Donna Kreuzer, board member with Pregnancy and Postpartum Health Alliance of Texas, stood in front of the House Committee on Public Health to share the tragic story of her daughter who died of postpartum depression. In tears, Kreuzer urged lawmakers to support a bill that would help women get diagnosed before it’s too late.

“My daughter did not survive postpartum depression and I don’t want that to happen to anybody else,” Kreuzer said Tuesday. “Each of you please realize that (it) is real. It needs to be addressed as quickly as possible.”

The committee heard three bills that aim to increase access to screening and treatment for postpartum depression. This mental illness, advocates said, is among the reasons of a recent spike in pregnancy-related deaths among Texan mothers.

According to a report by the Maternal Mortality and Morbidity Task Force, an agency under the Department of State Health Services, 189 mothers died less than a year after giving birth in 2011-2012, and suicide and substance abuse due to mental illness were two of the main contributors. According to research published in the August issue of the medical journal “Obstetrics and Gynecology,” the Texas maternal mortality rate has doubled since 2011.

 One of the bills, HB 2466, authored by state Rep. Sarah Davis, R-Houston, would provide mothers with the option to be screened and referred for treatment for maternal depression during their baby’s well-check visit with a pediatrician or other primary care provider. This would be covered through the baby’s Medicaid or Children’s Health Insurance Program plan for up to one year after the baby’s birth.

“Postpartum depression is not just about being overwhelmed or having a little anxiety. It is identified as one of the top killers of women in this state,” Davis said to committee members.

In Texas, women are usually screened after the birth of their child by their primary care doctor or by their OB/GYN. But part of the problem, advocates said, is that moms under Medicaid lose their benefits 60 days after delivery, and postpartum depression can be triggered three weeks to one year after having a baby.

According to a report released Monday by Texans Care for Children, a non-profit children’s policy organization, half of all cases of postpartum depression go undetected and undiagnosed. Children are more likely to experience developmental delays and a higher chance of experiencing depression later in childhood and adolescence, the study said.

Since pediatricians and other primary care providers frequently interact with mothers during a child’s first year of life, Davis said pediatricians should be able to conduct the screening and bill the insurance company.

Besides Davis’ bill, the committee also heard HB 2135, authored by state Rep. Garnet Coleman, D-Houston, which would provide screening and treatment coverage to a mom through the baby’s CHIP insurance program up to a year after birth.

HB 2604, authored by state Rep. Jessica Farrar, D-Houston, would require the Health and Human Services Commission to develop a strategic 5-year plan to improve access to postpartum depression screening, referral, treatment and support services.

Adriana Kohler, a senior health policy associate at Texans Care for Children, said that without early detection, women are four times more likely to use the emergency room and that untreated postpartum depression among moms incurs 90 percent higher health costs compared to non-depressed mothers.

All three bills were left pending in committee.

This story was published in the San Antonio Express-News April 5, 2017. 

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