Past and Current
#MeToo
Feminist-based movements such as #MeToo have encouraged women to be more open about the unique struggles they face, including postpartum mental illness. A famous example is actress Brooke Shield’s book detailing her experience with postpartum psychosis.
Screenings and Drugs
Antidepressants are the first line of defense, though there are concerns about infant drug exposure through breast milk. The greatest shift in treatment, however, has been the introduction of screenings for these conditions. Now, screenings at obstetric and pediatric appointments are considered fairly common, though their popularity differs across the United States.
Lindsay with her children Cora, Dawson, and Callan, as well as her husband Patrick
Lindsay Clancy's Story
Lindsay Clancy, a Duxbury MA resident, was accused of murdering her three children on the evening of January 24, 2023 while suffering from postpartum psychosis. Soon after, Rep. Jim O'Day and Sen. Joan Lovely (HD 4280 / SD 2398) petitioned to pass legislation protecting defendants who commit crimes due to their mood disorders. This bill, they say, would allow mothers like Clancy the opportunity to receive treatment after they've been found incompetent to stand trial or not guilty by reason of mental illness. The legislators, who are the former co-chairs of the Ellen Story Commission on Postpartum Depression, believe that the bill will be received well by the medical community. In particular, the proposal would emphasize prevention and education to mothers and healthcare providers. For example, the Department of Public Health would be required to maintain a digital resource center on perinatal mood and anxiety disorders, as well as distribute information to perinatal individuals and families about how to access that resource.
It has been difficult for action to take place at the federal level due to economic and political reasons
One such example is the Melanie Blocker-Stokes Postpartum Depression Research and Care Act (2003) which was introduced to Congress six times over three years, but was ultimately unsuccessful. However, this was revised to become the Melanie Blocker Stokes MOTHERS Act or “Moms Opportunity To Access Health, Education, Research and Support.” The MOTHERS Act was incorporated into the Patient Protection and Affordable Care Act 2008 draft under the Obama administration. Due to the need for bipartisan support, a number of amendments were made, often relating to the MOTHERS Act. Ultimately, some language from the MOTHERS ACT was included in Section 2952 of the Patient Protection and Affordable Care Act (2010).
Postpartum Support in the Affordable Care Act Today
Subsection A instructs the Secretary of Health and Human Services to expand and intensify research on postpartum depression and psychosis, as well as makes a similar statement to the Director of the National Institute of Mental Health. The next provision authorizes grants to establish cost-efficient systems for providing clinical services to women with, or at risk for, postpartum depression or psychosis. The last subsection appropriates money to study the benefits of screening and requires a report to Congress on the study results.
While three million dollars was appropriated for relevant research and clinical mandates, it has been difficult for research to begin due to issues receiving the funds stemming from the Supreme Court lawsuit National Federation of Independent Business v. Sebelius (2012), which concerned the legality of the Act. This is due to two provisions in the Affordable Care Act which challenged constitutional standards regarding Congress’s powers to regulate taxation and interstate commerce. Though the case was settled in 2012, the financial implications have slowed some of the Act’s smaller parts from reaching initiation.