In what was billed as a Mother's Day gift, the Pennsylvania House yesterday unanimously approved a bill designed to improve care for women suffering from depression during or after pregnancy.

The Prenatal and Postpartum Counseling Act would require doctors or midwives to give pregnant women information about the symptoms of prenatal depression, postpartum depression and psychosis and tell them where counseling is available.

The bill must pass the Senate and be signed by Gov. Rendell to become law.

News last year of a young woman who stabbed her toddler and left her in a West Philadelphia schoolyard prompted Rep. George Kenney (R., Phila., Montgomery) to tackle the issue. "Can we be proactive and catch some of these episodes prior to the tragedy?" he asked his staff.

The resulting bill is modeled on legislation passed in Texas after Andrea Yates drowned her five children.

Sharon Cole, a legislative research analyst for the House who helped write the bill, said her daughter developed depression this year while caring for her baby. "There's a lot of suffering going on out there," she said.

Barbara Lewin, a Philadelphia psychologist who specializes in postpartum depression, called the bill "just fabulous... . We've been waiting for some mandate of this kind for probably 30 years."

Women are often blindsided by depression or postpartum psychosis, a more severe condition linked to bipolar disorder, she said. "It is amazing how many women come to me and say, 'Why didn't anybody tell me about this?' "

Because his wife had postpartum depression, acting New Jersey Gov. Richard J. Codey has made heightening awareness a priority. His proposed budget calls for $2 million to screen uninsured mothers and $2.5 million for an education campaign. Mary Jo Codey was in Washington last week arguing for a federal bill that would expand research and help fund treatment of postpartum depression.

Bills aimed at raising awareness of the illness are pending in Minnesota, where Villanova University professor Mine Ener killed her baby, and in Washington, according to the National Conference of State Legislatures. California is considering requiring screening. New York and Virginia already have laws similar to the Pennsylvania proposal.

About the same percentage of women - 14.5 percent - have a new episode of depression during pregnancy as after, the Agency for Healthcare Research and Quality recently found. Postpartum psychosis, which is considered an emergency and usually requires hospitalization, affects 1 to 2 out of 1,000 new mothers. More than 145,000 Pennsylvania women gave birth in 2000.

James Knoer, an obstetrician-gynecologist at Pennsylvania Hospital, said he already asks all his pregnant patients about risk factors such as a previous bout of depression or postpartum depression. They talk about depression during all postpartum visits.

Knoer, whose group practice delivers 1,000 babies a year, says he sees no need for the bill. The proposed rules, he said, are "just another piece of paper to have to worry about."

Many doctors are not doing as well as Knoer, said Paul Gluck, a Miami obstetrician-gynecologist who headed an effort by the Florida health department and the American College of Obstetricians and Gynecologists to increase postpartum depression awareness. "There's no question that this is a population that is in need and underserved," he said.

While Gluck is no fan of government telling doctors how to treat patients, he says that, if Pennsylvania is going to pass a law, it should pass a stronger one. Pediatricians, who often see women sooner after the birth than ob-gyns, should be included. Depression screening, not just education, should be required. Many of the most depressed women, he said, don't recognize that they have a problem. "Giving a booklet to a woman halfway through a pregnancy would do nothing," he said.

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Last updated: 06/09/2005 - 11:18 AM