A new Pennsylvania law will provide patients with more education on postpartum depression

As she talked with fellow parents, state Rep. Elizabeth Fiedler was often struck by the reactions she’d draw after describing her work on a bill to address postpartum depression.

“They would say, ‘I think I had that. I think that might be the name for that intense sadness I had. I didn’t even know that was something I could get treatment for,’” said Fiedler, a Democrat who represents parts of South Philadelphia.

“I think there’s a lot of people out there struggling who have never put a name to the challenges they have.”

Fiedler’s Postpartum Depression Education Act this week passed both houses in the Pennsylvania legislature. Gov. Josh Shapiro plans to sign the bill into law, a spokesperson said.

It will require the state Department of Health to launch a public awareness campaign on postpartum depression and anxiety, educating the public on symptoms, treatment, and how to cope with the conditions. It will also encourage doctors around the state to provide patients with information about symptoms and treatment.

Fiedler said she was inspired to tackle the issue after reporting on postpartum depression and anxiety as a WHYY reporter in 2016.

“The first year of being a parent is still really clear in my mind. It’s joyful and wonderful and it’s also really hard, and a lot of people struggle,” said Fiedler, whose children are now 10 and 7. “Ever since I came into the legislature six years ago, I really wanted to do something on this issue.”

The Centers for Disease Control and Prevention estimates about one in eight women who have recently given birth show signs of postpartum depression, which include feelings of sadness, anger, distance from their baby, or doubt that they can care for them. Other parents might feel excessively anxious after giving birth, beyond normal levels of worry.

The stakes can be life-and-death. Mental illness was the leading factor behind deaths associated with pregnancy in Pennsylvania in 2020, according to a state report on maternal deaths released this spring. Pregnancy-associated deaths are those that occur either while a person is pregnant or in the year after giving birth.

Drug overdoses and addiction were the primary causes of maternal deaths related to mental illness. Another 29% of pregnancy-associated deaths were attributed to injuries, such as accidents, homicides, and suicides.

In addition to the public awareness campaign, Fielder’s bill will task health officials with creating an online list of mental health providers and other resources to address postpartum anxiety and depression. The department will also create a fact sheet with common symptoms that doctors around the state will be encouraged to give to new parents.

“We know many doctors already provide patients with resources, but it depends on where you’re at. Care and services differ from doctor to doctor, between medical institutions, and in different areas of the state,” Fiedler said.

It’s especially important to get these resources to Black mothers, who are at higher risk for symptoms of postpartum depression than their white counterparts, Fiedler said. Black Pennsylvanians also have the highest rate of pregnancy-associated deaths in the state.

“We know rates of depression are much higher in the Black community, and that bears out when we talk about women who are pregnant — that disparity absolutely continues,” she said.

Some mothers might also never get the care they need, Fiedler noted, because stigma and shame prevents them from discussing their struggles after giving birth.

Fiedler’s bill is the first to be passed from a legislative package nicknamed the “Momnibus,” spearheaded by the legislature’s Black Maternal Health Caucus, which includes state Rep. Morgan Cephas (D., Philadelphia).

The Momnibus includes a bill to require private insurers to cover blood pressure monitors for pregnant and postpartum patients to prevent potentially fatal high blood pressure, or preeclampsia. Another would require the state’s medical providers to complete implicit bias training as part of their continuing education.

» READ MORE: Can texting new parents to report their blood pressure help address maternal mortality? Penn thinks so.

An earlier version of Fiedler’s postpartum education bill had also included requirements for doctors to screen patients for postpartum depression after birth and at their baby’s wellness checkups afterward. That aspect was dropped after some lawmakers expressed concern about mandating additional work for doctors, a spokesperson for Fielder said.

Fielder said she plans to continue to work on increasing screenings for postpartum depression with a new bill in the next legislative session.

“I think Pennsylvania can do a lot better for new moms and babies,” Fiedler said. “We’re really committed to working as a team to get this package of bills across the line.”