BILL ANALYSIS
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THIRD READING
Bill No: ACR 105
Author: Nava (D), et al
Amended: 4/12/10 in Senate
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, the
American College of Obstetricians and Gynecologists,
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, clinically referred to as prenatal
mood and anxiety disorders, to explore and encourage the
use of prenatal screening tools, and to improve the
availability of effective treatment and community support
services.
CONTINUED
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ANALYSIS :
This resolution makes the following Legislative findings:
1. Maternal health and, more specifically, the mental
health of women before, during, and after childbirth is
an issue of great concern to women, their families, and
their physicians, 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 clinically referred to as
"perinatal mood and anxiety disorder" but commonly
referred to as "perinatal depression."
4. These afflictions can have potentially serous
repercussions upon the physical, emotional, social, and
physical health of mothers, fathers, 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 I the young children
of affected women; and that it is highly treatable with
therapeutic intervention, community-based supportive
services, and medication.
6. Studies show that up to 80 percent of pregnant and
postpartum women around the world experience the "baby
blues," which is express as frequent and prolonged
crying, anxiety, irritability, poor sleep, quick mood
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changes, and a sense of vulnerability. The onset of
the "baby blues" usually occurs within three days of
birth, may continue for a few weeks, and does not
normally require clinical treatment, but instead is
alleviate by emotional and community-based supportive
service, and practical assistance with the baby.
7. Between 10 and 20 percent of pregnant and new mothers
are affected by perinatal depression and related mod
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, and 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,
and infant, or both.
9. All factors contributing to perinatal depression and
related mood disorders are into fully understood or
recognized, but it is believed that these disorders are
caused by physiological factors, 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,
can greatly reduce the intensity and duration of
symptoms of perinatal depression and can promote
healing and recovery. This support can take the form
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of hotlines, Internet Web sites, community-based
support, home visitation, referral services, and
respite care. Services should be available regardless
of ability to pay, and services should be culturally
and linguistically appropriate. 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. Provisions of the proposed federal Melanie Blocker
Stokes MOTHERS Act made law by the federal Patient
Protection and Affordable Care Act directs the United
States Secretary of Health and Human Services, and the
National Institute of Mental Health , to expand and
intensify research and related activities with respect
to postpartum depression and postpartum psychosis and
directs 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. Provisions of the proposed federal Melanie Blocker
Stokes MOTHERS Act made law by the federal Patient
Protection and Affordable Care Act directs the United
States Secretary of Health and Human Services and the
National Institute of Mental Health, to expand and
intensify research and related activities with respect
to postpartum depression and postpartum psychosis and
directs 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.
14. 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
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of the illness; improved referral processes; improved
access to therapeutic intervention, including
medication, and other supportive services; more
research into perinatal depression disorders, including
postpartum psychosis and other perinatal mood and
anxiety disorders; and a greater understanding of how
the justice system interacts with mothers who suffer
from postpartum psychosis and are accused of a crime.
15. 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.
16. Many affected 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 limited
use 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.
17. Lack of available services due to inadequate funding
for comprehensive medical care, and specifically mental
health services, creates an environment where care may
not be readily available, and it is particularly
important to bring awareness to this problem so that
women and their families are able to seek out help.
18. Increased education and awareness, improved access to
health care, use of perinatal screening tools, and
understanding of 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.
19. There are many opportunities for the diverse health
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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.
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
DLW:do 4/19/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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