[Congressional Record Volume 148, Number 48 (Thursday, April 25, 2002)]
[Senate]
[Pages S3437-S3438]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SMITH of New Hampshire (for himself, Mr. Inhofe, and Mr. 
        Ensign):
  S. 2271. A bill to provide for research on, and services for, 
individuals with post-abortion depression and psychosis; to the 
Committee on Health, Education, Labor and Pensions.
 Mr. SMITH of New Hampshire. Mr. President, I rise today, along 
with Senators Inhofe and Ensign, to introduce the Post-Abortion Support 
and Services Act.
  On November 1, 2001, the Senate unanimously passed an amendment I 
introduced to the Labor-HHS Appropriations bill recognizing the 
existence of post-abortion syndrome. The amendment encouraged the 
National Institute of Mental Health (NIMH) to ``expand and intensify 
research and related activities'' regarding this issue, and it is the 
first time that the United States Senate is on record acknowledging 
that post-abortion syndrome is a serious problem for American women.
  This bill is an extension of what has already passed the Senate, and 
provides the National Institutes of Health with Federal resources to 
research the emotional impact of abortion on women. The bill also 
creates a $1.5 million grant program to fund the development of 
treatment programs for women who suffer from post-abortion syndrome.
  What is post-abortion syndrome? Many people have never heard of it. 
Many others deny its existence.
  Post-abortion syndrome is characterized by one or more of the 
following symptoms: severe depression, guilt, eating disorders, anxiety 
and panic attacks, addictions, anniversary grief, nightmares, lower 
self-esteem, intense anger, suicidal urges, sexual problems or 
promiscuity, difficulty with relationships, and unexplained sadness.
  A new study from the prestigious British Medical Journal reports that 
women who abort a first pregnancy are at greater risk of subsequent 
long-term clinical depression compared to women who carry an unintended 
first pregnancy to term.
  Among the key findings: the association between abortion and 
subsequent depression persists over at least 8 years. Many other 
studies show similar findings, and more.
  Post-abortion syndrome is a treatable disorder if promptly diagnosed 
by a trained provider and attended to with a personalized regimen of 
care including social support, counseling, therapy, medication, and if 
necessary, hospitalization.
  A number of women who have undergone abortions also experience 
debilitating physical health problems such as infection, cervical 
tearing, infertility, excess bleeding, and death. Thus, the bill also 
seeks to study the physical repercussions of abortion as well.
  After 29 years of legalized abortion, it is time that we recognize 
the suffering that so many women have undergone by carefully examining 
the women's emotional and physical health following her abortion 
decision. We have a responsibility to understand what they are going 
through and how we can appropriately diagnose and treat them.
  It is my sincere hope that we can pass this bill and give our support 
to potentially millions of women across the country who suffer alone 
with their private and profound guilt and depression. Many women who 
choose abortion have previously aborted. If we are ever going to end 
abortion in America, we must reach out with love and compassion to 
women who deeply regret their decision to abort their children, not 
only to encourage them through their present struggles, but also to 
help them so they will not choose abortion for themselves again in the 
future.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2271

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Post-Abortion Support and 
     Services Act''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) About 3,000,000 women per year in the United States 
     have an unplanned or unwanted pregnancy, and approximately 
     1,186,000 of these pregnancies end in elective abortion.
       (2) Abortion can have severe and long-term effects on the 
     mental and emotional well-being of women. Women often 
     experience sadness and guilt following abortions with

[[Page S3438]]

     no one to console them. They may have difficulty in bonding 
     with new babies, become overprotective parents, or develop 
     problems in their relationships with their spouses. Problems 
     such as eating disorders, depression, and suicide attempts 
     have also been traced to past abortions.
       (3) Negative emotional reactions associated with abortion 
     include, depression, bouts of crying, guilt, intense grief or 
     sadness, emotional numbness, eating disorders, drug and 
     alcohol abuse, suicidal urges, anxiety and panic attacks, 
     anger, rage, sexual problems or promiscuity, lowered self 
     esteem, nightmares and sleep disturbances, flashbacks, and 
     difficulty with relationships.
       (4) Women who aborted a first pregnancy are four times more 
     likely to report substance abuse compared to those who 
     suffered a natural loss of their first pregnancy, and are 
     five times more likely to report subsequent substance abuse 
     than women who carried to term.
       (5) Research shows that the more women attempt to cope with 
     abortion using means of avoidance, mental disengagement, or 
     denial, the more likely the women are to report post-abortion 
     distress, intrusive thoughts, and dissatisfaction.
       (6) Women who experience a lack of social support and 
     strong feelings of ambivalence are statistically more likely 
     to suffer severe negative emotional reactions to an abortion.
       (7) Depression and other maladjustments to abortion can be 
     prolonged by the failure of the medical community, loved 
     ones, and society to recognize the complexity of post-
     abortion reactions.
       (8) Many women submit to an abortion in violation of their 
     own moral beliefs or maternal desires in order to satisfy the 
     demands of others.
       (9) Women who submit to an abortion because of social 
     pressure are more likely to suffer from psychological 
     distress in subsequent years.
       (10) Post-abortion depression is a treatable disorder if 
     promptly diagnosed by a trained provider and attended to with 
     a personalized regimen of care including social support, 
     therapy, medication, and when necessary, hospitalization.
       (11) While there have been many studies regarding the 
     emotional aftermath of abortion, very little research has 
     been sponsored by the National Institutes of Health.

      TITLE I--RESEARCH ON POST-ABORTION DEPRESSION AND PSYCHOSIS

     SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVITIES OF THE 
                   NATIONAL INSTITUTE OF MENTAL HEALTH.

       (a) In General.--
       (1) Post-abortion conditions.--The Secretary of Health and 
     Human Services, acting through the Director of NIH and the 
     Director of the National Institute of Mental Health (in this 
     section referred to as the ``Institute''), shall expand and 
     intensify research and related activities of the Institute 
     with respect to post-abortion depression and post-abortion 
     psychosis (in this section referred to as ``post-abortion 
     conditions'').
       (2) Additional conditions.--In addition to the post-
     abortion conditions under paragraph (1), the Secretary of 
     Health and Human Services, acting through the Director of the 
     National Institutes of Health, shall expand and intensify 
     research and related activities of the National Institutes of 
     Health with respect to the physical side effects of having an 
     abortion, including infertility, excessive bleeding, cervical 
     tearing, infection, and death.
       (b) Coordination With Other Institutes.--The Director of 
     the Institute shall coordinate the activities of the 
     Directors under subsection (a) with similar activities 
     conducted by the other national research institutes and 
     agencies of the National Institutes of Health to the extent 
     that such Institutes and agencies have responsibilities that 
     are related to post-abortion conditions.
       (c) Programs for Post-Abortion Conditions.--In carrying out 
     subsection (a), the Director of the Institute shall conduct 
     or support research to expand the understanding of the causes 
     of, and to find a cure for, post-abortion conditions. 
     Activities under such subsection shall include conducting and 
     supporting the following:
       (1) Basic research concerning the etiology of the 
     conditions.
       (2) Epidemiological studies to address the frequency and 
     natural history of the conditions and the differences among 
     racial and ethnic groups with respect to the conditions.
       (3) The development of improved diagnostic techniques.
       (4) Clinical research for the development and evaluation of 
     new treatments, including new biological agents.
       (5) Information and education programs for health care 
     professionals and the public.
       (d) Longitudinal Study.--
       (1) In general.--The Director of the Institute shall 
     conduct a national longitudinal study to determine the 
     incidence and prevalence of cases of post-abortion 
     conditions, and the symptoms, severity, and duration of such 
     cases, toward the goal of more fully identifying the 
     characteristics of such cases and developing diagnostic 
     techniques.
       (2) Report.--Beginning not later than 3 years after the 
     date of the enactment of this Act, and periodically 
     thereafter for the duration of the study under paragraph (1), 
     the Director of the Institute shall prepare and submit to the 
     Congress reports on the findings of the study.
       (e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $3,000,000 for each of the fiscal years 2002 
     through 2006.

 TITLE II--DELIVERY OF SERVICES REGARDING POST-ABORTION DEPRESSION AND 
                               PSYCHOSIS

     SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS.

       (a) In General.--The Secretary of Health and Human Services 
     (in this title referred to as the ``Secretary'') shall, in 
     accordance with this title, make grants to provide for 
     projects for the establishment, operation, and coordination 
     of effective and cost-efficient systems for the delivery of 
     essential services to individuals with post-abortion 
     depression or post-abortion psychosis (referred to in this 
     section as a ``post-abortion condition'') and their families.
       (b) Recipients of Grants.--A grant under subsection (a) may 
     be made to an entity only if the entity--
       (1) is a public or nonprofit private entity that may 
     include a State or local government, a public or nonprofit 
     private hospital, a community-based organization, a hospice, 
     an ambulatory care facility, a community health center, a 
     migrant health center, a homeless health center, or another 
     appropriate public or nonprofit private entity; and
       (2) had experience in providing the services described in 
     subsection (a) before the date of the enactment of this Act.
       (c) Certain Activities.--To the extent practicable and 
     appropriate, the Secretary shall ensure that projects under 
     subsection (a) provide services for the diagnosis and 
     management of post-abortion conditions. Activities that the 
     Secretary may authorize for such projects may also include 
     the following:
       (1) Delivering or enhancing outpatient and home-based 
     health and support services, including case management, 
     screening and comprehensive treatment services for 
     individuals with or at risk for post-abortion conditions, and 
     delivering or enhancing support services for their families.
       (2) Improving the quality, availability, and organization 
     of health care and support services (including transportation 
     services, attendant care, day or respite care, and providing 
     counseling on financial assistance and insurance) for 
     individuals with post-abortion conditions and support 
     services for their families.
       (d) Integration With Other Programs.--To the extent 
     practicable and appropriate, the Secretary shall integrate 
     the program under this title with other grant programs 
     carried out by the Secretary, including the program under 
     section 330 of the Public Health Service Act.
       (e) Limitation on Amount of Grants.--A grant under 
     subsection (a) for any fiscal year may not be made in an 
     amount exceeding $100,000.

     SEC. 202. CERTAIN REQUIREMENTS.

       A grant may be made under section 201 only if the applicant 
     involved makes the following agreements:
       (1) Not more than 5 percent of the grant will be used for 
     administration, accounting, reporting, and program oversight 
     functions.
       (2) The grant will be used to supplement and not supplant 
     funds from other sources related to the treatment of post-
     abortion conditions.
       (3) The applicant will abide by any limitations deemed 
     appropriate by the Secretary on any charges to individuals 
     receiving services pursuant to the grant. As deemed 
     appropriate by the Secretary, such limitations on charges may 
     vary based on the financial circumstances of the individual 
     receiving services.
       (4) The grant will not be expended to make payment for 
     services authorized under section 201(a) to the extent that 
     payment has been made, or can reasonably be expected to be 
     made, with respect to such services--
       (A) under any State compensation program, under an 
     insurance policy, or under any Federal or State health 
     benefits program; or
       (B) by an entity that provides health services on a prepaid 
     basis.
       (5) The applicant will, at each site at which the applicant 
     provides services under section 201(a), post a conspicuous 
     notice informing individuals who receive the services of any 
     Federal policies that apply to the applicant with respect to 
     the imposition of charges on such individuals.

     SEC. 203. TECHNICAL ASSISTANCE.

       The Secretary may provide technical assistance to assist 
     entities in complying with the requirements of this title in 
     order to make such entities eligible to receive grants under 
     section 201.

     SEC. 204. AUTHORIZATION OF APPROPRIATIONS.

       For the purpose of carrying out this title, there is 
     authorized to be appropriated $300,000 for each of fiscal 
     years 2002 through 2006.
                                 ______