Saturday, April 15, 2006

New Jersey New Moms to be screened for depression

New Jersey Governor Jon S. Corzine on Thursday signed into law a measure that aims to provide help to women who become depressed after giving birth. Health care professionals will be required to educate expecting mothers and their families about postpartum depression and to screen new moms for the disorder.

While the intent of the bill is noble, there are some obvious problems with the language of the bill and monitoring mechanisms --
First, postpartum depression can happen anytime within the first year after childbirth -- the language of screening "new mothers for postpartum depression symptoms prior to discharge from the birthing facility and at the first few postnatal check-up visits;" is pretty vague -- the first two, three visits? -- it deosn't create a specific standard of care.

Secondly, there is no follow-up or feedback mechanism --From a research ethics viewpoint, there needs to be put in a formalized report process which protects the anonymity and privacy of the individual, yet collects sufficient to data to indicate that program is being effective -- that the message is getting through to the intended audience -- otherwise, how can it be shown that the legislation will have any effect? Without that, it amounts to more of a 'political' issue than a 'medical' issue.

Finally, the part of the bill that requires "Physicians, nurse midwives and other licensed health care professionals providing prenatal and postnatal care to women shall include fathers and other family members, as appropriate, in both the education and treatment processes" doesn't address issues of medical confidentiality, an important issue with HIPAA (Health Insurance Portability and Accountability Act of 1996 ) these days. This is a particular difficulty with legislatures mandating certain actions -- the legislature is telling the professionals do something that could be contrary to other laws (such as HIPAA) .

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