The "Mothers Act"
Currently, there is a bill before the U.S. Senate, calling for new laws that are supposedly designed to help new mothers who suffer from Postpartum Depression (PPD). But a closer look at the bill raises some very disturbing prospects.
Both those who favor and those who oppose the bill agree on some points:
- Postpartum depression (PPD) is real
- A mother suffering from it might be less responsive to the needs of her infant or other children
- Some mothers have harmed their child as a result of PDD
- Many women don't have anyone they can consult for help when they feel overwhelmed
The appeal of the Mothers Act
The bill has a long list of senators and organizations that have signed on as supporters. There is an enormous appeal to find a way to help new mothers who are struggling with depression, and the disclosures from celebrity moms who have suffered from PPD have brought public awareness to the issue.
But critics of the Mothers Act say that passage of the bill will have serious unforeseen consequences.
This bill is scheduled to be considered before Mothers Day, May 10,2009. If you wish to have your opinions counted by your Senator, you have about one week. Find your Senator's contact information here.
Problems with the legislation
New Jersey passed similar legislation in 2006, but it has led to disturbing reports from mothers who have been affected. Women have described confiding in a professional, only to be taken away by police and forced to go to a hospital emergency room. Others have called the hotline only to find they are speaking with someone who has no training or expertise.
Problems with "treatment"
For many mental health professionals and lawmakers the term "treatment" means antidepressants and other anti-psychotic drugs. But while psychotropic drugs appear to be useful for severe depression, they have been found to be of little value for moderate depression. (For details, see Myth of Depression as Disease by Leventhal et al.)
What's more, they have serious side effects, including depression, suicidal thoughts, and psychotic behaviors -- the very symptoms the drugs are supposed to relieve.
The prospect of mandatory screening raises some very disturbing scenarios.
There have been earlier programs that, like this bill, sound good until you take a closer look. Several years ago a program called "teen screen" claimed it would prevent teen suicides, and another was the Bush administration's "New Freedom Commission." They called for mandatory screening of all school age children to determine their mental health status and to provide "appropriate services." Critics say these are thinly veiled marketing techniques, promoted by the pharmaceutical industry, to increase the sale of drugs.
A Texas program was the model for the teen screen initiative. According to an article in the British Medical Journal in 2005, the Texas project mandated the use of the newer and more expensive antipsychotic drugs. This was to be expanded to develop "a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects…"
Putting babies at risk.
There's a good reason so many products, including prescription and non-prescription drugs, carry cautions that they should not be taken by pregnant or lactating mothers. Among the potential effects of antidepressants for the unborn baby are birth defects, heart disease, abortion, and premature birth.
The current bill (S. 324)
Last year Mothers Act (bill S. 1375) was introduced to the Senate and defeated. It has been edited (cleaned up) to remove many of the disturbing references to "treatment." The scope of the bill has been expanded and there is more lip service given to research, but it would be a mistake to believe that the final outcome of this edited version will differ from the previous one. See the text of Bill S.324. Meanwhile, here is information on last year's bill, which provides a much better look at what such a law will mean.
The wording of the previous bill (S. 1375)
Text of Bill S. 1375.
Following are excerpts from the bill, followed by our comments:
"To ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services, and to increase research at the National Institutes of Health on postpartum depression."
"Postpartum depression is a devastating mood disorder which strikes many women during and after pregnancy."
"The symptoms of postpartum mood and anxiety disorders are as defined in the latest edition of Diagnostic and Statistical Manual of Mood Disorders (DSM), as published by the American Psychological Association."
"Baby blues afflicts up to 80 percent of new mothers, postpartum depression occurs in 10 to 20 percent of new mothers, and postpartum psychosis strikes 1 in 1,000 new mothers."
"The causes of postpartum depression are complex and unknown at this time…"
But then the bill goes on to claim "Postpartum depression is a treatable disorder if promptly diagnosed by a trained provider and attended to with a personalized regimen of care including social support, therapy, medication, and when necessary hospitalization."
"Untreated, postpartum depression can lead to further depression, substance abuse, loss of employment, divorce and further social alienation, self-destructive behavior, or even suicide."
Fear of harsh remedies will prevent moms from seeking help
The prospect of being forced to take antipsychotic drugs or possibly lose custody of her baby, as has happened in New Jersey, will not bring PPD out of the shadows as the proponents claim. Such Draconian measures will have the opposite effect; they will encourage mothers to hide their true feelings and suffer alone.
A valuable use of taxpayer dollars in addressing PPD would be to collect the information on the many non-drug approaches that are being used to help new mothers, and to design research to test the effectiveness of each. Some of the treatments which appear to have been successful include:
Pregnancy and childbirth bring about dramatic changes in a woman's levels of hormones, and may use up her body's store of certain nutrients. Depletion of minerals, vitamins, and essential fatty acids can have a direct effect on a new mother's emotional health and ability to cope with the demands of motherhood. If she was poorly nourished before or during the pregnancy, or if she is genetically vulnerable, these factors can bring on depression. A mother who is deficient in trace minerals needs supplementation, not sedation. And her nursing baby needs nourishment, not a meal that includes Prozac, Zoloft and Paxil.
As this introduction shows, the intent is to first screen new mothers, provide "essential services" (nearly always involving drugs) and later try to find out the cause(s).
The term "mood disorder" puts this into the category of a mental illness.
Once a symptom makes it into the DSM, the stage is set for the official sanctioning of medication. ADD is another example.
So does that mean that 80% of new mothers have a "disorder"?
If the causes are unknown, how can it be appropriately treated?
Mothers have experienced postpartum symptoms for many generations, and most have found that the condition self-corrects. An exception was a mother named Melanie Blocker-Stokes, for whom the act is named. She committed suicide following months of treatment for PPD including four hospitalizations, at least four different drugs -- documented to cause suicidal ideation -- and electroshock therapy.
Another approach would be to find help so the new mother can get more sleep. Part-time assistance from a qualified baby sitter would be more desirable and far less costly than drug treatment, hospitalization or institutionalization. The December 2008 issue of the Journal of Obstetric, Gynecologic & Neonatal Nursing published a study that will come as no surprise to exhausted new moms. It is titled, "Postpartum Depression and Poor Sleep Quality Linked."