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LA City Council legislative package aims to improve maternal mental health care

(Ella Stapleton/Daily Bruin)

By Danna Castro Galindo

May 17, 2021 8:16 p.m.

This post was updated May 23 at 5:48 p.m.

Los Angeles City Council members introduced legislation May 4 to raise awareness of perinatal and postpartum mental health for Maternal Mental Health Awareness Month, which occurs every May.

If enacted, the legislative package – including two resolutions and a motion – would ask for increased reporting on legal screening requirements for perinatal depression, improve access to mental health treatment for pregnant and new mothers and require medical staff receive education on treating pregnant and postpartum women.

One of the resolutions introduced includes support for California Assembly Bill 935, the Mothers and Children Mental Health Support Act of 2021, which would improve screening, referrals and access to therapy and medication for perinatal depression.

Together, these pieces of legislation expand on a package of bills that former Gov. Jerry Brown signed in 2018 to increase funding, screening, awareness and guidelines for diagnosing maternal mental health disorders.

Roughly one in four women in Los Angeles County report feelings of depression after giving birth, according to the Los Angeles County Department of Public Health. Around 80% of new mothers will experience some negative feelings after giving birth, according to the American Pregnancy Association.

“For those of us who have suffered with postpartum depression, it feels like a cross to bear and often very lonely,” said Nury Martinez, the LA City Council president, in a press release. “We must normalize this issue so that the next woman dealing with postpartum depression understands what is happening to her and that she is not alone.”

The new motion in the legislative package would mandate that the LADPH, city staff and the Hospital Association of Southern California report the implementation of Brown’s legislation to the LA City Council, said Paul Koretz, an LA City Council member and a co-author of the legislation, in an emailed statement.

Koretz added that the motion will also establish an information campaign on perinatal depression and mental health and will require health plans to cover a telehealth consultation for pregnant women and those who are one year postpartum.

“We insist that mothers should be beaming and full of joy, without considering the immense physical, psychological and social changes that parents, and particularly new mothers, are grappling with,” Koretz said, referencing Liliana Carrillo, a mother in LA who experienced postpartum psychosis and is charged with killing her three children last month.

The legislative package, which cites the Carrillo case, also specifies the need to increase access to perinatal mental health services for low-income and immigrant mothers as well as communities of color.

Carolyn Ponting, a doctoral student whose research focuses on prenatal anxiety and depression interventions for racial and ethnic minority women, said postpartum depression can be more common among women who come from marginalized communities.

African American and Hispanic women are roughly twice as likely to experience postpartum depression symptoms than white women because of lower levels of social support and limited access to medical providers, according to a study conducted by researchers in the Mount Sinai Health System.

Ponting said one of the leading predictors of postpartum depression is prenatal depression and prenatal anxiety.

“One of the big shifts that we need to see in maternal mental health is a greater focus on anxiety and not just depression,” she said.

Ponting said she supports the city’s efforts to implement AB 935 because of its emphasis on earlier overall mental health screenings.

Constance Hammen, a psychology professor at UCLA whose research focuses on depression, said more work needs to be done to bring mental health resources and public health announcements to marginalized communities.

“Experts, whose messages (marginalized communities) will adhere to or believe in, could be people of faith or community activists,” Hammen said. “Medical professionals may or may not be in those positions.”

Ponting said health practitioners must become better acquainted with cultural beliefs about pregnancy and motherhood to prevent postpartum depression.

“We can get better targeted at reducing stigma if we have a sense of what the culturally specific stigmas are,” Ponting said.

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