IV
106TH CONGRESS
1ST SESSION
H. RES. 163
Expressing the sense of the House of Representatives with respect to
postpartum depression.
IN THE HOUSE OF REPRESENTATIVES
MAY 6, 1999
Mr. KINGSTON (for himself and Mrs. CAPPS) submitted the following
resolution; which was referred to the Committee on Commerce
RESOLUTION
Expressing the sense of the House of Representatives with
respect to postpartum depression.
Whereas postpartum depression is the name given to a wide
range of emotional, psychological, and physiological reac-
tions to childbirth including loneliness, sadness, fatigue,
low self-esteem, loss of identity, increased vulnerability,
irritability, confusion, disorientation, memory impair-
ment, agitation, and anxiety, which challenge the stamina
of the new mother suffering from postpartum depression
and can intensify and impair her ability to function and
nurture her newborn(s);
Whereas as many as 400,000 American women will suffer
from postpartum depression this year and will require
treatment. This constitutes up to 20 percent of women
who give birth. Incidence of mild, ‘‘transitory blues’’
•HRES 163 IH
ranges from 500 to 800 cases per 1,000 births (50 to 80
percent);
Whereas postpartum depression is the result of a chemical
imbalance triggered by a sudden dramatic drop in hor-
monal production after the birth of a baby, especially in
women who have an increased risk. Those women at
highest risk are those with a previous psychiatric dif-
ficulty, such as depression, anxiety, or panic disorder.
Levels of risk are greater for those with a family member
suffering from the same, including alcoholism;
Whereas women are more likely to suffer from mood and anx-
iety disorders during pregnancy and following childbirth
than at any other time in their lives. 70 to 80 percent
of all new mothers suffer some degree of postpartum
mood disorder lasting anywhere from a week to as much
as a year or more. Approximately 10 to 20 percent of
new mothers experience a paralyzing, diagnosable clinical
depression;
Whereas many new mothers suffering from postpartum de-
pression require counseling and treatment, yet many do
not realize that they require help. It is imperative that
the health care provider who treats her has a thorough
understanding of this disorder. Those whose illness is se-
vere may require medication to correct the underlying
brain chemistry that is disturbed. This often debilitating
condition has typically been a silent condition suffered
privately by women because of the feelings of shame or
guilt;
Whereas postpartum depression frequently strikes without
warning in women without any past emotional problems,
without any history of depression and without any com-
plications in pregnancy. Postpartum depression strikes
•HRES 163 IH
mothers who are in very satisfying marriages as well as
those who are single. It strikes women who had easy
pregnancies and deliveries, as well as women who suf-
fered prolonged, complicated labors and caesarean section
deliveries. Symptoms may appear at any time after deliv-
ery, often after the woman has returned home from the
hospital. It may strike after the first, third, or even
fourth birth;
Whereas postpartum depression is not a new phenomenon.
Hippocrates observed the connection between childbirth
and mental illness over 2,000 years ago. Louis V. Marce,
a French physician, detailed the identifiable signs and
symptoms of postpartum depression in 1858;
Whereas the most extreme and rare form of this condition,
called postpartum psychosis, hosts a quick and severe
onset, usually within 3 months. 80 percent of all cases
of this more extreme form present within 3 to 14 days
after delivery with intensifying symptoms; once suffered
recurrence rate with subsequent pregnancies is high;
Whereas postpartum mood disorders occur after the mother
has had frequent contact prenatally with health care pro-
fessionals who might identify symptoms and those at
risk. In the United States, where medical surveillance of
new mothers often lapses between discharge from the
hospital and the physical checkup 6 weeks later, the rec-
ognition of postpartum illness is left mainly to chance.
The focus of the 6-week checkup is on the medical as-
pects of her reproductive system and not her mental
health;
Whereas having a baby often marks one of the happiest times
in a woman’s life. For 9 months, she awaits her child’s
birth with a whole range of emotions ranging from nerv-
•HRES 163 IH
ous anticipation to complete joy. Society is quite clear
about what her emotions are expected to be once the
baby is born. Joy and other positive feelings are empha-
sized, while sadness and other negative emotions are
minimized. It is culturally acceptable to be depressed
after a death or divorce but not by the arrival of an in-
fant. Because of the social stigma surrounding depression
after delivery, women are afraid to say that something is
wrong if they are experiencing something different than
what they are expected to feel. Mothers are ashamed,
fearful, and embarrassed to share their negative feelings
and can also be fearful of losing their babies;
Whereas treatment can significantly reduce the duration and
severity of postpartum psychiatric illness;
Whereas postpartum depression dramatically distorts the
image of perfect new motherhood and is often dismissed
by those suffering and those around her. It is thought to
be a weakness on the part of the sufferer—self-induced
an self-controllable;
Whereas education can help take away the ‘‘stigma’’ of
postpartum depression and can make it easier to detect
and diagnose this disorder in its earliest stages, pre-
venting the most severe cases;
Whereas at present, the United States lacks any organized
treatment protocol for postpartum depression. Sufferers
have few treatment resources. The United States lags be-
hind most other developed countries in providing such in-
formation, support, and treatment;
Whereas the United States Government and its agencies col-
lect very little data on postpartum illness;
•HRES 163 IH
Whereas if early recognition and treatment are to occur,
postpartum depression must be discussed in childbirth
classes and obstetrical office visits, as are conditions,
such as hemorrhage and sepsis;
Whereas early detection, diagnosis, and treatment of
postpartum illness will become easier if public education
is enhanced to lift the social stigma, thereby increasing
the chance that women will inform others of her symp-
toms as she would for physical complications;
Whereas research shows that in the first few weeks after de-
livery, a woman’s chance of requiring a psychiatric ad-
mission is 7 times higher than at any other time in her
life. It is estimated that as many as 90 percent realize
something is wrong, but less than 2 percent report symp-
toms to their health care provider. The remaining individ-
uals are either undiagnosed, misdiagnosed, or seek no
medical assistance;
Whereas it is estimated that as many as 90 percent of women
realize something is wrong; however less than 2 percent
report symptoms to their health care provider. Only
about 20 percent of women with the disorder receive
treatment. 
The 
remaining 
individuals 
are 
either
undiagnosed, misdiagnosed, or seek no medical assist-
ance;
Whereas in addition to the mother, the effects of postpartum
depression can also impact the child and the father sig-
nificantly. Infants of mothers with postpartum depression
are at risk for socioemotional difficulties in life. Maternal
depression can affect the mother’s ability to respond sen-
sitively to her infant’s needs. A depressed mother is less
likely to provide her children with appropriate levels of
stimulation and to express positive affect. Research gen-
•HRES 163 IH
erally shows that children who receive warm and respon-
sive caregiving from the moment of birth and are se-
curely attached to their caregivers cope with difficult
times more easily when they are older. They are more cu-
rious, get along better with other children, and perform
better in school than those who are less securely at-
tached;
Whereas a mother’s marriage can also become severely
strained when dealing with a postpartum illness. Hus-
bands/fathers feel anxious and helpless, not under-
standing what is going wrong or what is the source of the
depression. They can express exasperation and even re-
sentment as a result of the problems created by the ill-
ness. They are also more likely to become depressed
themselves, further compromising the functioning of the
family. Lack of support from the partner can contribute
to the development or continuation of postpartum depres-
sion. Husbands, partners, family members, and friends
need access to information on these issues in order to
support their wives, relatives, or friends;
Whereas severe postpartum illness can obstruct the important
pattern of friendship and support that most couples with
newborns tend to form. Family units as a whole can ex-
perience isolation;
Whereas education is helpful to new parents coping with
these emotional and hormonal changes and also helps
them to decide if and when they need to seek outside
help; and
Whereas postpartum depression is one of the most treatable
and curable of all forms of mental illness. Learning about
postpartum depression helps prevent it and relieve it:
Now, therefore, be it
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Resolved, That the House of Representatives—
(1) recommends that all hospitals and clinics
which deliver babies provide departing new mothers
and fathers or family members with complete infor-
mation about postpartum depression, its symptoms,
methods of coping with it, and treatment resources;
(2) encourages all obstetricians to inquire pre-
natally about any psychiatric problems the mother
may have experienced, including substance abuse,
existence of the above in any family members, and,
ideally screen for ongoing depression;
(3) encourages all obstetricians to screen new
mothers for postpartum depression symptoms prior
to discharge from the hospital and again when they
bring in their babies for early checkups;
(4) recommends that appropriate health care
professionals be trained specifically in screening
women for signs of postpartum depression in order
to improve chances of early detection;
(5) recognizes that a coordinated system of reg-
istry should be developed to collect data on mental
disorders in the new mother and that the National
Institutes of Health should undertake additional re-
search on postpartum psychiatric illnesses;
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(6) recognizes the impact of a mother’s
postpartum depression on fathers and other family
members as well and strongly encourages that they
be included in both the education and treatment
processes to help them better understand the nature
and causes of postpartum depression so they too can
overcome the spillover effects of the condition and
improve their ability to be supportive; and
(7) calls on the citizens of the United States,
particularly the medical community, to learn more
about postpartum depression, how to educate women
and families about it, and thus ultimately lower the
likelihood that women around the country will con-
tinue to suffer in silence.
Æ