S. 796 

One Hundred Seventeenth Congress 

of the 

United States of America 

AT THE FIRST SESSION 

Begun and held at the City of Washington on Sunday, 

the third day of January, two thousand and twenty one 

An Act 

To codify maternity care coordination programs at the Department of Veterans 

Affairs, and for other purposes. 

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 ‘‘Protecting Moms Who Served 

Act of 2021’’. 

SEC. 2. DEFINITIONS. 

In this Act: 

(1) MATERNAL MORTALITY.—The term ‘‘maternal mortality’’ 

means a death occurring during pregnancy or within a oneyear period after pregnancy that is caused by pregnancy-related 

or childbirth complications, including suicide, overdose, or other 

death resulting from a mental health or substance use disorder 

attributed to or aggravated by pregnancy-related or childbirth 

complications. 

(2) POSTPARTUM.—The term ‘‘postpartum’’, with respect to 

an individual, means the one-year period beginning on the 

last day of the pregnancy of the individual. 

(3) PREGNANCY-ASSOCIATED DEATH.—The term ‘‘pregnancyassociated death’’ means the death of a pregnant or postpartum 

individual, by any cause, that occurs during pregnancy or 

within one year following pregnancy, regardless of the outcome, 

duration, or site of the pregnancy. 

(4) PREGNANCY-RELATED DEATH.—The term ‘‘pregnancyrelated death’’ means the death of a pregnant or postpartum 

individual that occurs during pregnancy or within one year 

following pregnancy from a pregnancy complication, a chain 

of events initiated by pregnancy, or the aggravation of an 

unrelated condition by the physiologic effects of pregnancy. 

(5) RACIAL AND ETHNIC MINORITY GROUP.—The term ‘‘racial 

and ethnic minority group’’ has the meaning given that term 

in section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 

300u–6(g)(1)). 

(6) SEVERE MATERNAL MORBIDITY.—The term ‘‘severe 

maternal morbidity’’ means a health condition, including a 

mental health condition or substance use disorder, attributed 

to or aggravated by pregnancy or childbirth that results in 

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

of the individual who was pregnant. 
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SEC. 3. SUPPORT BY DEPARTMENT OF VETERANS AFFAIRS OF MATERNITY CARE COORDINATION. 

(a) PROGRAM ON MATERNITY CARE COORDINATION.— (1) IN GENERAL.—The Secretary of Veterans Affairs shall 

carry out the maternity care coordination program described 

in Veterans Health Administration Directive 1330.03. 

(2) TRAINING AND SUPPORT.—In carrying out the program 

under paragraph (1), the Secretary shall provide to community 

maternity care providers training and support with respect 

to the unique needs of pregnant and postpartum veterans, 

particularly regarding mental and behavioral health conditions 

relating to the service of those veterans in the Armed Forces. 

(b) AUTHORIZATION OF APPROPRIATIONS.— (1) IN GENERAL.—There is authorized to be appropriated to the Secretary $15,000,000 for fiscal year 2022 for the program under subsection (a)(1). 

(2) SUPPLEMENT NOT SUPPLANT.—Amounts authorized 

under paragraph (1) are authorized in addition to any other 

amounts authorized for maternity health care and coordination 

for the Department of Veterans Affairs. 

(c) DEFINITIONS.—In this section: 

(1) COMMUNITY MATERNITY CARE PROVIDERS.—The term 

‘‘community maternity care providers’’ means maternity care 

providers located at non-Department facilities who provide 

maternity care to veterans under section 1703 of title 38, United 

States Code, or any other law administered by the Secretary 

of Veterans Affairs. 

(2) NON-DEPARTMENT FACILITIES.—The term ‘‘non-Department facilities’’ has the meaning given that term in section 

1701 of title 38, United States Code. 

SEC. 4. REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL 

MORBIDITY AMONG PREGNANT AND POSTPARTUM VETERANS. 

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

of the enactment of this Act, the Comptroller General of the United 

States shall submit to the Committee on Veterans’ Affairs of the 

Senate and the Committee on Veterans’ Affairs of the House of 

Representatives, and make publicly available, a report on maternal 

mortality and severe maternal morbidity among pregnant and 

postpartum veterans, with a particular focus on racial and ethnic 

disparities in maternal health outcomes for veterans. 

(b) MATTERS INCLUDED.—The report under subsection (a) shall 

include the following: 

(1) To the extent practicable— 

(A) the number of pregnant and postpartum veterans 

who have experienced a pregnancy-related death or pregnancy-associated death in the most recent 10 years of available data; 

(B) the rate of pregnancy-related deaths per 100,000 

live births for pregnant and postpartum veterans; 

(C) the number of cases of severe maternal morbidity 

among pregnant and postpartum veterans in the most 

recent year of available data; 

(D) an assessment of the racial and ethnic disparities 

in maternal mortality and severe maternal morbidity rates 

among pregnant and postpartum veterans; 
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(E) identification of the causes of maternal mortality 

and severe maternal morbidity that are unique to veterans, 

including post-traumatic stress disorder, military sexual 

trauma, and infertility or miscarriages that may be caused 

by service in the Armed Forces; 

(F) identification of the causes of maternal mortality 

and severe maternal morbidity that are unique to veterans 

from racial and ethnic minority groups and such other 

at-risk populations as the Comptroller General considers 

appropriate; 

(G) identification of any correlations between the 

former rank of veterans and their maternal health outcomes; 

(H) the number of veterans who have been diagnosed 

with infertility by a health care provider of the Veterans 

Health Administration each year in the most recent five 

years, disaggregated by age, race, ethnicity, sex, marital 

status, and geographical location; 

(I) the number of veterans who have received a clinical 

diagnosis of unexplained infertility by a health care provider of the Veterans Health Administration each year 

in the most recent five years; and 

(J) an assessment of the extent to which the rate 

of incidence of clinically diagnosed infertility among veterans compare or differ to the rate of incidence of clinically 

diagnosed infertility among the civilian population. 

(2) An assessment of the barriers to determining the 

information required under paragraph (1) and recommendations 

for improvements in tracking maternal health outcomes among 

pregnant and postpartum veterans who— 

(A) have health care coverage through the Department; 

(B) are enrolled in the TRICARE program (as defined 

in section 1072 of title 10, United States Code); 

(C) have employer-based or private insurance; 

(D) are enrolled in the Medicaid program under title 

XIX of the Social Security Act (42 U.S.C. 1396 et seq.); 

(E) are eligible to receive health care furnished by— 

(i) the Indian Health Service; 

(ii) Tribal health programs; or 

(iii) urban Indian organizations; or 

(F) are uninsured. 

(3) Recommendations for legislative and administrative 

actions to increase access to mental and behavioral health 

care for pregnant and postpartum veterans who screen positively for maternal mental or behavioral health conditions. 

(4) Recommendations to address homelessness, food insecurity, poverty, and related issues among pregnant and 

postpartum veterans. 

(5) Recommendations on how to effectively educate maternity care providers on best practices for providing maternity 

care services to veterans that addresses the unique maternal 

health care needs of veteran populations. 

(6) Recommendations to reduce maternal mortality and 

severe maternal morbidity among pregnant and postpartum 

veterans and to address racial and ethnic disparities in 

maternal health outcomes for each of the groups described 

in subparagraphs (A) through (F) of paragraph (2). 
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(7) Recommendations to improve coordination of care 

between the Department and non-Department facilities for 

pregnant and postpartum veterans, including recommendations 

to improve— 

(A) health record interoperability; and 

(B) training for the directors of the Veterans Integrated 

Service Networks, directors of medical facilities of the 

Department, chiefs of staff of such facilities, maternity 

care coordinators, and staff of relevant non-Department 

facilities. 

(8) An assessment of the authority of the Secretary of 

Veterans Affairs to access maternal health data collected by 

the Department of Health and Human Services and, if 

applicable, recommendations to increase such authority. 

(9) To the extent applicable, an assessment of potential 

causes of or explanations for lower maternal mortality rates 

among veterans who have health care coverage through the 

Department of Veterans Affairs compared to maternal mortality 

rates in the general population of the United States. 

(10) Any other information the Comptroller General determines appropriate with respect to the reduction of maternal 

mortality and severe maternal morbidity among pregnant and 

postpartum veterans and to address racial and ethnic disparities in maternal health outcomes for veterans. 

(c) DEFINITIONS.—In this section, the terms ‘‘Tribal health program’’ and ‘‘urban Indian organization’’ have the meanings given 

those terms in section 4 of the Indian Health Care Improvement 

Act (25 U.S.C. 1603). 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.