The nurse calls the police after women seek help with postpartum depression. Correct calls?
Four months later, her second child, Jessica botten, began to feel very upset. Little things will bother her, just like her glider chair.
“It started to creak,” she said. “So when I sat there shaking the baby, it squeaked, and I was just angry at that stupid chair.”
According to the American psychological association, she read online, irritability may be symptoms of postpartum depression – the situation during pregnancy or after pregnancy affect as many as 1/7 women. In the state of California, where Porten lives, these rates are even higher, spurring state lawmakers to introduce a package of bills to improve the mental health screening and treatment of new mothers.
He wants them to help women avoid what she’s going through.
She went to a women’s clinic in Sacramento, Capital OB/GYN, to accept her medical grant as payment, talking about drug selection and treatment. Ms. Boten admitted that the nurse said she had some violent thoughts.
“What I’m describing is probably hitting myself or pushing the baby too tight,” she said. “But on the whole date, I was very determined that I wouldn’t hurt myself or hurt my children.”
But the nurse’s attitude to her changed, she said. “I could see that she wouldn’t listen to me anymore,” Mr. Boten said.
The nurse called the police. The police escorted Porten and her baby to the emergency room. The hospital staff changed her into a robe and took away her purse, but they asked her to keep the diaper bag for the baby. Although the hospital staff were sympathetic, he said, they kept them in a room and kept looking.
“Like, everyone knows I’m not crazy,” she said. “Everyone knows it’s normal – but they’re following the deal.”
Finally, at midnight, 10 hours after her first visit to the doctor’s office, a social worker sent her home. Porten wrote on Facebook that the whole thing made her feel like a criminal.
“It’s perfectly legal,” Porten said. “Everyone is protecting their responsibilities, not thinking about me.”
The manager of Capital OB/GYN declined to comment. Sutter Health spokesman Gary Zavoral, who is in charge of Porten’s emergency room, said hospital staff must adhere to strict protocols once patients arrive in the emergency room for evaluation.
“The process is to make sure everyone is safe: personal safety, family security, employee safety,” he said. “It does take a few hours, so 10 hours is not uncommon.”
Dr. Melanie Thomas, a psychologist at the university of California, San Francisco and the zuck San Francisco general hospital, said that when patients quote violent thoughts, doctors think differently.
If California law is dangerous to itself or to others, it allows doctors to automatically limit people with mental disorders. But Thomas says the danger posed by imminent danger may be vague.
“You can imagine a provider, a social worker, can be any number of people in a different way to explain this phrase, about what is necessary, what is not,” she said.
Thomas says the legal and medical protocols are not always consistent. Sometimes, she felt compelled to rely on her clinical judgment for legal reasoning.
That’s one of the reasons Sacramento lawmakers are launching a series of bills specifically targeting maternal mental health. R-san Diego senator Brian Maienschein supports two of them. People need doctors to screen new mothers for depression; Under current law, this is voluntary.
“The Numbers here are very important, and I think that’s something that doctors really should know and should be ready for diagnosis and treatment,” he said. He added that the screening also “in this case education a woman, this is a problem that may affect her.”
Another bill from mason would guide the state to develop a new federal funding for post-natal planning and advocacy. It was established under the 21st century cures act, which was passed in the final months of the Obama administration.
“Getting federal money is a good thing,” said Maienschein. “This is federal money. I want to see California, not another state.”
“I went into the waiting room and saw a lot of medi-cal recipients – so they were all low income,” she said. “If I bring a lawsuit, it will only cause economic damage to facilities that are obviously short of resources.”
Instead, Porten said she would advocate a new California bill. She thinks it will help doctors and nurses in the clinic better help new mothers get the care they need.
“I won’t take it away,” she said. “I want to build it.”
The story is part of a collaboration between NPR and KQED and Kaiser health news.