II 

117TH CONGRESS 

2D SESSION S. 5284 

To improve the public health response to addressing maternal mortality and 

morbidity during the COVID–19 public health emergency. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 15, 2022 

Ms. WARREN (for herself, Mr. BOOKER, Mrs. GILLIBRAND, and Ms. SMITH) 

introduced the following bill; which was read twice and referred to the 

Committee on Health, Education, Labor, and Pensions 

A BILL 

To improve the public health response to addressing maternal 

mortality and morbidity during the COVID–19 public 

health emergency. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Maternal Health Pan5 demic Response Act of 2022’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) The World Health Organization declared 

9 COVID–19 a ‘‘Public Health Emergency of InterVerDate Sep 11 2014 15:53 Dec 29, 2022 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S5284.IS S5284

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1 national Concern’’ on January 30, 2020. As of De2 cember 12, 2022, there have been over 643,875,000 

3 confirmed cases of, and over 6,630,000 deaths asso4 ciated with, COVID–19 worldwide. 

5 (2) In the United States, the number of cases 

6 of COVID–19 has quickly surpassed the number of 

7 such cases in every other nation, and as of Decem8 ber 12, 2022, over 99,000,000 cases and 1,080,000 

9 deaths have been reported by the United States 

10 alone. 

11 (3) Longstanding systemic health and social in12 equities have put communities of color at increased 

13 risk of contracting COVID–19 or experiencing se14 vere illness; age-adjusted hospitalization rates from 

15 COVID–19 are highest for American Indian and 

16 Alaska Native, Black, and Latinx people. 

17 (4) Prior to the start of the COVID–19 pan18 demic, the United States was facing a maternal mor19 tality and morbidity crisis, in which the United 

20 States has the highest maternal mortality rate in the 

21 developed world, and the crisis is worsening. 

22 (5) More than 50,000 women in the United 

23 States annually experience severe maternal mor24 bidity, and much larger numbers experience more 

25 common harmful challenges, such as prenatal and 


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1 postpartum mood disorders, including depression, 

2 anxiety disorder, and PTSD; limited access to pre3 natal and postpartum care, diagnosis, and treatment 

4 of complications; intimate partner violence; and lack 

5 of support for meeting breastfeeding goals. Many 

6 perinatal complications are preventable or treatable, 

7 and most injuries, long-term adverse effects, and 

8 deaths are preventable. 

9 (6) Compared to White women, Black and 

10 American Indian and Alaska Native women in the 

11 United States are 2 to 4 times more likely to die 

12 from pregnancy-related complications, and Black 

13 and American Indian and Alaska Native women suf14 fer disproportionately high rates of maternal mor15 bidity. The maternal mortality rate for Hispanic 

16 women, which historically has been lower than such 

17 rate for White women, is increasing and is now 

18 nearly the same as that of White women. 

19 (7) The causes of maternal mortality and mor20 bidity are complex and include racial, ethnic, socio21 economic, and geographic inequities; racism, bias, 

22 and discrimination; comorbidities; and inadequate 

23 access to the health care system, including behav24 ioral health care, which are factors that have simiVerDate Sep 11 2014 15:53 Dec 29, 2022 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S5284.IS S5284

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1 larly contributed to the racial disparities seen in 

2 COVID–19 outcomes. 

3 (8) The burden of morbidity and mortality in 

4 the United States for both COVID–19 and maternal 

5 health outcomes has also fallen disproportionately on 

6 Black, Latinx, and American Indian and Alaska Na7 tive communities, who suffer the most from great 

8 public health needs and are the most medically un9 derserved. Underserved women also include those liv10 ing in maternity care deserts, which lack obstetric 

11 providers and hospitals or birth centers offering ob12 stetric care. 

13 (9) According to the Centers for Disease Con14 trol and Prevention, ‘‘pregnant and recently preg15 nant people with COVID–19 are at increased risk 

16 for severe illness when compared with non-pregnant 

17 people’’. Additionally, ‘‘pregnant people with 

18 COVID–19 are also at increased risk for preterm 

19 birth and some data suggest an increased risk for 

20 other adverse pregnancy complications and out21 comes, such as preeclampsia, coagulopathy, and still22 birth, compared with pregnant people without 

23 COVID–19’’. Research has also shown that COVID– 

24 19 infection during pregnancy may increase the risk 

25 of preeclampsia; having preeclampsia and other 


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1 pregnancy complications also increases the risks of 

2 serious COVID–19 infection. 

3 (10) As of December 2022, the latest informa4 tion from the Centers for Disease Control and Pre5 vention indicates that pregnant women are more 

6 likely to be hospitalized and are at higher risk for 

7 intensive care unit admissions than nonpregnant 

8 women due to COVID–19, and Latinx and Black 

9 pregnant people have been disproportionately in10 fected by COVID–19, as well as more likely to expe11 rience severe disease. 

12 (11) Our understanding of the specific impact 

13 of COVID–19 on pregnant people has grown signifi14 cantly. Pregnant and newly delivered women are 

15 more susceptible to serious infection from COVID– 

16 19, a direct impact. In addition, the COVID–19 

17 pandemic has further strained the health care sys18 tem and decreased access to preconception, prenatal, 

19 and postpartum care. The lack of access to care, in20 cluding mental health care, increases the risks of 

21 maternal mortality and morbidity, pregnancy loss, 

22 and infant mortality. It has also added another layer 

23 of fear and vulnerability for pregnant people, with 

24 disproportionate effects on people of color. 


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1 (12) As of March 7, 2022, over 180,000 preg2 nant people in the United States have tested positive 

3 for COVID–19 and 293 pregnant people have died 

4 as a result of COVID–19. 

5 (13) The World Health Organization states 

6 that everyone ‘‘has the right to safe and positive 

7 childbirth experience, whether or not they have a 

8 confirmed COVID–19 infection, this includes the 

9 right to respect and dignity, a companion of choice, 

10 clear communication by maternity staff, pain relief 

11 strategies, and mobility in labor when possible and 

12 the position of choice’’. 

13 (14) A COVID–19 public health response with14 out concerted Federal action and focus on maternal 

15 health care access and quality, research, data collec16 tion, mitigation of negative socioeconomic con17 sequences of the pandemic, and protection of the 

18 right to safe and positive childbirth experience has 

19 exacerbated the maternal mortality and morbidity 

20 crisis. Risk has also increased for pregnant women 

21 who have not been provided with a continuum of re22 spectful, responsive, and empowering care from pre23 conception through postpartum, during the pan24 demic and beyond. 


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1 SEC. 3. DEFINITIONS. 

2 In this Act: 

3 (1) COVID–19 PUBLIC HEALTH EMERGENCY.— 

4 The term ‘‘COVID–19 public health emergency’’ 

5 means the period beginning on the date that the 

6 public health emergency declared by the Secretary of 

7 Health and Human Services under section 319 of 

8 the Public Health Service Act (42 U.S.C. 247d) on 

9 January 31, 2020, with respect to COVID–19 took 

10 effect, and ending on the later of the end of such 

11 public health emergency or January 1, 2023. 

12 (2) CULTURALLY CONGRUENT.—The term ‘‘cul13 turally congruent’’, with respect to care or maternity 

14 care, means care that is anti-racist and is in agree15 ment with the preferred cultural values, beliefs, 

16 worldview, and practices of the health care consumer 

17 and other stakeholders. 

18 (3) INDIAN TRIBE, TRIBAL ORGANIZATION, AND

19 URBAN INDIAN ORGANIZATION.—The terms ‘‘Indian 

20 Tribe’’ and ‘‘Tribal organization’’ have the meanings 

21 given the terms ‘‘Indian tribe’’ and ‘‘tribal organiza22 tion’’, respectively, in section 4 of the Indian Self23 Determination and Education Assistance Act (25 

24 U.S.C. 5304), and the term ‘‘urban Indian organiza25 tion’’ has the meaning given such term in section 4 


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1 of the Indian Health Care Improvement Act (25 

2 U.S.C. 1603). 

3 (4) MATERNAL MORTALITY.—The term ‘‘mater4 nal mortality’’ means a death occurring during preg5 nancy or within one year of the end of pregnancy, 

6 from a pregnancy complication, a chain of events 

7 initiated by pregnancy, or the aggravation of an un8 related condition by the physiologic effects of preg9 nancy. 

10 (5) POSTPARTUM.—The term ‘‘postpartum’’ 

11 means the 1-year period beginning on the last day 

12 of a person’s pregnancy. 

13 (6) RESPECTFUL MATERNITY CARE.—The term 

14 ‘‘respectful maternity care’’ means care organized 

15 for, and provided to, all pregnant and postpartum 

16 people in a manner that— 

17 (A) is culturally congruent and linguis18 tically appropriate; 

19 (B) maintains a person’s dignity, privacy, 

20 and confidentiality; 

21 (C) ensures freedom from harm and mis22 treatment; and 

23 (D) enables informed choice and contin24 uous support during labor, childbirth, and 

25 postpartum. 


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1 (7) SECRETARY.—The term ‘‘Secretary’’ means 

2 the Secretary of Health and Human Services. 

3 (8) SEVERE MATERNAL MORBIDITY.—The term 

4 ‘‘severe maternal morbidity’’ means an unexpected 

5 outcome caused by labor and delivery that results in 

6 significant short-term or long-term consequences to 

7 the health of the pregnant person. 

8 SEC. 4. EMERGENCY FUNDING FOR FEDERAL DATA COL9 LECTION, SURVEILLANCE, AND RESEARCH 

10 ON MATERNAL HEALTH OUTCOMES DURING 

11 THE COVID–19 PUBLIC HEALTH EMERGENCY 

12 OR A FUTURE PUBLIC HEALTH EMERGENCY. 

13 To conduct or support data collection, surveillance, 

14 and research on maternal health as a result of the 

15 COVID–19 public health emergency or a future public 

16 health emergency, including support to assist in the capac17 ity building for State, Tribal, territorial, and local public 

18 health departments to collect and transmit racial, ethnic, 

19 and other demographic data related to maternal health, 

20 there are authorized to be appropriated— 

21 (1) $100,000,000 for the Surveillance for 

22 Emerging Threats to Mothers and Babies program 

23 of the Centers for Disease Control and Prevention, 

24 to support the Centers for Disease Control and Pre25 vention in its efforts to— 


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1 (A) work with public health, clinical, and 

2 community-based organizations to provide time3 ly, continually updated guidance to families and 

4 health care providers on ways to reduce health 

5 risks to mothers and babies and tailor interven6 tions to improve their long-term health; 

7 (B) partner with more State, Tribal, terri8 torial, and local public health programs in the 

9 collection and analysis of clinical data on the 

10 impact of COVID–19 and future public health 

11 emergencies on pregnant and postpartum pa12 tients and their newborns, including among 

13 pregnant people of color; and 

14 (C) establish regionally based centers of 

15 excellence to offer medical, public health, and 

16 other knowledge to ensure communities, espe17 cially communities of color, rural communities, 

18 and other underserved communities can help 

19 pregnant and postpartum patients and infants 

20 get the care they need; 

21 (2) $30,000,000 for the Enhancing Reviews 

22 and Surveillance to Eliminate Maternal Mortality 

23 program (commonly known as the ‘‘ERASE MM 

24 program’’) of the Centers for Disease Control and 

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1 trol and Prevention in expanding its partnerships 

2 with States and Indian Tribes and provide technical 

3 assistance to existing Maternal Mortality Review 

4 Committees; 

5 (3) $45,000,000 for the Pregnancy Risk As6 sessment Monitoring System (commonly known as 

7 the ‘‘PRAMS’’) of the Centers for Disease Control 

8 and Prevention, to support the Centers for Disease 

9 Control and Prevention in its efforts to— 

10 (A) create a COVID–19 supplement to its 

11 PRAMS questionnaire; 

12 (B) add questions around experiences of 

13 respectful, responsive, and empowering mater14 nity care in prenatal, intrapartum, and 

15 postpartum care; 

16 (C) conduct a rapid assessment of 

17 COVID–19 awareness, impact on care and ex18 periences, and use of preventive measures 

19 among pregnant, laboring and birthing, and 

20 postpartum people during the COVID–19 pub21 lic health emergency; and 

22 (D) work to transition the survey to an 

23 electronic platform and expand the survey to a 

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1 served communities, and with sensitivity to in2 dividuals who lack access to such a platform; 

3 and 

4 (4) $15,000,000 for the National Institute of 

5 Child Health and Human Development, to conduct 

6 or support research for interventions to mitigate the 

7 effects of the COVID–19 public health emergency on 

8 pregnant and postpartum people, including Black, 

9 Latinx, Asian-American and Pacific Islander, and 

10 American Indian and Alaska Native people, as well 

11 as people living in areas with limited maternity care. 

12 SEC. 5. COVID–19 MATERNAL HEALTH DATA COLLECTION 

13 AND DISCLOSURE. 

14 (a) DATA COLLECTION.—The Secretary, acting 

15 through the Director of the Centers for Disease Control 

16 and Prevention and the Administrator of the Centers for 

17 Medicare & Medicaid Services, shall make publicly avail18 able, on the website of the Centers for Disease Control 

19 and Prevention, pregnancy and postpartum data collected 

20 across all surveillance systems relating to COVID–19, 

21 disaggregated by race, ethnicity, primary language, dis22 ability status, gender identity, sexual orientation, immi23 gration status, insurance status, and State and Tribal lo24 cation, including the following: 


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1 (1) Data related to all COVID–19 diagnostic 

2 testing, including the number of pregnant people 

3 and postpartum people tested and the number of 

4 positive cases. 

5 (2) Data related to all suspected cases of 

6 COVID–19 in pregnant, birthing, and postpartum 

7 people who did not undergo testing. 

8 (3) Data related to all COVID–19 serologic 

9 testing, including the number of pregnant and 

10 postpartum people tested and the number of such 

11 serologic tests that were positive. 

12 (4) Data related to treatment for COVID–19, 

13 including hospitalizations, emergency room, and in14 tensive care unit admissions of pregnant, birthing, 

15 and postpartum people related to COVID–19. 

16 (5) Data related to COVID–19 outcomes, in17 cluding total fatalities and case fatality (expressed 

18 as the proportion of people who were infected with 

19 COVID–19 and died from the virus) of pregnant 

20 and postpartum people. 

21 (6) Data related to pregnancy and infant health 

22 outcomes for pregnant people with confirmed or sus23 pected COVID–19, which may include stillbirths, 

24 maternal mortality and morbidity, infant mortality, 


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1 preterm births, low-birth weight infants, and cesar2 ean section births. 

3 (7) Data related to all long-term effects of 

4 COVID–19 related to cases contracted during the 

5 pregnancy or postpartum period. 

6 (b) TIMELINE.—The Secretary shall update the data 

7 made available under this section not less frequently than 

8 monthly, during the COVID–19 public health emergency 

9 and for at least one month after the end of the COVID– 

10 19 public health emergency. 

11 (c) PRIVACY.—In publishing data under this section, 

12 the Secretary shall take all necessary steps to protect the 

13 privacy of people whose information is included in such 

14 data, including by complying with— 

15 (1) privacy protections under the regulations 

16 promulgated under section 264(c) of the Health In17 surance Portability and Accountability Act of 1996 

18 (42 U.S.C. 1320d–2 note); and 

19 (2) protections from all inappropriate internal 

20 use by an entity that collects, stores, or receives the 

21 data, including use of such data in determinations of 

22 eligibility (or continued eligibility) in health plans, 

23 and from inappropriate uses. 

24 (d) INDIAN HEALTH SERVICE.—The Director of the 

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1 ease Control and Prevention shall consult with Indian 

2 Tribes and confer with urban Indian organizations on data 

3 collection and reporting for purposes of this section. 

4 (e) DATA COLLECTION GUIDANCE.—The Secretary 

5 shall issue guidance to States and local public health de6 partments to ensure that all relevant demographic data, 

7 including pregnancy and postpartum status, are collected 

8 and included when sending COVID–19 testing specimen 

9 to laboratories, and State and local health departments 

10 and Indian Tribes are disaggregating data on COVID–19 

11 status in data on maternal and infant morbidity and mor12 tality. The Secretary shall ensure that the guidance is de13 veloped in consultation with Indian Tribes to ensure that 

14 it includes Tribally developed best practices on reducing 

15 misclassification of American Indian and Alaska Native 

16 people in Federal, State, and local public health surveil17 lance systems. 

18 SEC. 6. PUBLIC HEALTH COMMUNICATION REGARDING MA19 TERNAL CARE DURING COVID–19. 

20 (a) PUBLIC HEALTH CAMPAIGN.—The Director of 

21 the Centers for Disease Control and Prevention shall un22 dertake a robust public health education effort to enhance 

23 access by pregnant people, their employers, and their pro24 viders to accurate, evidence-based health information 

25 about COVID–19 and pregnancy, safety, and risk, with 


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1 a particular focus on reaching pregnant and postpartum 

2 people in underserved communities. 

3 (b) EMERGENCY TEMPORARY STANDARD.— 

4 (1) IN GENERAL.—In consideration of the grave 

5 risk presented by COVID–19 and the need to 

6 strengthen protections for employees, pursuant to 

7 section 6(c)(1) of the Occupational Safety and 

8 Health Act of 1970 (29 U.S.C. 655(c)(1)) and not9 withstanding the provisions of law and the executive 

10 order described in paragraph (3), not later than 7 

11 days after the date of enactment of this Act, the 

12 Secretary of Labor shall promulgate an emergency 

13 temporary standard to protect all employees at occu14 pational risk from occupational exposure to SARS– 

15 CoV–2. 

16 (2) PREGNANT AND POSTPARTUM EMPLOY17 EES.—The emergency temporary standard promul18 gated under this subsection shall include consider19 ation of the risks and needs specific to pregnant and 

20 postpartum employees. 

21 (3) INAPPLICABLE PROVISIONS OF LAW AND

22 EXECUTIVE ORDER.—The requirements of chapter 6 

23 of title 5, United States Code (commonly referred to 

24 as the ‘‘Regulatory Flexibility Act’’), subchapter I of 

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1 monly referred to as the ‘‘Paperwork Reduction 

2 Act’’), the Unfunded Mandates Reform Act of 1995 

3 (2 U.S.C. 1501 et seq.), and Executive Order 12866 

4 (58 Fed. Reg. 190; relating to regulatory planning 

5 and review) shall not apply to the standard promul6 gated under this subsection. 

7 (c) TASK FORCE ON BIRTHING EXPERIENCE AND

8 SAFE, RESPECTFUL, RESPONSIVE, AND EMPOWERING

9 MATERNITY CARE DURING PANDEMICS AND OTHER PUB10 LIC HEALTH EMERGENCIES.— 

11 (1) ESTABLISHMENT.—The Secretary, in con12 sultation with the Director of the Centers for Dis13 ease Control and Prevention and the Administrator 

14 of the Health Resources and Services Administra15 tion, shall convene a task force to develop Federal 

16 recommendations regarding respectful, responsive, 

17 and empowering maternity care, including safe birth 

18 care and postpartum care, during public health 

19 emergencies. 

20 (2) DUTIES.—The task force established under 

21 paragraph (1) shall develop, publicly post, and up22 date Federal recommendations in multiple languages 

23 to ensure quality, provide nondiscriminatory mater24 nity care, promote positive birthing experiences, and 

25 improve maternal health outcomes during the 


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1 COVID–19 public health emergency and future pub2 lic health emergencies, with a particular focus on 

3 outcomes for communities of color and rural popu4 lations. Such guidelines and recommendations 

5 shall— 

6 (A) address, with particular attention to 

7 ensuring equitable treatment on the basis of 

8 race and ethnicity— 

9 (i) measures to facilitate respectful, 

10 responsive, and empowering maternity 

11 care; 

12 (ii) measures to facilitate telehealth 

13 maternity care for pregnant people who 

14 cannot regularly access in-person care; 

15 (iii) strategies to increase access to 

16 specialized care for those with high-risk 

17 pregnancies or pregnant individuals with 

18 elevated risk factors; 

19 (iv) diagnostic testing for pregnant 

20 and laboring patients; 

21 (v) birthing without one’s chosen com22 panions, with one’s chosen companions, 

23 and with smartphone or other telehealth 

24 connection to one’s chosen companions; 


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1 (vi) newborn separation after birth in 

2 relation to maternal infection status; 

3 (vii) breast milk feeding in relation to 

4 maternal infection status; 

5 (viii) licensure, training, scope of 

6 practice, and Medicaid and other insurance 

7 reimbursement for certified midwives, cer8 tified nurse-midwives, certified professional 

9 midwives, in a manner that facilitates in10 clusion of midwives of color and midwives 

11 from underserved communities; 

12 (ix) financial support and training for 

13 perinatal health workers who provide non14 clinical support to people from pregnancy 

15 through the postpartum period, such as a 

16 doula, community health worker, peer sup17 porter, lactation consultant, nutritionist or 

18 dietitian, social worker, home visitor, or a 

19 patient navigator in a manner that facili20 tates inclusion from underserved commu21 nities; 

22 (x) strategies to ensure and expand 

23 doula coverage under State Medicaid pro24 grams; 


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1 (xi) how to identify, address, and 

2 treat prenatal and postpartum mental and 

3 behavioral health conditions, such as anx4 iety, substance use disorder, and depres5 sion, which may have arisen or increased 

6 during the COVID–19 public health emer7 gency, and how to mitigate the impact of 

8 future public health emergencies on mater9 nal mental health; 

10 (xii) how to identify and address in11 stances of intimate partner violence during 

12 pregnancy which may arise or intensify 

13 during public health emergencies, and how 

14 to mitigate the impact of future public 

15 health emergencies on maternal mental 

16 health; 

17 (xiii) strategies to address hospital ca18 pacity concerns in communities with a 

19 surge in infectious disease cases and to 

20 provide childbearing people with options 

21 that reduce potential for cross-contamina22 tion and increase the ability to implement 

23 their care preferences while maintaining 

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1 iliary maternity units and freestanding 

2 birth centers; 

3 (xiv) provision of child care services 

4 during prenatal appointments for mothers 

5 whose children are unable to attend as a 

6 result of restrictions relating to the public 

7 health emergencies; 

8 (xv) how to identify and address rac9 ism, bias, and discrimination in the deliv10 ery treatment and support to pregnant and 

11 postpartum people, including evaluating 

12 the value of training for hospital staff on 

13 implicit bias and racism, respectful, re14 sponsive, and empowering maternity care, 

15 and demographic data collection; 

16 (xvi) how to address the needs of un17 documented pregnant women and new 

18 mothers who may be afraid or unable to 

19 seek needed care during the COVID–19 

20 public health emergency; 

21 (xvii) how to address the needs of un22 insured pregnant women who have histori23 cally relied on emergency departments for 

24 care; 


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1 (xviii) how to identify women at risk 

2 for depression, anxiety disorder, psychosis, 

3 obsessive-compulsive disorder, and other 

4 maternal mood disorders before, during, 

5 and after pregnancy, and how to treat 

6 those diagnosed with a postpartum mood 

7 disorder; 

8 (xix) how to effectively and compas9 sionately screen for substance abuse during 

10 pregnancy and postpartum and help moms 

11 find support and effective treatment; and 

12 (xx) such other matters as the task 

13 force determines appropriate; 

14 (B) identify barriers to the implementation 

15 of the guidelines and recommendations; 

16 (C) take into consideration existing State 

17 and other programs that have demonstrated ef18 fectiveness in addressing pregnancy, birth, and 

19 postpartum care during the COVID–19 public 

20 health emergency; and 

21 (D) identify policies specific to COVID–19 

22 that should be discontinued when safely possible 

23 and those that should be continued as the pub24 lic health emergency abates. 


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1 (3) MEMBERSHIP.—The task force established 

2 under paragraph (1) shall be comprised of— 

3 (A) representatives of the Department of 

4 Health and Human Services, including rep5 resentatives of— 

6 (i) the Secretary; 

7 (ii) the Director of the Centers for 

8 Disease Control and Prevention; 

9 (iii) the Administrator of the Health 

10 Resources and Services Administration; 

11 (iv) the Administrator of the Centers 

12 for Medicare & Medicaid Services; 

13 (v) the Director of the Agency for 

14 Healthcare Research and Quality; and 

15 (vi) the Director of the Indian Health 

16 Service; 

17 (B) at least 3 State, local, or territorial 

18 public health officials representing departments 

19 of public health, who shall represent jurisdic20 tions from different regions of the United 

21 States with relatively high concentrations of 

22 historically marginalized populations, to be ap23 pointed by the Secretary; 

24 (C) at least 1 Tribal public health official 

25 representing departments of public health; 


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1 (D) 1 or more representatives of a commu2 nity-based organization that addresses adverse 

3 maternal health outcomes with a specific focus 

4 on racial and ethnic inequities in maternal 

5 health outcomes, appointed by the Secretary, 

6 with special consideration given to organizations 

7 led by a person of color or from communities 

8 with significant minority populations; 

9 (E) 1 or more obstetrician-gynecologist or 

10 other physician who provides obstetric care, 

11 with special consideration for physicians who 

12 are from, or work in, communities experiencing, 

13 or that have experienced, the highest rates of 

14 COVID–19 mortality and morbidity; 

15 (F) 1 or more nurse, such as a certified 

16 nurse-midwife, women’s health nurse practi17 tioner, or other nurse who provides obstetric 

18 care, with special consideration for nurses who 

19 are from, or work in, communities experiencing, 

20 or that have experienced, the highest rates of 

21 COVID–19 mortality and morbidity; 

22 (G) 1 or more perinatal health workers 

23 who provide non-clinical support to people from 

24 pregnancy through postpartum period, such as 

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1 porter, lactation consultant, nutritionist or die2 titian, social worker, home visitor, or patient 

3 navigator; 

4 (H) 1 or more patients who were pregnant 

5 or gave birth during the COVID–19 public 

6 health emergency; 

7 (I) 1 or more patients who contracted 

8 COVID–19 and later gave birth; 

9 (J) 1 or more patients who have received 

10 support from a perinatal health worker who 

11 provides prenatal and postpartum support, such 

12 as a doula, community health worker, peer sup13 porter, lactation consultant, nutritionist or die14 titian, social worker, home visitor, or a patient 

15 navigator, or a spouse or family member of 

16 such patient; and 

17 (K) racially and ethnically diverse rep18 resentation from at least 3 independent experts 

19 with knowledge or field experience with racial 

20 and ethnic disparities in public health, women’s 

21 health, or maternal mortality and severe mater22 nal morbidity. 


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1 SEC. 7. GAO REPORT ON MATERNAL HEALTH AND PUBLIC 

2 HEALTH EMERGENCY PREPAREDNESS. 

3 Not later than 1 year after the end of the public 

4 health emergency declared by the Secretary of Health and 

5 Human Services under section 319 of the Public Health 

6 Service Act (42 U.S.C. 247d) on January 31, 2020, with 

7 respect to COVID–19, the Comptroller General of the 

8 United States shall submit to the appropriate committees 

9 of Congress a report on maternal health and public health 

10 emergency preparedness, including prenatal, labor and de11 livery, and postpartum care during the COVID–19 public 

12 health emergency, including the following: 

13 (1) A review of the prenatal, labor and delivery, 

14 and postpartum experiences of people during the 

15 COVID–19 public health emergency, which shall— 

16 (A) identify barriers to accessing pre17 conception, pregnancy, birth, and postpartum 

18 care during a pandemic, including maternal be19 havioral health care; 

20 (B) assess the extent to which public and 

21 private insurers were providing coverage for 

22 maternal health care during the public health 

23 emergency, including for telehealth services and 

24 out-of-hospital births; 

25 (C) review the impact of the continuous 

26 enrollment condition included in the Families 


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•S 5284 IS

1 First Coronavirus Response Act (Public Law 

2 116–127) had on enrollment of postpartum peo3 ple in State Medicaid programs and analyze 

4 health care services utilized by this population 

5 in the postpartum period; 

6 (D) to the extent practicable, analyze ma7 ternal and infant health outcomes by race and 

8 ethnicity (including quality of care, mortality, 

9 morbidity, cesarean section rates, preterm birth, 

10 prevalence of prenatal and postpartum anxiety 

11 and depression, and other mood disorders) dur12 ing the COVID–19 public health emergency and 

13 the impact of Federal and State policy changes 

14 made in response to the COVID–19 pandemic 

15 on such outcomes; 

16 (E) identify contributors to population17 based disparities seen in COVID–19 outcomes, 

18 such as racial profiling of, and bias and dis19 crimination against, Black, American Indian 

20 and Alaska Native, Latinx, and Asian-American 

21 and Pacific Islander people; 

22 (F) review the impact of increased unem23 ployment, paid family leave, changes in health 

24 care coverage, and other social determinants of 

25 health for pregnant and postpartum people durVerDate Sep 11 2014 15:53 Dec 29, 2022 Jkt 039200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S5284.IS S5284

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•S 5284 IS

1 ing the public health emergency, including inti2 mate partner violence; and 

3 (G) assess the impact of the lack of inclu4 sion of pregnant and lactating people in clinical 

5 trials for COVID–19 therapeutics and vaccines. 

6 (2) Consultation with maternity care providers, 

7 maternal behavioral health care specialists, research8 ers who specialize in women’s health or maternal 

9 mortality and severe maternal morbidity, people who 

10 experienced pregnancy or childbirth during the 

11 COVID–19 public health emergency, representatives 

12 from community-based organizations that address 

13 maternal health, and perinatal health workers who 

14 provide nonclinical support to pregnant and 

15 postpartum people (such as a doula, community 

16 health worker, peer support, certified lactation con17 sultant, nutritionist or dietician, social worker, home 

18 visitor, or navigator). 

19 (3) Recommendations to improve the public 

20 health emergency response and preparedness efforts 

21 of the Federal Government specific to maternal 

22 health, with a particular focus on outcomes for mi23 nority women, including— 


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•S 5284 IS

1 (A) ways to improve research, surveillance, 

2 and data collection of the Federal Government 

3 related to maternal health; 

4 (B) ways for the Federal Government to 

5 factor maternal health outcomes and disparities 

6 into decisions regarding distribution of re7 sources, including COVID–19 tests, personal 

8 protective equipment, and emergency funding; 

9 (C) the extent to which guidelines and rec10 ommendations of the Federal Government re11 lated to maternal health care during the 

12 COVID–19 public health emergency were cul13 turally congruent and linguistically competent 

14 for minority women; 

15 (D) ways to improve the distribution of 

16 public health funds, data, and information to 

17 Indian Tribes and Tribal organizations with re18 gard to maternal health during public health 

19 emergencies; and 

20 (E) opportunities to incentivize or require 

21 sponsors to include safety data on pregnant and 

22 lactating people for therapeutics and vaccines in 

23 emergency use authorization submissions. 

Æ 


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