Postpartum Depression – Massachusetts Needs Universal Screenings

On January 27, dozens of lawyers, doctors, survivors of postpartum depression and their families, and legislators gathered at the State House for a press event and hearing on H. 3897: An Act Relative to Postpartum Depression. The bill, sponsored by Representative Ellen Story (D-Amherst) and twenty co-sponsors, is designed to “bring postpartum depression to light.” The bill provides for: 1) universal screening; 2) a comprehensive referral network; 3) education and awareness for both the public and professionals.

Twenty-four people testified at the hearing before the Joint Committee on Financial Services and offered their professional and personal experience with postpartum depression. Many of these individuals also spoke at the press event. Although their experiences differed, all of the people who testified seemed to agree that the majority of women who suffer from postpartum depression are not diagnosed and that the illness, if diagnosed, is easily treatable.

Dr. Ed Tronick, Director of the Child Development Unit of Children’s Hospital, said, “This bill is a long time coming, and our attention to postpartum depression is a long time coming.” He and others shared the findings of their research on infant development; postpartum depression not only affects the mother but it also significantly impacts her child’s development. Several other doctors, including psychiatrists and pediatricians, expressed their support for the bill based on their interactions with patients who had suffered from the illness and their research studies.

All of the doctors who spoke were in favor of the three aims of the bill, although some did express concern about “legislating the practice of medicine” and hindering clinical judgment. Several doctors, however, stated that they believe the bill is necessary because a simple screening tool would “catch” many instances of postpartum depression that would go undiagnosed without the use of a screening tool. Dr. Alison Schonwald, a doctor in the Developmental Behavioral Outreach Unit at Children’s Hospital, spoke about the successful implementation of screenings in light of Rosie D., a court case that resulted in MassHealth’s requiring a validated mental health screening at every well child visit; she said these screenings would not be in place but for the decision. Dr. Schonwald said that she believes the passage of this law is necessary for the successful screening, diagnosis, and treatment of postpartum depression. Dr. Janice Goodman, Associate Professor in the School of Nursing at the MGH Institute of Health Professions, agreed. She said, “Simply asking, ‘How are you feeling?’ isn’t enough. Without a screening tool, even the best provider will miss most patients who suffer from postpartum depression.”

Several survivors of postpartum depression also shared their touching stories. Two of the women testifying said that when their depression was overwhelming, yet still undiagnosed, they went to the emergency room for treatment. Marylou Sudders, President of the Massachusetts Society for the Prevention of Cruelty to Children and former Commissioner of Mental Health, spoke not from her professional experience but instead described the effects of postpartum depression on her family. She said that she wished that her mother had been diagnosed rather than dismissed and listened to rather than ignored.

We agree with the Globe’s editorial today: “Early detection could stave off far more serious problems for mothers and their babies, whose well-being is deeply linked to the first few months of care. And universal screening would ensure that no woman falls through the cracks. The sooner new mothers can be diagnosed, the sooner they will recover.”

We urge the committee to take into account the personal stories heard at the hearing and report out favorably H. 3897.
-Alyssa Minsky, HLA Attorney