The legislation builds on guidelines recently issued by the United States Preventive Services Task Force (USPSTF), which recommend that women should be screened for depression during pregnancy and after giving birth. The recommendation received a “B” rating from the Task Force, meaning that screening for maternal depression must now be covered under the Affordable Care Act. Last week Governor Andrew M. Cuomo announced that the New York State Department of Financial Services (DFS) has issued guidance informing insurers of their responsibility to cover screening for maternal depression under the Affordable Care Act.
In 2014, Senator Krueger and Assembly Member Richard Gottfried sponsored legislation, which passed unanimously in both houses of the Legislature and was signed into law by Governor Cuomo, to provide education and promote screening and treatment-referrals for postpartum depression and other maternal depression disorders in New York State.
“Maternal depression” includes a range of perinatal mood disorders, emotional and psychological reactions a woman may experience during pregnancy or up to a year after childbirth. Symptoms can include feelings of despair or guilt, sadness, fatigue, difficulty concentrating, changes in appetite, and thoughts of suicide or of harming the baby. Maternal depression includes prenatal depression, “baby blues,” postpartum anxiety, postpartum depression, and postpartum psychosis. The latter is the most severe of these conditions, often including hallucinations and delusions, and results in infanticide and suicide rates of four and five percent, respectively.
Maternal depression affects a significant portion of pregnant women and new mothers; in fact, it is one of the most common medical complications women may experience during and after pregnancy. Each year, approximately 10 to 15 percent of new mothers develop postpartum depression, while 50 to 80 percent of new mothers will experience “baby blues.” A small but significant number – about 0.1 to 0.2 percent of new mothers – develop symptoms serious enough to be considered postpartum psychosis.
Maternal depression can lead to significant negative consequences for those affected and their families and children if left untreated. However, treatment for maternal depression has an 80 to 90 percent success rate. Early diagnosis and treatment significantly improve prognoses.
Amy Hines Kramer, Advocacy and Government Affairs Chairperson at March of Dimes New York, said: “Maternal depression can be successfully treated when women have treatment options and peer support. March of Dimes supports maternal depression education, screening and treatment to improve the lives of New York moms, babies and families. Today’s bill will expand education, access to referrals for treatment, resources and support for moms.”
Leah Kaufman, MD, FACOG, Legislative Chair of the American Congress of Obstetricians and Gynecologists (ACOG) District II, said: “Depression in the prenatal and postpartum period can have detrimental effects on women and their families. Unfortunately there is a paucity of resources to effectively treat patients creating gaps in access to care for all women. ACOG District II is dedicated to working with the state to ensure that there is an investment in comprehensive treatment and referral resources, including telehealth options, to improve clinical outcomes for women and families. ACOG thanks the legislative sponsors for their commitment to this issue.”
Elie Ward, MSW, Director of Policy & Advocacy for the NYS American Academy of Pediatrics, said: “It is critical that women identified through newly available universal maternal depression screening have access to high quality mental health treatment. Diagnosing maternal depression without providing easy access to high quality mental health services isn’t adequate to keep mothers and babies safe during a very dangerous time in their lives. Treatment for maternal depression is treatment to ensure health and resilience for Mom’s and their babies!”
Sonia Murdock, Executive Director, Postpartum Resource Center of New York, said: “Thank you to the members of the Senate Health Committee for passing the Maternal Depression bill. With today being World Maternal Mental Health Awareness Day, New York continues to be a leader with assuring New York moms and families will not suffer in silence and get to the help and support they need for recovery.”