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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