Bill Fuels Debate Over Universal Screening For Postpartum Depression

Main Category: Depression
Also Included In: Pregnancy / Obstetrics;  Women's Health / Gynecology
Article Date: 15 Jul 2009 - 5:00 PDT

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A bill (HR 20, S 324) in Congress that would mandate funding for research, services and public education related to postpartum depression has sparked debate over whether all women should be screened for the condition, Time reports. The Melanie Blocker-Stokes Postpartum Depression Research and Care Act, also known as the Mothers Act, passed the House and is before the Senate. The bill does not specifically include funding for PPD testing, though an earlier version did; regardless, critics say it would still lead to greater screening. According to Time, the issue at the center of the debate is whether PPD screening identifies actual cases "or simply contribute[s] to the potentially dangerous medicalization of motherhood." Ingrid Johnston-Robledo, director of women's studies at the State University of New York, said that experts on both sides of the debate agree about increased support for women. "The problem with women's reproductive health issues is that they tend to be ignored or exaggerated," Johnston-Robledo said. She added, "We need to find a way to come down in the middle: acknowledge women's depression but not assume that all women who struggle with the transition to motherhood are depressed."

Critics of the bill argue that mental health screenings are notorious for giving false positives. They also contend that increased testing is a bid by pharmaceutical companies to sell more medication to women who do not need it. Some psychologists argue that universal PPD screening would be misdirected because the greatest risk factor for the condition is previous depression, not giving birth. Paula Caplan, a clinical and research psychologist, said, "(We) should be addressing the social factors causing women to be upset after they give birth, not locating the problem within the women."

Some proponents of PPD screening say it is not supposed to be used as a diagnostic tool but as a way to identify which patients require further evaluation. According to Time, studies suggest that PPD affects as many as one out of seven women who have recently given birth and that leaving it untreated exposes women and their infants to unwarranted risk. Katherine Wisner, a psychiatrist at the University of Pittsburgh Medical Center, said, "Postpartum depression is not a benign, uncommon thing." She added, "We screen all infants for (the genetic disorder) phenylketonuria, which is extremely rare. Why don't we screen women for this?" (Elton, Time, 7/20).

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