I 

108TH CONGRESS 

2D SESSION H. R. 4543 

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

depression and psychosis. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 9, 2004 

Mr. PITTS (for himself and Mrs. JO ANN DAVIS of Virginia) 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’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

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

9 United States have an unplanned or unwanted preg-
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1 nancy, and approximately 1,186,000 of these preg2 nancies end in elective abortion. 

3 (2) Abortion can have severe and long-term ef4 fects on the mental and emotional well-being of 

5 women. Women often experience sadness and guilt 

6 following abortions with no one to console them. 

7 They may have difficulty in bonding with new ba8 bies, become overprotective parents or develop prob9 lems in their relationship with their spouses. Prob10 lems such as eating disorders, depression and suicide 

11 attempts have also been traced to past abortions. 

12 (3) The symptoms of post-abortion depression 

13 include bouts of crying, guilt, intense grief or sad14 ness, emotional numbness, eating disorders, drug 

15 and alcohol abuse, suicidal urges, anxiety and panic 

16 attacks, anger/rage, sexual problems or promiscuity, 

17 lowered self esteem, nightmares and sleep disturb18 ance, flashbacks, and difficulty with relationships. 

19 (4) Women who aborted a first pregnancy are 

20 four times more likely to report substance abuse 

21 compared to those who suffered a natural loss of 

22 their first pregnancy, and they are five times more 

23 likely to report subsequent substance abuse than 

24 women who carried to term. 
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1 (5) Greater thought suppression is associated 

2 with experiencing more intrusive thoughts of the 

3 abortion. Both suppression and intrusive thoughts, 

4 in turn, are positively related to increases in psycho5 logical distress over time. 

6 (6) Women who experience decision-making dif7 ficulties and may lack social support may experience 

8 more negative emotional consequences to induced 

9 abortion. 

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

11 lack of understanding in society and the medical 

12 community of the complexity of post-abortion de13 pression, and economic pressures placed on hospitals 

14 and providers are contributing factors. 

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

16 directly related to higher levels of immediate regret 

17 and more mental undoing over subsequent years. 

18 (9) Post-abortion depression is a treatable dis19 order if promptly diagnosed by a trained provider 

20 and attended to with a personalized regimen of care 

21 including social support, therapy, medication, and 

22 when necessary hospitalization. 

23 (10) While there have been many studies re24 garding the emotional aftermath of abortion, very 
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1 little research has been sponsored by the National 

2 Institutes of Health. 

3 TITLE I—RESEARCH ON POST4 ABORTION DEPRESSION AND 

5 PSYCHOSIS 

6 SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI7 TIES OF NATIONAL INSTITUTE OF MENTAL 

8 HEALTH. 

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

10 Human Services, acting through the Director of NIH and 

11 the Director of the National Institute of Mental Health 

12 (in this section referred to as the ‘‘Institute’’), shall ex13 pand and intensify research and related activities of the 

14 Institute with respect to post-abortion depression and 

15 post-abortion psychosis (in this section referred to as 

16 ‘‘post-abortion conditions’’). 

17 (b) COORDINATION WITH OTHER INSTITUTES.—The 

18 Director of the Institute shall coordinate the activities of 

19 the Director under subsection (a) with similar activities 

20 conducted by the other national research institutes and 

21 agencies of the National Institutes of Health to the extent 

22 that such Institutes and agencies have responsibilities that 

23 are related to post-abortion conditions. 

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

25 In carrying out subsection (a), the Director of the Insti-
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1 tute shall conduct or support research to expand the un2 derstanding of the causes of, and to find a cure for, post3 abortion conditions. Activities under such subsection shall 

4 include conducting and supporting the following: 

5 (1) Basic research concerning the etiology and 

6 causes of the conditions. 

7 (2) Epidemiological studies to address the fre8 quency and natural history of the conditions and the 

9 differences among racial and ethnic groups with re10 spect to the conditions. 

11 (3) The development of improved diagnostic 

12 techniques. 

13 (4) Clinical research for the development and 

14 evaluation of new treatments, including new biologi15 cal agents. 

16 (5) Information and education programs for 

17 health care professionals and the public. 

18 (d) LONGITUDINAL STUDY.— 

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

20 shall conduct a national longitudinal study to deter21 mine the incidence and prevalence of cases of post22 abortion conditions, and the symptoms, severity, and 

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

24 identifying the characteristics of such cases and de25 veloping diagnostic techniques. 
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1 (2) REPORT.—Beginning not later than 3 years 

2 after the date of the enactment of this Act, and peri3 odically thereafter for the duration of the study 

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

5 shall prepare and submit to the Congress reports on 

6 the findings of the study. 

7 (e) AUTHORIZATION OF APPROPRIATIONS.—For the 

8 purpose of carrying out this section, there is authorized 

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

10 2005 through 2009. 

11 TITLE II—DELIVERY OF SERV12 ICES REGARDING POST-ABOR13 TION DEPRESSION AND PSY14 CHOSIS 

15 SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 

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

17 Human Services (in this title referred to as the ‘‘Sec18 retary’’) shall in accordance with this title make grants 

19 to provide for projects for the establishment, operation, 

20 and coordination of effective and cost-efficient systems for 

21 the delivery of essential services to individuals with post22 abortion depression or post-abortion psychosis (referred to 

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

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

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

5 nonprofit private hospital, community-based organi6 zation, hospice, ambulatory care facility, community 

7 health center, migrant health center, or homeless 

8 health center; or other appropriate public or non9 profit private entity; and 

10 (2) had experience in providing the services de11 scribed in subsection (a) before the date of the en12 actment of this Act. 

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

14 and appropriate, the Secretary shall ensure that projects 

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

16 management of post-abortion conditions. Activities that 

17 the Secretary may authorize for such projects may also 

18 include the following: 

19 (1) Delivering or enhancing outpatient and 

20 home-based health and support services, including 

21 case management, screening and comprehensive 

22 treatment services for individuals with or at risk for 

23 post-abortion conditions; and delivering or enhancing 

24 support services for their families. 
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1 (2) Delivering or enhancing inpatient care man2 agement services that ensure the well being of the 

3 mother and family and the future development of 

4 the infant. 

5 (3) Improving the quality, availability, and or6 ganization of health care and support services (in7 cluding transportation services, attendant care, 

8 homemaker services, day or respite care, and pro9 viding counseling on financial assistance and insur10 ance) for individuals with post-abortion conditions 

11 and support services for their families. 

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

13 extent practicable and appropriate, the Secretary shall in14 tegrate the program under this title with other grant pro15 grams carried out by the Secretary, including the program 

16 under section 330 of the Public Health Service Act. 

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

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

19 in an amount exceeding $100,000. 

20 SEC. 202. CERTAIN REQUIREMENTS. 

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

22 applicant involved makes the following agreements: 

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

24 be used for administration, accounting, reporting, 

25 and program oversight functions. 
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1 (2) The grant will be used to supplement and 

2 not supplant funds from other sources related to the 

3 treatment of post-abortion conditions. 

4 (3) The applicant will abide by any limitations 

5 deemed appropriate by the Secretary on any charges 

6 to individuals receiving services pursuant to the 

7 grant. As deemed appropriate by the Secretary, such 

8 limitations on charges may vary based on the finan9 cial circumstances of the individual receiving serv10 ices. 

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

12 payment for services authorized under section 

13 201(a) to the extent that payment has been made, 

14 or can reasonably be expected to be made, with re15 spect to such services— 

16 (A) under any State compensation pro17 gram, under an insurance policy, or under any 

18 Federal or State health benefits program; or 

19 (B) by an entity that provides health serv20 ices on a prepaid basis. 

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

22 applicant provides services under section 201(a), 

23 post a conspicuous notice informing individuals who 

24 receive the services of any Federal policies that 
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1 apply to the applicant with respect to the imposition 

2 of charges on such individuals. 

3 SEC. 203. TECHNICAL ASSISTANCE. 

4 The Secretary may provide technical assistance to as5 sist entities in complying with the requirements of this 

6 title in order to make such entities eligible to receive 

7 grants under section 201. 

8 SEC. 204. AUTHORIZATION OF APPROPRIATIONS. 

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

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

11 fiscal years 2005 through 2009. 

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