Alabama lawmakers are advancing legislation that would require healthcare professionals to assess women for postpartum depression, a move supporters say will help promptly identify and address maternal mental health concerns many women face after giving birth.

Senate Bill 191 (SB191), sponsored by Sen. Vivian Figures (D-Mobile), and House Bill 322 (HB322), introduced by Rep. Frances Holk-Jones (R-Foley), have now both cleared the Senate and House healthcare committees. The House version of the bill is set for a full vote on March 18.

The proposed legislation mandates postpartum depression screening as part of postnatal and pediatric care but does not dictate specific treatments. Healthcare professionals would be required to assess new mothers for signs of postpartum depression while still maintaining professional discretion in recommending treatments.

Additionally, the Alabama Department of Public Health (ADPH) would be responsible for developing educational materials on postpartum depression for both healthcare providers and parents. These resources, which will outline symptoms, risk factors, and available treatments, must be made available on the ADPH website. Hospitals would be required to distribute this information to parents or family members upon a newborn’s discharge.

Initially, both bills included provisions prohibiting Alabama Medicaid from enforcing “step therapy” protocols for postpartum depression medications, ensuring that patients would not have to try lower-cost medications before accessing more expensive treatments. However, Alabama Medicaid Commissioner Stephanie Azar preemptively removed the step therapy requirement, a change that took effect on March 1. As a result, those provisions were removed from the bills.

The bills have so far received bipartisan support but not without some opposition.

Sen. Larry Stutts (R-Tuscumbia), an obstetrician-gynecologist, voted against SB191 in committee, arguing that doctors already screen for postpartum depression and that legislative mandates are unnecessary.

“We don’t have a bill that says you have to check blood pressure or weigh a patient when they come in for an appointment. That is just part of their care,” Stutts said. “I am not against screening mothers for postpartum depression—I’ve done it thousands of times—but I don’t think this should be a legislative issue.”

Sen. Figures refuted Stutts’ stance, emphasizing the importance of standardized screening.

“As we know, there are stories, and there’s data out there of women who have gone through postpartum depression,” said Figures. “They were not diagnosed, and their doctor did not screen them. Their doctor did not ask them those questions and ended up killing their children, the baby, and themselves. There are so many stories out there. I always say it is best to be safe than sorry. We cannot say that everybody does anything. There are some doctors who don’t necessarily ask these questions.”

According to the Centers for Disease Control and Prevention (CDC), a 2018 survey found that 13% of new mothers reported postpartum depressive symptoms. Additionally, one in five women said they were not asked about depression before birth, while one in eight reported not being screened at all during postpartum visits.

Rep. Holk-Jones stressed that Alabama faces a higher-than-average rate of postpartum depression.

“Over 9,000 moms in our state suffer from this condition—that’s nearly one in five new mothers. compared to the national average of one in seven,” she stated. “If left untreated, postpartum depression increases long-term healthcare costs and can negatively affect the development of a child.”

According to the Public Affairs Research Council of Alabama (PARCA),  PPD has a wide-reaching effect in Alabama. as evidenced by the study on the Safer Birth in Bama website.

• Nearly 10,000 women in Alabama experienced PPD in 2023
• The total estimated cost of PPD in Alabama in 2023 is over $350 million
• The economic impact of PPD extends over a period of six years

Supporters argue that the legislation is necessary to address maternal mental health, while opponents remain concerned about adding regulatory requirements to healthcare practices. Regardless of the outcome, the debate highlights the growing recognition of the importance of mental health care for new mothers in Alabama.

Sherri Blevins is a writer for Mountain Valley News and a staff writer for Yellowhammer News. You may contact her at [email protected].