117TH CONGRESS 

1ST SESSION S. 796 

AN ACT 

To codify maternity care coordination programs at the 

Department of Veterans Affairs, and for other purposes. 

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

2 This Act may be cited as the ‘‘Protecting Moms Who 

3 Served Act of 2021’’. 

4 SEC. 2. DEFINITIONS. 

5 In this Act: 

6 (1) MATERNAL MORTALITY.—The term ‘‘mater7 nal mortality’’ means a death occurring during preg8 nancy or within a one-year period after pregnancy 

9 that is caused by pregnancy-related or childbirth 

10 complications, including suicide, overdose, or other 

11 death resulting from a mental health or substance 

12 use disorder attributed to or aggravated by preg13 nancy-related or childbirth complications. 

14 (2) POSTPARTUM.—The term ‘‘postpartum’’, 

15 with respect to an individual, means the one-year pe16 riod beginning on the last day of the pregnancy of 

17 the individual. 

18 (3) PREGNANCY-ASSOCIATED DEATH.—The 

19 term ‘‘pregnancy-associated death’’ means the death 

20 of a pregnant or postpartum individual, by any 

21 cause, that occurs during pregnancy or within one 

22 year following pregnancy, regardless of the outcome, 

23 duration, or site of the pregnancy. 

24 (4) PREGNANCY-RELATED DEATH.—The term 

25 ‘‘pregnancy-related death’’ means the death of a 

26 pregnant or postpartum individual that occurs dur-
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1 ing pregnancy or within one year following preg2 nancy from a pregnancy complication, a chain of 

3 events initiated by pregnancy, or the aggravation of 

4 an unrelated condition by the physiologic effects of 

5 pregnancy. 

6 (5) RACIAL AND ETHNIC MINORITY GROUP.— 

7 The term ‘‘racial and ethnic minority group’’ has the 

8 meaning given that term in section 1707(g)(1) of 

9 the Public Health Service Act (42 U.S.C. 300u– 

10 6(g)(1)). 

11 (6) SEVERE MATERNAL MORBIDITY.—The term 

12 ‘‘severe maternal morbidity’’ means a health condi13 tion, including a mental health condition or sub14 stance use disorder, attributed to or aggravated by 

15 pregnancy or childbirth that results in significant 

16 short-term or long-term consequences to the health 

17 of the individual who was pregnant. 

18 SEC. 3. SUPPORT BY DEPARTMENT OF VETERANS AFFAIRS 

19 OF MATERNITY CARE COORDINATION. 

20 (a) PROGRAM ON MATERNITY CARE COORDINA21 TION.— 

22 (1) IN GENERAL.—The Secretary of Veterans 

23 Affairs shall carry out the maternity care coordina24 tion program described in Veterans Health Adminis25 tration Directive 1330.03. 
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1 (2) TRAINING AND SUPPORT.—In carrying out 

2 the program under paragraph (1), the Secretary 

3 shall provide to community maternity care providers 

4 training and support with respect to the unique 

5 needs of pregnant and postpartum veterans, particu6 larly regarding mental and behavioral health condi7 tions relating to the service of those veterans in the 

8 Armed Forces. 

9 (b) AUTHORIZATION OF APPROPRIATIONS.— 

10 (1) IN GENERAL.—There is authorized to be 

11 appropriated to the Secretary $15,000,000 for fiscal 

12 year 2022 for the program under subsection (a)(1). 

13 (2) SUPPLEMENT NOT SUPPLANT.—Amounts 

14 authorized under paragraph (1) are authorized in 

15 addition to any other amounts authorized for mater16 nity health care and coordination for the Depart17 ment of Veterans Affairs. 

18 (c) DEFINITIONS.—In this section: 

19 (1) COMMUNITY MATERNITY CARE PRO20 VIDERS.—The term ‘‘community maternity care pro21 viders’’ means maternity care providers located at 

22 non-Department facilities who provide maternity 

23 care to veterans under section 1703 of title 38, 

24 United States Code, or any other law administered 

25 by the Secretary of Veterans Affairs. 
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1 (2) NON-DEPARTMENT FACILITIES.—The term 

2 ‘‘non-Department facilities’’ has the meaning given 

3 that term in section 1701 of title 38, United States 

4 Code. 

5 SEC. 4. REPORT ON MATERNAL MORTALITY AND SEVERE 

6 MATERNAL MORBIDITY AMONG PREGNANT 

7 AND POSTPARTUM VETERANS. 

8 (a) GAO REPORT.—Not later than two years after 

9 the date of the enactment of this Act, the Comptroller 

10 General of the United States shall submit to the Com11 mittee on Veterans’ Affairs of the Senate and the Com12 mittee on Veterans’ Affairs of the House of Representa13 tives, and make publicly available, a report on maternal 

14 mortality and severe maternal morbidity among pregnant 

15 and postpartum veterans, with a particular focus on racial 

16 and ethnic disparities in maternal health outcomes for vet17 erans. 

18 (b) MATTERS INCLUDED.—The report under sub19 section (a) shall include the following: 

20 (1) To the extent practicable— 

21 (A) the number of pregnant and 

22 postpartum veterans who have experienced a 

23 pregnancy-related death or pregnancy-associ24 ated death in the most recent 10 years of avail25 able data; 
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1 (B) the rate of pregnancy-related deaths 

2 per 100,000 live births for pregnant and 

3 postpartum veterans; 

4 (C) the number of cases of severe maternal 

5 morbidity among pregnant and postpartum vet6 erans in the most recent year of available data; 

7 (D) an assessment of the racial and ethnic 

8 disparities in maternal mortality and severe ma9 ternal morbidity rates among pregnant and 

10 postpartum veterans; 

11 (E) identification of the causes of maternal 

12 mortality and severe maternal morbidity that 

13 are unique to veterans, including post-traumatic 

14 stress disorder, military sexual trauma, and in15 fertility or miscarriages that may be caused by 

16 service in the Armed Forces; 

17 (F) identification of the causes of maternal 

18 mortality and severe maternal morbidity that 

19 are unique to veterans from racial and ethnic 

20 minority groups and such other at-risk popu21 lations as the Comptroller General considers ap22 propriate; 

23 (G) identification of any correlations be24 tween the former rank of veterans and their 

25 maternal health outcomes; 
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1 (H) the number of veterans who have been 

2 diagnosed with infertility by a health care pro3 vider of the Veterans Health Administration 

4 each year in the most recent five years, 

5 disaggregated by age, race, ethnicity, sex, mar6 ital status, and geographical location; 

7 (I) the number of veterans who have re8 ceived a clinical diagnosis of unexplained infer9 tility by a health care provider of the Veterans 

10 Health Administration each year in the most 

11 recent five years; and 

12 (J) an assessment of the extent to which 

13 the rate of incidence of clinically diagnosed in14 fertility among veterans compare or differ to 

15 the rate of incidence of clinically diagnosed in16 fertility among the civilian population. 

17 (2) An assessment of the barriers to deter18 mining the information required under paragraph 

19 (1) and recommendations for improvements in track20 ing maternal health outcomes among pregnant and 

21 postpartum veterans who— 

22 (A) have health care coverage through the 

23 Department; 
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1 (B) are enrolled in the TRICARE program 

2 (as defined in section 1072 of title 10, United 

3 States Code); 

4 (C) have employer-based or private insur5 ance; 

6 (D) are enrolled in the Medicaid program 

7 under title XIX of the Social Security Act (42 

8 U.S.C. 1396 et seq.); 

9 (E) are eligible to receive health care fur10 nished by— 

11 (i) the Indian Health Service; 

12 (ii) Tribal health programs; or 

13 (iii) urban Indian organizations; or 

14 (F) are uninsured. 

15 (3) Recommendations for legislative and admin16 istrative actions to increase access to mental and be17 havioral health care for pregnant and postpartum 

18 veterans who screen positively for maternal mental 

19 or behavioral health conditions. 

20 (4) Recommendations to address homelessness, 

21 food insecurity, poverty, and related issues among 

22 pregnant and postpartum veterans. 

23 (5) Recommendations on how to effectively edu24 cate maternity care providers on best practices for 

25 providing maternity care services to veterans that 
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1 addresses the unique maternal health care needs of 

2 veteran populations. 

3 (6) Recommendations to reduce maternal mor4 tality and severe maternal morbidity among preg5 nant and postpartum veterans and to address racial 

6 and ethnic disparities in maternal health outcomes 

7 for each of the groups described in subparagraphs 

8 (A) through (F) of paragraph (2). 

9 (7) Recommendations to improve coordination 

10 of care between the Department and non-Depart11 ment facilities for pregnant and postpartum vet12 erans, including recommendations to improve— 

13 (A) health record interoperability; and 

14 (B) training for the directors of the Vet15 erans Integrated Service Networks, directors of 

16 medical facilities of the Department, chiefs of 

17 staff of such facilities, maternity care coordina18 tors, and staff of relevant non-Department fa19 cilities. 

20 (8) An assessment of the authority of the Sec21 retary of Veterans Affairs to access maternal health 

22 data collected by the Department of Health and 

23 Human Services and, if applicable, recommendations 

24 to increase such authority. 
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1 (9) To the extent applicable, an assessment of 

2 potential causes of or explanations for lower mater3 nal mortality rates among veterans who have health 

4 care coverage through the Department of Veterans 

5 Affairs compared to maternal mortality rates in the 

6 general population of the United States. 

7 (10) Any other information the Comptroller 

8 General determines appropriate with respect to the 

9 reduction of maternal mortality and severe maternal 

10 morbidity among pregnant and postpartum veterans 

11 and to address racial and ethnic disparities in ma12 ternal health outcomes for veterans. 

13 (c) DEFINITIONS.—In this section, the terms ‘‘Tribal 

14 health program’’ and ‘‘urban Indian organization’’ have 

15 the meanings given those terms in section 4 of the Indian 

16 Health Care Improvement Act (25 U.S.C. 1603). 

Passed the Senate October 7, 2021. 

Attest: 

Secretary. 

117TH CONGRESS 

1ST SESSION S. 796 

AN ACT 

To codify maternity care coordination programs at 

other purposes. the Department of Veterans Affairs, and for