BILL NUMBER: ACR 53	CHAPTERED
	BILL TEXT

	RESOLUTION CHAPTER  66
	FILED WITH SECRETARY OF STATE  JULY 28, 2011
	APPROVED BY GOVERNOR  JULY 28, 2011
	ADOPTED IN SENATE  JULY 14, 2011
	ADOPTED IN ASSEMBLY  JUNE 20, 2011

INTRODUCED BY   Assembly Member Roger Hernández

                        APRIL 26, 2011

   Relative to perinatal depression prevention.


	LEGISLATIVE COUNSEL'S DIGEST


   ACR 53, Roger Hernández. Kelly Abraham Martinez Act: perinatal
depression prevention.
   This measure would enact the Kelly Abraham Martinez Act, which
would urge hospital providers, mental health care providers, health
plans, and insurers to invest resources to educate women about
perinatal depression risk factors and triggers. This measure would
also request that a statewide collaborative network of stakeholders
focused on the areas of health, maternal health, and infant and child
development, along with the American College of Obstetricians and
Gynecologists, the American Academy of Pediatrics, the California
Psychological Association, the Los Angeles County Perinatal Mental
Health Task Force, and Postpartum Support International collaborate
to explore ways to assist with the development of perinatal
depression prevention educational materials.



   WHEREAS, In 2010, the Legislature proclaimed the month of May,
each year, as Perinatal Depression Awareness Month in California; and

   WHEREAS, Perinatal depression and other mood disorders related to
pregnancy and childbirth can take many forms, including depression,
anxiety, panic disorder, obsessive-compulsive disorder, and
psychosis, with onset occurring during pregnancy and after childbirth
and, therefore, it is clinically referred to as perinatal mood and
anxiety disorders, "PMADs," and herein referred to as perinatal
depression; and
   WHEREAS, Perinatal depression can have potentially serious
repercussions upon the physical, emotional, social, and physical
health of mothers, fathers, infants, children, families, and
ultimately California communities, and therefore it is of interest to
the Legislature; and
   WHEREAS, Perinatal depression is serious, debilitating, and
sometimes tragic and afflicts between 10 to 20 percent of new mothers
and pregnant women; and
   WHEREAS, Perinatal depression can afflict any woman regardless of
race ethnicity, socioeconomic level, and level of educational
attainment. Also, research shows that a growing number of fathers
experience post partum depression; and
   WHEREAS, Perinatal depression is largely preventable when women,
their families, and medical providers understand the risk factors and
potential triggers and are encouraged to take precautionary
measures; and
   WHEREAS, Measures to prevent perinatal depression through
education regarding the range of disorders and understanding of the
risk factors and triggers can reduce stigma and can help women and
their families to connect with providers, support networks, and
informed and supportive resources in the community; and
   WHEREAS, The presence of risk factors may increase the chances of
some women experiencing perinatal depression during pregnancy or
following the birth of the child, making it imperative that women and
their families receive information and support at the earliest
possible moment; and
   WHEREAS, Understanding risk factors and receiving general
information about perinatal depression will help to ensure healthier
pregnancies, births, and infant and child development; and
   WHEREAS, Through no fault of their own, some women are at greater
risk of experiencing perinatal depression, and therefore all women
and their families should become educated about risk factors; and
   WHEREAS, Risk factors include, but are not limited to, the
following:
   (1) Personal or family history of depression, anxiety, or other
mental illness, including at other times of reproductive change or in
response to fertility drugs.
   (2) Stressors related to finances, legal needs, interpersonal
relationships, or immigration.
   (3) History of personal trauma including domestic violence.
   (4) Early childhood loss of a parent or recent loss of a parent.
   (5) Sleeping difficulties prior to pregnancy, including, but not
limited to, insomnia.
   (6) The inability to relax or sleep even if competent help for the
baby is available.
   (7) Difficulty conceiving or a medically complicated pregnancy.
   (8) Unwanted pregnancy or ambivalence toward motherhood.
   (9) Premature birth or other infant health complications.
   (10) Prior miscarriage or prior traumatic birth.
   (11) Traumatic childbirth as perceived by the mother or birth that
did not go as expected.
   (12) Lack of support or negative judgment from partner, other
family, or other social networks.
   (13) Breast-feeding difficulties.
   (14) Thyroid dysfunction or family history of thyroid dysfunction;
and
   WHEREAS, Mothers need support and companionship after the birth of
a baby, including, but not limited to, practical help with the
physical demands and respite from infant care. Perinatal depression
is more likely to develop when these demands are faced in isolation,
especially when other risk factors are present; and
   WHEREAS, During pregnancy and immediately after childbirth, strong
social support from a partner, family, and others is extremely
important and can take many forms; and
   WHEREAS, Research suggests that the following interventions may
prevent or lessen the intensity and duration of perinatal depression:

   (1) Early recognition during pregnancy of perinatal depression
risk factors.
   (2) Early detection of symptoms present in pregnancy or post
partum.
   (3) Planning of emotional support for mothers when symptoms are
anticipated or present, including, but not limited to, immediate
connection with other mothers and time alone or with a partner.
   (4) Planning for practical support, including, but not limited to,
food preparation, care of other children in the home, and providing
time and space for the new mother to sleep.
   (5) Limiting highly conflict-ridden familiar relationships and
finding support from other services.
   (6) Psychotherapeutic interventions centered on improving maternal
competence and the quality of bonding between the mother and the
baby.
   (7) Intervening early in breast-feeding difficulties. For some
mothers, breast-feeding can afford protection by lowering the stress
response. However, breast-feeding is only protective as long as it is
a positive experience.
   (8) Providing additional support and counseling during pregnancy
and the post partum period for women with more severe psychiatric
histories, including, but not limited to, pre-pregnancy consultation,
medication management, and psychotherapeutic interventions; and
   WHEREAS, Increasing awareness about perinatal depression and
related risk factors and increasing awareness of the need to educate
women and their families at the earliest possible point about
perinatal depression and its risk factors and triggers are imperative
among hospital providers, including, but not limited to, instructors
of childbirth and breast-feeding classes, and the nursing staff of
delivery units, obstetrician-gynecologists and other medical
providers, health plans, and insurers; now, therefore, be it
   Resolved by the Assembly of the State of California, the Senate
thereof concurring, That the Legislature declares that this measure
shall be known as the Kelly Abraham Martinez Act; and be it further
   Resolved, That the Legislature hereby urges hospital providers,
including, but not limited to, instructors of childbirth and
breast-feeding classes, delivery nursing staff,
obstetrician-gynecologists, and other medical providers, mental
health care providers, health plans, and insurers to invest resources
to educate women about perinatal depression risk factors and
triggers; and be it further
   Resolved, That a statewide collaborative network of stakeholders
focused on the areas of health, maternal health, and infant and child
development, along with the American College of Obstetricians and
Gynecologists, the American Academy of Pediatrics, the California
Psychological Association, the Los Angeles County Perinatal Mental
Health Task Force, and Postpartum Support International, are
requested to collaborate to explore ways to assist with the
development of perinatal depression prevention educational materials;
and be it further
   Resolved, That the Chief Clerk of the Assembly transmit copies of
this resolution to the author for appropriate distribution.