosed by a trained provider 

23 and attended to with a personalized regimen of care 

24 including social support, therapy, medication, and 

25 when necessary hospitalization. 


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1 (10) While there have been many studies re2 garding the emotional aftermath of abortion, very 

3 little research has been sponsored by the National 

4 Institutes of Health. 

5 (11) A major New Zealand study shows abor6 tion has serious negative consequences for women. 

7 Among the alarming findings with respect to girls 

8 15 through 18 years of age are the following: 

9 (A) With respect to experiencing major de10 pression— 

11 (i) those who had not become preg12 nant had a 31.2 percent chance; 

13 (ii) those who became pregnant but 

14 did not have an abortion had a 35.7 per15 cent chance; and 

16 (iii) those who had an abortion had an 

17 astonishing 78.6 percent chance. 

18 (B) With respect to experiencing anxiety— 

19 (i) those who had not become preg20 nant had a 37.9 percent chance; 

21 (ii) those who became pregnant but 

22 did not have an abortion had a 35.7 per23 cent chance; and 

24 (iii) those who had an abortion had a 

25 64.3 percent chance. 


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1 (C) With respect to thoughts of suicide— 

2 (i) those who had not become preg3 nant had a 23 percent chance; 

4 (ii) those who became pregnant but 

5 did not have an abortion had a 25 percent 

6 chance; and 

7 (iii) those who had an abortion had a 

8 50 percent chance. 

9 TITLE I—RESEARCH ON POST10 ABORTION DEPRESSION AND 

11 PSYCHOSIS 

12 SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI13 TIES OF NATIONAL INSTITUTE OF MENTAL 

14 HEALTH. 

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 section referred 

19 to as the ‘‘Institute’’), shall expand and intensify research 

20 and related activities of the Institute with respect to post21 abortion depression and post-abortion psychosis (in this 

22 section referred to as ‘‘post-abortion conditions’’). 

23 (b) COORDINATION WITH OTHER INSTITUTES.—The 

24 Director of the Institute shall coordinate the activities of 

25 the Director under subsection (a) with similar activities 


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1 conducted by the other national research institutes and 

2 agencies of the National Institutes of Health to the extent 

3 that such Institutes and agencies have responsibilities that 

4 are related to post-abortion conditions. 

5 (c) PROGRAMS FOR POST-ABORTION CONDITIONS.— 

6 In carrying out subsection (a), the Director of the Insti7 tute shall conduct or support research to expand the un8 derstanding of the causes of, and to find a cure for, post9 abortion conditions. Activities under such subsection shall 

10 include conducting and supporting the following: 

11 (1) Basic research concerning the etiology and 

12 causes of the conditions. 

13 (2) Epidemiological studies to address the fre14 quency and natural history of the conditions and the 

15 differences among racial and ethnic groups with re16 spect to the conditions. 

17 (3) The development of improved diagnostic 

18 techniques. 

19 (4) Clinical research for the development and 

20 evaluation of new treatments, including new biologi21 cal agents. 

22 (5) Information and education programs for 

23 health care professionals and the public. 

24 (d) LONGITUDINAL STUDY.— 


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1 (1) IN GENERAL.—The Director of the Institute 

2 shall conduct a national longitudinal study to deter3 mine the incidence and prevalence of cases of post4 abortion conditions, and the symptoms, severity, and 

5 duration of such cases, toward the goal of more fully 

6 identifying the characteristics of such cases and de7 veloping diagnostic techniques. 

8 (2) REPORT.—Beginning not later than 3 years 

9 after the date of the enactment of this Act, and peri10 odically thereafter for the duration of the study 

11 under paragraph (1), the Director of the Institute 

12 shall prepare and submit to the Congress reports on 

13 the findings of the study. 

14 (e) AUTHORIZATION OF APPROPRIATIONS.—For the 

15 purpose of carrying out this section, there is authorized 

16 to be appropriated $3,000,000 for each of the fiscal years 

17 2010 through 2014. 

18 TITLE II—DELIVERY OF SERV19 ICES REGARDING POST-ABOR20 TION DEPRESSION AND PSY21 CHOSIS 

22 SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 

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

24 Human Services (in this title referred to as the ‘‘Sec25 retary’’) shall in accordance with this title make grants 


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1 to provide for projects for the establishment, operation, 

2 and coordination of effective and cost-efficient systems for 

3 the delivery of essential services to individuals with post4 abortion depression or post-abortion psychosis (referred to 

5 in this section as a ‘‘post-abortion condition’’) and their 

6 families. 

7 (b) RECIPIENTS OF GRANTS.—A grant under sub8 section (a) may be made to an entity only if the entity— 

9 (1) is a public or nonprofit private entity, which 

10 may include a State or local government; a public or 

11 nonprofit private hospital, community-based organi12 zation, hospice, ambulatory care facility, community 

13 health center, migrant health center, or homeless 

14 health center; or other appropriate public or non15 profit private entity; and 

16 (2) had experience in providing the services de17 scribed in subsection (a) before the date of the en18 actment of this Act. 

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

20 and appropriate, the Secretary shall ensure that projects 

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

22 management of post-abortion conditions. Activities that 

23 the Secretary may authorize for such projects may also 

24 include the following: 


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1 (1) Delivering or enhancing outpatient and 

2 home-based health and support services, including 

3 case management, screening and comprehensive 

4 treatment services for individuals with or at risk for 

5 post-abortion conditions; and delivering or enhancing 

6 support services for their families. 

7 (2) Delivering or enhancing inpatient care man8 agement services that ensure the well being of the 

9 mother and family and the future development of 

10 the infant. 

11 (3) Improving the quality, availability, and or12 ganization of health care and support services (in13 cluding transportation services, attendant care, 

14 homemaker services, day or respite care, and pro15 viding counseling on financial assistance and insur16 ance) for individuals with post-abortion conditions 

17 and support services for their families. 

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

19 extent practicable and appropriate, the Secretary shall in20 tegrate the program under this title with other grant pro21 grams carried out by the Secretary, including the program 

22 under section 330 of the Public Health Service Act. 

23 (e) LIMITATION ON AMOUNT OF GRANTS.—A grant 

24 under subsection (a) may not for any fiscal year be made 

25 in an amount exceeding $100,000. 


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1 SEC. 202. CERTAIN REQUIREMENTS. 

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

3 applicant involved makes the following agreements: 

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

5 be used for administration, accounting, reporting, 

6 and program oversight functions. 

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

8 not supplant funds from other sources related to the 

9 treatment of post-abortion conditions. 

10 (3) The applicant will abide by any limitations 

11 deemed appropriate by the Secretary on any charges 

12 to individuals receiving services pursuant to the 

13 grant. As deemed appropriate by the Secretary, such 

14 limitations on charges may vary based on the finan15 cial circumstances of the individual receiving serv16 ices. 

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

18 payment for services authorized under section 

19 201(a) to the extent that payment has been made, 

20 or can reasonably be expected to be made, with re21 spect to such services— 

22 (A) under any State compensation pro23 gram, under an insurance policy, or under any 

24 Federal or State health benefits program; or 

25 (B) by an entity that provides health serv26 ices on a prepaid basis. 


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

2 applicant provides services under section 201(a), 

3 post a conspicuous notice informing individuals who 

4 receive the services of any Federal policies that 

5 apply to the applicant with respect to the imposition 

6 of charges on such individuals. 

7 SEC. 203. TECHNICAL ASSISTANCE. 

8 The Secretary may provide technical assistance to as9 sist entities in complying with the requirements of this 

10 title in order to make such entities eligible to receive 

11 grants under section 201. 

12 SEC. 204. AUTHORIZATION OF APPROPRIATIONS. 

13 For the purpose of carrying out this title, there is 

14 authorized to be appropriated $300,000 for each of the 

15 fiscal years 2010 through 2014. 

Æ 


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