One little-discussed part of the healthcare overhaul is something called the Melanie Blocker Stokes Mothers Act.
One little-discussed part of the healthcare overhaul is something called the Melanie Blocker Stokes Mothers Act. Named after a young Chicago woman who committed suicide shortly after her daughter was born, it earmarks 3 million dollars for research into post-partum depression. The act isn’t exactly what advocates wanted, but they’ll take it.[audio:100623mspostpar.mp3]
When it comes to post-partum depression, we typically hear about the absolutely worst cases; a psychotic mother killing her children or herself. These cases are rare, say experts — and the symptoms typically far more subtle. Susan Ellis Murphy of the Southern New Jersey Perinatal Cooperative.
Murphy: “She feels guilty, she may feel isolated, she is home alone, she may be someone who is used to working outside of the home and now she is home with this baby 24 hours a day, she may spend long periods of time with the baby with little to no help, and so she may feel that she is not supported through the process.”
About 10 percent of women develop some form of post-partum depression – experts say hormones play a role, as well as a family history of depression, and general life circumstances.
Without care, even a mild case can worsen and have a devastating impact on mothers and children, says therapist and national advocate Susan Dowd Stone.
Stone: “Everything from learning disabilities to family disintegration to chronic depression for the mother if it’s left untreated.”
Alicia, a New Jersey mother of two, didn’t feel like herself after the birth of her second child – who arrived via a traumatic emergency C- section:
Alicia: “In addition to having my insides opened up and spread on the table I felt like my soul had been taken out and I was just this hollow shell.”
Alicia couldn’t bond with her daughter, cried all the time, and started to isolate herself:
Alicia: “And I’m normally like a social butterfly, and I was afraid to leave my house, I was afraid to talk to the neighbors, because if they asked how the baby was doing I was probably going to burst into tears at the drop of a hat, and I didn’t want to be known as the crazy lady.”
In New Jersey, hospitals routinely screen for post-partum depression before discharging a new mother. Alicia had been referred to a follow-up visit with a counselor, and started therapy and medications to treat her depression. She says getting the screening made a big difference:
Alicia: “I’m sure at some point I would have sought help for it, but I probably would have waited a lot longer, thinking it would go away on its own.”
The state of New Jersey was the first to devote major resources to post-partum depression, and to offer routine screenings. Advocates had lobbied for the inclusion of mandatory screenings in the national legislation – but that proved controversial. Critics argued it would pathologize normal feelings after birth, and drive up anti-depressant use. Susan Dowd Stone says critics misunderstood the meaning of “mandatory screening”:
Stone: “There is no such thing as a mandated screening. The mandated part of the screening falls to the healthcare facility and the healthcare provider. It’s not that women are mandated to be screened, it’s the healthcare facilities are mandated to provide it.”
The screenings didn’t make it into the healthcare reform bill, but those 3 million dollars for research and education did. Stone says while she is disappointed screenings are not part of the federal law, research and education will go a long way in reducing debilitating mood disorders after pregnancy:
Stone: “This is about primary prevention. Preventing these disorders from happening, preventing them from worsening, bringing mothers into treatment as early as possible to avoid a progression into a more serious health issue.”
In New Jersey, Susan Ellis Murphy says now that more women are getting into treatment early, their prognosis looks better:
Murphy: “This is one of the few behavioral health disorders where I can say to people you’re going to get better, once we find the recipe for you, you will get better I know that.”
Alicia’s daughter is two now, and Alicia continues her therapy sessions and medications. She says her relationship with her daughter has improved since the turbulent infant days:
Alicia: “I’m sure that she could feel the stress that I had trying to take care of her, and now that I’m a much calmer person I think it’s a lot easier for the two of us to connect.”
National advocates like Susan Dowd Stone say the next step is to use the federal funding to develop awareness campaigns, and community-based programs for struggling new mothers.