After giving birth to her baby girl Summer, and while her family was
admiring the new arrival, Melanie Blocker Stokes grew very quiet.
"I knew right away something was wrong," Melanie's mother,
Carol Blocker, recalled. "I said, 'Melanie, what's the matter?' But she
was just staring at the ceiling."
Later, at home with Summer, Melanie told her mother that she thought the
baby hated her and that all the neighbors knew she was a terrible mother."
She told me she was going to die, and there was nothing I could do to
stop her," Carol Blocker said. "She asked her brother for a
A couple of hospitalizations later, Melanie Blocker Stokes did commit
It was only after her death that Carol Blocker began to learn about
postpartum depression and psychosis. She took her newfound knowledge and her
daughter's story to Chicago Rep. Bobby Rush (D-Ill.), who introduced the
Melanie Blocker-Stokes Postpartum Depression Research and Care Act.
That was eight years ago, and the bill, which would fund research and
targeted grants for treatment services for individuals with postpartum
depression (PPD) and psychosis, has yet to become law. The House passed its
version of the bill in 2007, and the Senate version is now in the Committee on
Health, Education, Labor, and Pensions.
Michelle Dirst, deputy director for Senate affairs in APA's Department of
Government Relations, said that with health care reform consuming Congress's
time and energy, the bill won't be considered separately but could be passed
as part of whatever reform package is signed. At press time, the bill was
included as an amendment to the health reform package unveiled in late
September by Senate Finance Committee Chair Max Baucus (D-Mont.). Dirst also
said it was possible the bill could be "hot
lined"—Congressional jargon for fast track approval of legislation
that has no significant opposition.
Certainly, the goal—research on and treatment of PPD—would
appear to be unimpeachable. "Postpartum depression affects probably well
over 10 percent of women in this country, and it has demonstrable ill effects
on mother and child," said APA past President Nada Stotland, M.D., who
testified in support of the bill before Congress in 2007.
Yet it has encountered some curious roadblocks along the way.
Antipsychiatry groups have cropped up on the Internet stating that the
legislation would mandate the use of drugs. "Utterly ridiculous"
is how Stotland reacted. "It's another scare tactic by antipsychiatry
forces. Women are not going to be coerced into taking any treatment they don't
A provision in the original bill calling for screening of new mothers in
states that received grants for treatment under the bill was removed in the
face of opposition. That provision said that states receiving grants"
shall ensure that new mothers, during visits to a [licensed health care
professional] within the first year after the birth of their child, are
offered screenings for postpartum conditions by using the Edinburgh Postnatal
Depression Scale (EPDS) or other appropriate tests. If the results of such
screening provide warning signs for postpartum conditions, the new mother
shall be referred to an appropriate mental health care provider."
In a letter to the editor of Time magazine, which published an
article earlier this year focusing on PPD and concerns around mandated
screening, APA and representatives from the American College of Obstetricians
and Gynecologists, American Psychological Association, Association of Women's
Health, Obstetric and Neonatal Nurses, and the President's Advisory Council
expressed support of the bill and the need for early identification, but
pointed out that the newly introduced legislation did not call for mandated
"Postpartum depression is treatable, but first it must be
recognized," the group wrote. "Since many young women see the
doctor only during pregnancy and routinely just once after delivery, those
visits are a special opportunity for evaluation. Depression can be
successfully treated with psychotherapy, medication, or a combination of the
two. Every new mother who is depressed should have access to quality,
affordable diagnosis and treatment.
"[T]he article focused on the screening of new mothers, but the
legislation it discusses does not include screening. Instead, Congress
recognizes the importance of this issue with the introduction of the Melanie
Blocker Stokes MOTHERS Act, which would authorize research to better
understand the causes and treatments for postpartum depression and provide
support to women suffering from postpartum depression and
Dirst said that the prospects for passage are muddied by the
all-but-exclusive focus by Congress on health care reform, but she urged APA
members to contact their representatives in support of a bill that has already
been lingering for eight years.
The Melanie Blocker Stokes MOTHERS Act can be accessed at<http://thomas.loc.gov>
by searching on the bill number, S 324. ▪