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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Post-Abortion Depres-
sion Research and Care Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) About 3,000,000 women per year in the 
United States have an unplanned or unwanted preg-
nancy, and approximately 1,186,000 of these preg-
nancies end in elective abortion. 
(2) Abortion can have severe and long-term ef-
fects on the mental and emotional well-being of 
women. Women often experience sadness and guilt 
following abortions with no one to console them. 
They may have difficulty in bonding with new ba-
bies, become overprotective parents or develop prob-
lems in their relationship with their spouses. Prob-
lems such as eating disorders, depression and suicide 
attempts have also been traced to past abortions. 
(3) The symptoms of post-abortion depression 
include bouts of crying, guilt, intense grief or sad-
ness, emotional numbness, eating disorders, drug 
and alcohol abuse, suicidal urges, anxiety and panic 
attacks, anger/rage, sexual problems or promiscuity, 
lowered self esteem, nightmares and sleep disturb-
ance, flashbacks, and difficulty with relationships. 
(4) Women who aborted a first pregnancy are 
four times more likely to report substance abuse 
compared to those who suffered a natural loss of 
their first pregnancy, and they are five times more 
likely to report subsequent substance abuse than 
women who carried to term.
little research has been sponsored by the National 
Institutes of Health. 
TITLE I—RESEARCH ON POST- 
ABORTION DEPRESSION AND 
PSYCHOSIS 
SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES OF NATIONAL INSTITUTE OF MENTAL 
HEALTH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of NIH and 
the Director of the National Institute of Mental Health 
(in this section referred to as the ‘‘Institute’’), shall ex-
pand and intensify research and related activities of the 
Institute with respect to post-abortion depression and 
post-abortion psychosis (in this section referred to as 
‘‘post-abortion conditions’’). 
(b) COORDINATION WITH OTHER INSTITUTES.—The 
Director of the Institute shall coordinate the activities of 
the Director under subsection (a) with similar activities 
conducted by the other national research institutes and 
agencies of the National Institutes of Health to the extent 
that such Institutes and agencies have responsibilities that 
are related to post-abortion conditions. 
(c) PROGRAMS FOR POST-ABORTION CONDITIONS.— 
In carrying out subsection (a), the Director of the Insti-
tute shall conduct or support research to expand the un-
derstanding of the causes of, and to find a cure for, post- 
abortion conditions. Activities under such subsection shall 
include conducting and supporting the following: 
(1) Basic research concerning the etiology and 
causes of the conditions. 
(2) Epidemiological studies to address the fre-
quency and natural history of the conditions and the 
differences among racial and ethnic groups with re-
spect to the conditions. 
(3) The development of improved diagnostic 
techniques. 
(4) Clinical research for the development and 
evaluation of new treatments, including new biologi-
cal agents. 
(5) Information and education programs for 
health care professionals and the public. 
(d) LONGITUDINAL STUDY.— 
(1) IN GENERAL.—The Director of the Institute 
shall conduct a national longitudinal study to deter-
mine the incidence and prevalence of cases of post- 
abortion conditions, and the symptoms, severity, and 
duration of such cases, toward the goal of more fully 
identifying the characteristics of such cases and de-
veloping diagnostic techniques.
(2) REPORT.—Beginning not later than 3 years 
after the date of the enactment of this Act, and peri-
odically thereafter for the duration of the study 
under paragraph (1), the Director of the Institute 
shall prepare and submit to the Congress reports on 
the findings of the study. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $3,000,000 for each of the fiscal years 
2005 through 2009. 
TITLE II—DELIVERY OF SERV-
ICES REGARDING POST-ABOR-
TION DEPRESSION AND PSY-
CHOSIS 
SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this title referred to as the ‘‘Sec-
retary’’) shall in accordance with this title make grants 
to provide for projects for the establishment, operation, 
and coordination of effective and cost-efficient systems for 
the delivery of essential services to individuals with post- 
abortion depression or post-abortion psychosis (referred to 
in this section as a ‘‘post-abortion condition) and their 
families.
(b) RECIPIENTS OF GRANTS.—A grant under sub-
section (a) may be made to an entity only if the entity— 
(1) is a public or nonprofit private entity, which 
may include a State or local government; a public or 
nonprofit private hospital, community-based organi-
zation, hospice, ambulatory care facility, community 
health center, migrant health center, or homeless 
health center; or other appropriate public or non-
profit private entity; and 
(2) had experience in providing the services de-
scribed in subsection (a) before the date of the en-
actment of this Act. 
(c) CERTAIN ACTIVITIES.—To the extent practicable 
and appropriate, the Secretary shall ensure that projects 
under subsection (a) provide services for the diagnosis and 
management of post-abortion conditions. Activities that 
the Secretary may authorize for such projects may also 
include the following: 
(1) Delivering or enhancing outpatient and 
home-based health and support services, including 
case management, screening and comprehensive 
treatment services for individuals with or at risk for 
post-abortion conditions; and delivering or enhancing 
support services for their families.
(2) Delivering or enhancing inpatient care man-
agement services that ensure the well being of the 
mother and family and the future development of 
the infant. 
(3) Improving the quality, availability, and or-
ganization of health care and support services (in-
cluding transportation services, attendant care, 
homemaker services, day or respite care, and pro-
viding counseling on financial assistance and insur-
ance) for individuals with post-abortion conditions 
and support services for their families. 
(d) INTEGRATION WITH OTHER PROGRAMS.—To the 
extent practicable and appropriate, the Secretary shall in-
tegrate the program under this title with other grant pro-
grams carried out by the Secretary, including the program 
under section 330 of the Public Health Service Act. 
(e) LIMITATION ON AMOUNT OF GRANTS.—A grant 
under subsection (a) may not for any fiscal year be made 
in an amount exceeding $100,000. 
SEC. 202. CERTAIN REQUIREMENTS. 
A grant may be made under section 201 only if the 
applicant involved makes the following agreements: 
(1) Not more than 5 percent of the grant will 
be used for administration, accounting, reporting, 
and program oversight functions.
(2) The grant will be used to supplement and 
not supplant funds from other sources related to the 
treatment of post-abortion conditions. 
(3) The applicant will abide by any limitations 
deemed appropriate by the Secretary on any charges 
to individuals receiving services pursuant to the 
grant. As deemed appropriate by the Secretary, such 
limitations on charges may vary based on the finan-
cial circumstances of the individual receiving serv-
ices. 
(4) The grant will not be expended to make 
payment for services authorized under section 
201(a) to the extent that payment has been made, 
or can reasonably be expected to be made, with re-
spect to such services— 
(A) under any State compensation pro-
gram, under an insurance policy, or under any 
Federal or State health benefits program; or 
(B) by an entity that provides health serv-
ices on a prepaid basis. 
(5) The applicant will, at each site at which the 
applicant provides services under section 201(a), 
post a conspicuous notice informing individuals who 
receive the services of any Federal policies that
apply to the applicant with respect to the imposition 
of charges on such individuals. 
SEC. 203. TECHNICAL ASSISTANCE. 
The Secretary may provide technical assistance to as-
sist entities in complying with the requirements of this 
title in order to make such entities eligible to receive 
grants under section 201. 
SEC. 204. AUTHORIZATION OF APPROPRIATIONS. 
For the purpose of carrying out this title, there is 
authorized to be appropriated $300,000 for each of the 
fiscal years 2005 through 2009. 
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