BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | ACR 105|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
THIRD READING
Bill No: ACR 105
Author: Nava (D), et al
Amended: 3/9/10 in Assembly
Vote: 21
WITHOUT REFERENCE TO COMMITTEE OR FILE
ASSEMBLY FLOOR : 76-0, 4/5/10 (Consent)- See last page for
vote
SUBJECT : Perinatal Depression Awareness Month
SOURCE : Junior League of California
DIGEST : This resolution proclaims the month of May, each
year, as Perinatal Depression Awareness Month in
California, and requests the State Department of Health
Care Services, the State Department of Public Health, the
State Department of Mental Health, First 5 California,
Postpartum Support International, and other stakeholders to
work together to explore ways to improve women's access to
mental health care at the state and local levels, to
facilitate increased awareness and education about
perinatal depression, to explore and encourage the use of
prenatal screening tools, and to improve the availability
of effective treatment and community support services.
ANALYSIS :
This resolution makes the following Legislative findings:
CONTINUED
ACR 105
Page
2
1. Maternal health and, more specifically, the mental
health of women before, during, and after childbirth is
an issue of great concern to women and their families
and is, therefore, of interest to the Legislature.
2. Perinatal depression and other mood disorders are
serious and debilitating, but treatable disorders that
affect childbearing women and their families.
3. 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 appropriate to use the broader,
more accurate term of "perinatal depression" to
describe the many levels and degrees of severity of
these afflictions.
4. These afflictions can have potentially serious
repercussions upon the physical, emotional, social, and
physical health of mothers, infants, children, and
families.
5. It is critical that there is heightened awareness and
increased education among all Californians as to the
incidence of perinatal depression; that it affects all
categories of women and teenage girls regardless of
their age, race, or income level; that it can have a
profound impact on the family and significantly
contribute to adverse developmental and behavioral
outcomes and attachment disorders in the young children
of affected women; and that it is highly treatable with
therapeutic intervention, community-based supportive
services, and additionally, where appropriate,
medication.
6. Studies show that up to 80 percent of pregnant and
postpartum women around the world experience the "baby
blues," which is expressed as frequent and prolonged
crying, anxiety, irritability, poor sleep, quick mood
changes, and a sense of vulnerability. The onset of
the "baby blues" usually occurs within three days of
ACR 105
Page
3
birth, may continue for a few weeks, and does not
normally require clinical treatment, but is, instead,
alleviated by emotional and community-based supportive
services, and practical assistance with the baby.
7. Between 10 and 20 percent of pregnant and new mothers
are affected by perinatal depression and related mood
disorders, and may experience symptoms of depressed
mood, inability to find pleasure in usually engaging
activities, sleep disturbances, diminished
concentration, appetite and weight loss, anxiety and
panic attacks, feelings of guilt and worthlessness,
suicidal thoughts, and fears about hurting the baby.
8. One to two out of every 1,000 new mothers can
experience postpartum psychosis, which may begin with
manic states, hyperactivity, an inability to sleep, and
avoidance of the baby, and may lead to delusions,
hallucinations, incoherence, and thoughts of harming
the child or themselves and the inability to suppress
these thoughts resulting in bodily harm to the mother,
infant, or both.
9. All factors contributing to perinatal depression and
related mood disorders are not fully understood or
recognized, but it is believed that these disorders are
caused by physiological factors, such as hormone
levels, and can be exacerbated by such external risk
factors as marital problems, sleep deprivation, lack of
social support, poverty, and preexisting mental
illnesses.
10. Mental illness related to childbearing is often
overlooked and is heavily stigmatized because expectant
and new mothers are expected to be happy, and mothers
who are suffering from a form of these disorders feel
confused, ashamed, and isolated.
11. According to the American College of Obstetricians and
Gynecologists (ACOG), a strong social support network,
including hotlines, Internet Web site resources,
including Postpartum Support International, respite
care, community-based support, including faith-based
supportive services, home visitation programs, and
ACR 105
Page
4
informed and accessible resources, and referrals that
accommodate all, regardless of ability to pay and that
are culturally competent, can greatly reduce the
intensity and duration of symptoms of perinatal
depression and can promote healing and recovery.
Social and community-based support includes removing
stigma as a barrier to accessing help, empathy,
information, and practical help that leads women and
their families to obtain effective treatment and
support services and creates an environment in which
women learn that they are not alone, they are not to
blame, and they will get better.
12. The proposed federal Melanie Blocker Stokes MOTHERS
Act will direct the United States Secretary of Health
and Human Services, the National Institutes of Health,
including the National Institute of Mental Health, to
expand and intensify research and related activities
with respect to postpartum depression and postpartum
psychosis and will direct the Secretary of Health and
Human Services to 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 perinatal
depression or postpartum psychosis and their families.
13. The highly publicized tragic deaths of children at the
hands of their mothers who suffered from postpartum
psychosis have emphasized the need for more awareness
of the illness; improved referral processes; improved
access to therapeutic intervention, including
medication, and other supportive services; more
research into perinatal depression and related mood
disorders, including postpartum psychosis; and a
greater understanding of how the justice system
interacts with mothers who suffer from postpartum
psychosis and are accused of a crime.
14. Many women are not adequately informed about, screened
for, and treated for perinatal depression because they
are uninsured, underinsured, lack access to
comprehensive health care, or face cultural and
linguistic barriers.
ACR 105
Page
5
15. Many at-risk women may not get help because of the
stigma associated with mental illness, lack of
information about perinatal depression and related mood
disorders as part of their overall reproductive health
care; because there is limited knowledge; and nonuse of
screening and assessment tools; and because they are
unaware of services; support and treatment for
perinatal depression, such as medication, therapeutic
interventions, including counseling, support groups,
and community-based supportive services.
16. Increased education and awareness, improved access to
health care, proper universal use of perinatal
screening tools, and prioritizing perinatal depression
by all service providers and community support systems
who interface with pregnant and new mothers are all
critical factors in identifying mothers-to-be who are
at risk, and providing prompt diagnosis, treatment, and
proper community-based supportive services that can
effectively work together to facilitate recovery.
17. There is ample opportunity for the diverse health care
community, including obstetricians and gynecologists,
pediatricians, psychologists, psychiatrists, social
workers, case managers, nurses, childbirth educators,
nurse midwives, nurse practitioners, doulas, health
educators, breast-feeding instructors, and community
advocates, to make women aware of perinatal depression
and related mood disorders and identify at-risk women
during prenatal visits, home visitation sessions,
prepared childbirth classes, labor and delivery,
breast-feeding classes, postpartum well-baby checkups,
and parenting classes.
18. It behooves hospitals, health plans, and insurance
companies to establish and encourage these policies of
diagnosis, identification, and referral to informed
treatment and supportive services.
This resolution proclaims the month of May, each year, as
Perinatal Depression Awareness Month in California, and
requests the State Department of Health Care Services, the
State Department of Public Health, the State Department of
Mental Health, First 5 California, Postpartum Support
ACR 105
Page
6
International, and other stakeholders to work together to
explore ways to improve women's access to mental health
care at the state and local levels, to facilitate increased
awareness and education about perinatal depression, to
explore and encourage the use of prenatal screening tools,
and to improve the availability of effective treatment and
community support services.
FISCAL EFFECT : Fiscal Com.: No
SUPPORT : (Verified 4/12/10)
Junior League of California (source)
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall,
Bill Berryhill, Tom Berryhill, Block, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Charles
Calderon, Carter, Chesbro, Conway, Cook, Coto, Davis, De
La Torre, De Leon, DeVore, Emmerson, Eng, Evans, Feuer,
Fletcher, Fong, Fuentes, Fuller, Furutani, Gaines,
Galgiani, Garrick, Gilmore, Hagman, Hall, Harkey,
Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries,
Jones, Knight, Lieu, Logue, Bonnie Lowenthal, Ma,
Mendoza, Miller, Monning, Nava, Nestande, Niello,
Nielsen, V. Manuel Perez, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, John
A. Perez
NO VOTE RECORDED: Blakeslee, Norby, Portantino, Vacancy
CTW:do 4/13/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****