I 

116TH CONGRESS 

2D SESSION H. R. 8027 

To improve the public health response to addressing maternal mortality and 

morbidity during the COVID–19 public health emergency. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 11, 2020 

Ms. UNDERWOOD (for herself, Ms. WILD, Mr. KHANNA, Ms. MOORE, Ms. 

NORTON, Ms. ROYBAL-ALLARD, Mr. CARSON of Indiana, Mr. FOSTER, 

Mr. TRONE, Mr. LAWSON of Florida, Mrs. MCBATH, Mr. BUTTERFIELD, 

Ms. OMAR, Ms. JUDY CHU of California, Mr. COHEN, and Mr. KENNEDY) introduced the following bill; which was referred to the Committee 

on Energy and Commerce, and in addition to the Committees on Education and Labor, and Natural Resources, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

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 2020’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) The World Health Organization declared 

4 COVID–19 a ‘‘Public Health Emergency of Inter5 national Concern’’ on January 30, 2020. By the be6 ginning of August 2020, there have been over 

7 18,000,000 confirmed cases of, and over 700,000 

8 deaths associated with, COVID–19 worldwide. 

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

10 of COVID–19 has quickly surpassed the number of 

11 such cases in every other nation, and as of August 

12 5, 2020, over 4,000,000 cases and 156,000 deaths 

13 have been reported by the United States alone. 

14 (3) Long-standing systemic health and social 

15 inequities have put communities of color at increased 

16 risk of contracting COVID–19 or experiencing se17 vere illness; age-adjusted hospitalization rates from 

18 COVID–19 are highest for American Indian and 

19 Alaska Native, Black, and Latinx people. 

20 (4) Prior to the start of the COVID–19 pan21 demic, the United States was facing a maternal mor22 tality and morbidity crisis, in which the United 

23 States has the highest maternal mortality rate in the 

24 developed world, and that rate is not improving. 

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

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1 bidity, and much larger numbers experience more 

2 common harmful challenges, such as prenatal and 

3 postpartum anxiety and depression and lack of sup4 port for meeting breastfeeding goals. 

5 (6) Compared to White women, Black and 

6 American Indian and Alaska Native women in the 

7 United States are significantly more likely to die 

8 from pregnancy-related complications, and Black 

9 and American Indian and Alaska Native women suf10 fer disproportionately high rates of maternal mor11 bidity. 

12 (7) The causes of maternal mortality and mor13 bidity are complex and include racial, ethnic, and so14 cioeconomic inequities; racism, bias, and discrimina15 tion; comorbidities; and inadequate access to the 

16 health care system, including behavioral health care, 

17 which are factors that have similarly contributed to 

18 the racial disparities seen in COVID–19 outcomes. 

19 (8) The burden of morbidity and mortality in 

20 the United States for both COVID–19 and maternal 

21 health outcomes has also fallen disproportionately on 

22 Black, Latinx, and American Indian and Alaska Na23 tive communities, who suffer the most from great 

24 public health needs and are the most medically un25 derserved. 


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1 (9) According to the Centers for Disease Con2 trol and Prevention, ‘‘pregnant people have changes 

3 in their bodies that may increase their risk of some 

4 infections’’ and ‘‘pregnant people have had a higher 

5 risk of severe illness when infected with viruses from 

6 the same family as COVID–19 and other viral res7 piratory infections, such as influenza’’. 

8 (10) As of June 25, 2020, the latest informa9 tion from the Centers for Disease Control and Pre10 vention indicates that pregnant women are more 

11 likely to be hospitalized and are at higher risk for 

12 intensive care unit admissions than nonpregnant 

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

14 pregnant people have been disproportionately in15 fected by COVID–19. 

16 (11) Our understanding of the specific impact 

17 of COVID–19 on pregnant people is limited, in part 

18 due to a lack of robust data collection, but the 

19 COVID–19 pandemic has further strained the health 

20 care system and added another layer of fear and vul21 nerability for pregnant people, with disproportionate 

22 effects on people of color. 

23 (12) As of July 30, 2020, over 14,000 pregnant 

24 people in the United States have tested positive for 


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1 COVID–19 and 35 pregnant people have died as re2 sult of COVID–19. 

3 (13) The World Health Organization states 

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

5 childbirth experience, whether or not they have a 

6 confirmed COVID–19 infection, this includes the 

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

8 clear communication by maternity staff, pain relief 

9 strategies, and mobility in labor when possible and 

10 the position of choice’’. 

11 (14) A COVID–19 public health response with12 out concerted Federal action and focus on maternal 

13 health care access and quality, research, data collec14 tion, mitigating negative socioeconomic consequences 

15 of the pandemic, and safeguarding the right to safe 

16 and positive childbirth experience will risk exacer17 bating the maternal mortality and morbidity crisis. 

18 SEC. 3. DEFINITIONS. 

19 In this Act: 

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

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

22 means the period beginning on the date that the 

23 public health emergency declared by the Secretary of 

24 Health and Human Services under section 319 of 

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


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

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

3 public health emergency or January 1, 2023. 

4 (2) CULTURALLY CONGRUENT.—The term ‘‘cul5 turally congruent’’, with respect to care or maternity 

6 care, means care that is anti-racist and is in agree7 ment with the preferred cultural values, beliefs, 

8 worldview, and practices of the health care consumer 

9 and other stakeholders. 

10 (3) INDIAN TRIBE, TRIBAL ORGANIZATION, AND

11 URBAN INDIAN ORGANIZATION.—The terms ‘‘Indian 

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

13 given the terms ‘‘Indian tribe’’ and ‘‘tribal organiza14 tion’’, respectively, in section 4 of the Indian Self15 Determination and Education Assistance Act (25 

16 U.S.C. 5304), and the term ‘‘urban Indian organiza17 tion’’ has the meaning given such term in section 4 

18 of the Indian Health Care Improvement Act (25 

19 U.S.C. 1603). 

20 (4) MATERNAL MORTALITY.—The term ‘‘mater21 nal mortality’’ means a death occurring during preg22 nancy or within one year of the end of pregnancy, 

23 from a pregnancy complication, a chain of events 

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1 related condition by the physiologic effects of preg2 nancy. 

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

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

5 of a person’s pregnancy. 

6 (6) RESPECTFUL MATERNITY CARE.—The term 

7 ‘‘respectful maternity care’’ refers to care organized 

8 for, and provided to, all pregnant and postpartum 

9 people in a manner that is culturally congruent, 

10 maintains their dignity, privacy, and confidentiality, 

11 ensures freedom from harm and mistreatment, and 

12 enables informed choice and continuous support dur13 ing labor, childbirth, and postpartum. 

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

15 the Secretary of Health and Human Services. 

16 (8) SEVERE MATERNAL MORBIDITY.—The term 

17 ‘‘severe maternal morbidity’’ means an unexpected 

18 outcome caused by labor and delivery that results in 

19 significant short-term or long-term consequences to 

20 the health of the pregnant person. 


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1 SEC. 4. EMERGENCY FUNDING FOR FEDERAL DATA COL2 LECTION, SURVEILLANCE AND RESEARCH ON 

3 MATERNAL HEALTH OUTCOMES DURING THE 

4 COVID–19 PUBLIC HEALTH EMERGENCY. 

5 To conduct or support data collection, surveillance, 

6 and research on maternal health as a result of the 

7 COVID–19 public health emergency, including support to 

8 assist in the capacity building for State, Tribal, territorial, 

9 and local public health departments to collect and trans10 mit racial, ethnic, and other demographic data related to 

11 maternal health, there are authorized to be appro12 priated— 

13 (1) $100,000,000 for the Surveillance for 

14 Emerging Threats to Mothers and Babies program 

15 of the Centers for Disease Control and Prevention, 

16 to support the Centers for Disease Control and Pre17 vention in its efforts to— 

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

19 community-based organizations to provide time20 ly, continually updated guidance to families and 

21 health care providers on ways to reduce risk to 

22 mothers and babies and tailor interventions to 

23 improve their long-term health; 

24 (B) partner with more State, Tribal, terri25 torial, and local public health programs in the 

26 collection and analysis of clinical data on the 


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1 impact of COVID–19 on pregnant and 

2 postpartum patients and their newborns, includ3 ing among pregnant people of color; and 

4 (C) establish regionally based centers of 

5 excellence to offer medical, public health, and 

6 other knowledge to ensure communities, espe7 cially communities of color, can help pregnant 

8 and postpartum patients and infants get the 

9 care they need; 

10 (2) $30,000,000 for the Enhancing Reviews 

11 and Surveillance to Eliminate Maternal Mortality 

12 program (commonly known as the ‘‘ERASE MM 

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

14 Prevention, to support the Centers for Disease Con15 trol and Prevention in expanding its partnerships 

16 with States and Indian Tribes and provide technical 

17 assistance to existing Maternal Mortality Review 

18 Committees; 

19 (3) $45,000,000 for the Pregnancy Risk As20 sessment Monitoring System (commonly known as 

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

22 and Prevention, to support the Centers for Disease 

23 Control and Prevention in its efforts to— 

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

25 PRAMS questionnaire; 


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1 (B) add questions around experiences of 

2 respectful maternity care in prenatal, 

3 intrapartum, and postpartum care; 

4 (C) conduct a rapid assessment of 

5 COVID–19 awareness, impact on care and ex6 periences, and use of preventive measures 

7 among pregnant, laboring and birthing, and 

8 postpartum people during the COVID–19 pub9 lic health emergency; and 

10 (D) work to transition the survey to an 

11 electronic platform and expand the survey to a 

12 larger population, with a special focus on reach13 ing underrepresented communities; and 

14 (4) $15,000,000 for the National Institute of 

15 Child Health and Human Development, to conduct 

16 or support research for interventions to mitigate the 

17 effects of the COVID–19 public health emergency on 

18 pregnant and postpartum people, including Black, 

19 Latinx, Asian American and Pacific Islander, and 

20 American Indian and Alaska Native people. 

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

22 AND DISCLOSURE. 

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

24 through the Director of the Centers for Disease Control 

25 and Prevention and the Administrator of the Centers for 


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1 Medicare & Medicaid Services, shall make publicly avail2 able, on the website of the Centers for Disease Control 

3 and Prevention, pregnancy and postpartum data collected 

4 across all surveillance systems relating to COVID–19, 

5 disaggregated by race, ethnicity, State, and Tribal location 

6 including the following: 

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

8 testing, including the number of pregnant people 

9 and postpartum people tested and the number of 

10 positive cases. 

11 (2) Data related to all suspected cases of 

12 COVID–19 in pregnant, birthing, and postpartum 

13 people who did not undergo testing. 

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

15 testing, including the number of pregnant and 

16 postpartum people tested and the number of such 

17 serologic tests that were positive. 

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

19 including hospitalizations, emergency room, and in20 tensive care unit admissions of pregnant, birthing, 

21 and postpartum people related to COVID–19. 

22 (5) Data related to COVID–19 outcomes, in23 cluding total fatalities and case fatality (expressed 

24 as the proportion of people who were infected with 


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

2 and postpartum people. 

3 (6) Data related to pregnancy and infant health 

4 outcomes for pregnant people with confirmed or sus5 pected COVID–19, which may include stillbirths, 

6 maternal mortality and morbidity, infant mortality, 

7 preterm births, low-birth weight infants, and cesar8 ean section births. 

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

10 made available under this section not less frequently than 

11 monthly, during the COVID–19 public health emergency 

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

13 19 public health emergency. 

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

15 the Secretary shall take all necessary steps to protect the 

16 privacy of people whose information is included in such 

17 data, including by complying with— 

18 (1) privacy protections under the regulations 

19 promulgated under section 264(c) of the Health In20 surance Portability and Accountability Act of 1996 

21 (42 U.S.C. 1320d–2 note); and 

22 (2) protections from all inappropriate internal 

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

24 data, including use of such data in determinations of 


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1 eligibility (or continued eligibility) in health plans, 

2 and from inappropriate uses. 

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

4 Indian Health Service and Director of the Centers for Dis5 ease Control and Prevention shall consult with Indian 

6 Tribes and confer with urban Indian organizations on data 

7 collection and reporting for purposes of this section. 

8 (e) DATA COLLECTION GUIDANCE.—The Secretary 

9 shall issue guidance to States and local public health de10 partments to ensure that all relevant demographic data, 

11 including pregnancy and postpartum status, are collected 

12 and included when sending COVID–19 testing specimen 

13 to laboratories, and State and local health departments 

14 and Indian Tribes are disaggregating data on COVID–19 

15 status in data on maternal and infant morbidity and mor16 tality. The Secretary shall ensure that the guidance is de17 veloped in consultation with Indian Tribes to ensure that 

18 it includes tribally developed best practices on reducing 

19 misclassification of American Indian and Alaska Native 

20 people in Federal, State, and local public health surveil21 lance systems. 


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1 SEC. 6. INCLUSION OF PREGNANT PEOPLE AND LACTATING 

2 PEOPLE IN VACCINE AND THERAPEUTIC DE3 VELOPMENT FOR COVID–19. 

4 (a) IN GENERAL.—The Director of the National In5 stitutes of Health shall— 

6 (1) support and advance the responsible inclu7 sion of pregnant and lactating people in COVID–19 

8 therapeutic and vaccine clinical trials when safe and 

9 appropriate; 

10 (2) prioritize the implementation of final rec11 ommendations made by the Task Force on Research 

12 Specific to Pregnant Women and Lactating Women 

13 to improve the inclusion of pregnant and lactating 

14 people in clinical research when safe and appro15 priate, particularly as these recommendations apply 

16 to the development and issuance of safe and effective 

17 COVID–19 therapeutics and vaccines; and 

18 (3) ensure that at least one COVID–19 vaccine 

19 developed and made available for use in the United 

20 States is suitable for pregnant people and lactating 

21 people. 

22 (b) REQUIREMENTS.— 

23 (1) REPORTING REQUIREMENTS.—The Director 

24 of the National Institutes of Health shall collect in25 formation from every developer of a drug or biologi26 cal product for the treatment or prevention of 


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1 COVID–19 in the clinical stages of development that 

2 received Federal funding from the Department of 

3 Health and Human Services and its subagencies re4 garding— 

5 (A) how evidence is being generated to 

6 evaluate the safety, efficacy, and appropriate 

7 dosing of the drug or biological product among 

8 pregnant people and lactating people; 

9 (B) plans for the systematic collection of 

10 data from people who are inadvertently exposed 

11 to the drug or biological product while pregnant 

12 or lactating; 

13 (C) plans for the inclusion of pregnant 

14 people and lactating people, including racial and 

15 ethnic minorities disproportionately affected by 

16 COVID–19, in clinical trials or the rationale for 

17 exclusion; and 

18 (D) plans for performing Developmental 

19 and Reproductive Toxicology studies, or the ra20 tionale for not performing such studies. 

21 (2) DRUG APPROVALS AND BIOLOGICAL PROD22 UCT LICENSING.—The Commissioner of Food and 

23 Drugs shall require a drug or biological product de24 veloper submit, as part of an application for ap25 proval of a drug under section 505 of the Federal 


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1 Food, Drug, and Cosmetic Act (21 U.S.C. 355) or 

2 licensing of a biological product under section 351 of 

3 the Public Health Service Act (42 U.S.C. 262) for 

4 the treatment or prevention of COVID–19— 

5 (A) an adequate representation of the ef6 fect of the drug or biological product on preg7 nant people and lactating people, either through 

8 the inclusion of pregnant people and lactating 

9 people in clinical trials when safe and appro10 priate or other research, or through a scientific 

11 and ethical justification as to why pregnant 

12 people or lactating people were not included in 

13 clinical trials; and 

14 (B) a comprehensive plan for the collection 

15 of additional evidence of safety and efficacy for 

16 pregnant and lactating people after approval 

17 under such section 505 or licensure under such 

18 section 351, or after issuance of an emergency 

19 use authorization under section 564 of the Fed20 eral Food, Drug, and Cosmetic Act (21 U.S.C. 

21 360bbb–3). 

22 SEC. 7. PUBLIC HEALTH COMMUNICATION REGARDING MA23 TERNAL CARE DURING COVID–19. 

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

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1 dertake a robust public health education effort to enhance 

2 access by pregnant people, their employers, and their pro3 viders to accurate, evidence-based health information 

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

5 a particular focus on reaching pregnant people in under6 served communities. 

7 (b) EMERGENCY TEMPORARY STANDARD.— 

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

9 risk presented by COVID–19 and the need to 

10 strengthen protections for employees, pursuant to 

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

12 Health Act of 1970 (29 U.S.C. 655(c)(1)) and not13 withstanding the provisions of law and the Executive 

14 order listed in paragraph (3), not later than 7 days 

15 after the date of enactment of this Act, the Sec16 retary of Labor shall promulgate an emergency tem17 porary standard to protect all employees at occupa18 tional risk from occupational exposure to SARS– 

19 CoV–2. 

20 (2) PREGNANT AND POSTPARTUM EMPLOY21 EES.—The emergency temporary standard promul22 gated under this subsection shall include consider23 ation of the risks and needs specific to pregnant and 

24 postpartum employees. 


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1 (3) INAPPLICABLE PROVISIONS OF LAW AND

2 EXECUTIVE ORDER.—The requirements of chapter 6 

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

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

5 chapter 35 of title 44, United States Code (com6 monly referred to as the ‘‘Paperwork Reduction 

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

8 (2 U.S.C. 1501 et seq.), and Executive Order 12866 

9 (58 Fed. Reg. 190; relating to regulatory planning 

10 and review), as amended, shall not apply to the 

11 standard promulgated under this subsection. 

12 (c) TASK FORCE ON BIRTHING EXPERIENCE AND

13 SAFE, RESPECTFUL MATERNITY CARE IN RESPONSE TO

14 THE COVID–19 PUBLIC HEALTH EMERGENCY.— 

15 (1) ESTABLISHMENT.—The Secretary, in con16 sultation with the Director of the Centers for Dis17 ease Control and Prevention and the Administrator 

18 of the Health Resources and Services Administra19 tion, shall convene a task force to develop Federal 

20 recommendations regarding respectful maternity 

21 care, including safe birth care and postpartum care, 

22 during the COVID–19 public health emergency. 

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

24 paragraph (1) shall develop, publicly post, and up25 date Federal recommendations in multiple languages 


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1 to ensure quality, provide nondiscriminatory mater2 nity care, promote positive birthing experiences, and 

3 improve maternal health outcomes during the 

4 COVID–19 public health emergency, with a par5 ticular focus on outcomes for communities of color 

6 and rural populations. Such guidelines and rec7 ommendations shall— 

8 (A) address, with particular attention to 

9 ensuring equitable treatment on the basis of 

10 race and ethnicity— 

11 (i) measures to facilitate respectful 

12 maternity care; 

13 (ii) strategies to increase access to 

14 specialized care for those with high-risk 

15 pregnancies or pregnant individuals with 

16 elevated risk factors; 

17 (iii) COVID–19 diagnostic testing for 

18 pregnant and laboring patients; 

19 (iv) birthing without one’s chosen 

20 companions, with one’s chosen companions, 

21 and with smartphone or other telehealth 

22 connection to one’s chosen companions; 

23 (v) newborn separation after birth in 

24 relation to maternal COVID–19 status; 


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1 (vi) breast milk feeding in relation to 

2 maternal COVID–19 status; 

3 (vii) licensure, training, scope of prac4 tice, and Medicaid and other insurance re5 imbursement for certified midwives, cer6 tified nurse-midwives, certified professional 

7 midwives, in a manner that facilitates in8 clusion of midwives of color and midwives 

9 from underserved communities; 

10 (viii) financial support for perinatal 

11 health workers who provide non-clinical 

12 support to people from pregnancy through 

13 the postpartum period, such as a doula, 

14 community health worker, peer supporter, 

15 lactation consultant, nutritionist or dieti16 tian, social worker, home visitor, or a pa17 tient navigator in a manner that facilitates 

18 inclusion from underserved communities; 

19 (ix) how to identify, address, and 

20 treat prenatal and postpartum mental and 

21 behavioral health conditions, such as anx22 iety, substance use disorder, and depres23 sion, which may have arisen or increased 

24 during the COVID–19 public health emer25 gency; 


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1 (x) strategies to address hospital ca2 pacity concerns in communities with a 

3 surge in COVID–19 cases and to provide 

4 childbearing people with options that re5 duce potential for cross-contamination and 

6 increase the ability to implement their care 

7 preferences while maintaining safety and 

8 quality, such as the use of auxiliary mater9 nity units and freestanding birth centers; 

10 (xi) how to identify and address rac11 ism, bias, and discrimination in the deliv12 ery treatment and support to pregnant and 

13 postpartum people, including evaluating 

14 the value of training for hospital staff on 

15 implicit bias and racism, respectful mater16 nity care, and demographic data collection; 

17 and 

18 (xii) such other matters as the task 

19 force determines appropriate; 

20 (B) identify barriers to the implementation 

21 of the guidelines and recommendations; 

22 (C) take into consideration existing State 

23 and other programs that have demonstrated ef24 fectiveness in addressing pregnancy, birth, and 


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1 postpartum care during the COVID–19 public 

2 health emergency; and 

3 (D) identify policies specific to COVID–19 

4 that should be discontinued when safely possible 

5 and those that should be continued as the pub6 lic health emergency abates. 

7 (3) MEMBERSHIP.—The task force established 

8 under paragraph (1) shall be comprised of— 

9 (A) representatives of the Department of 

10 Health and Human Services, including rep11 resentatives of— 

12 (i) the Secretary; 

13 (ii) the Director of the Centers for 

14 Disease Control and Prevention; 

15 (iii) the Administrator of the Health 

16 Resources and Services Administration; 

17 (iv) the Administrator of the Centers 

18 for Medicare & Medicaid Services; 

19 (v) the Director of the Agency for 

20 Healthcare Research and Quality; and 

21 (vi) the Director of the Indian Health 

22 Service; 

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

24 public health officials representing departments 

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1 tions from different regions of the United 

2 States with relatively high concentrations of 

3 historically marginalized populations, to be ap4 pointed by the Secretary; 

5 (C) at least 1 Tribal public health official 

6 representing departments of public health; 

7 (D) 1 or more representatives of a commu8 nity-based organization that addresses adverse 

9 maternal health outcomes with a specific focus 

10 on racial and ethnic inequities in maternal 

11 health outcomes, appointed by the Secretary, 

12 with special consideration given to organizations 

13 led by a person of color or from communities 

14 with significant minority populations; 

15 (E) 1 or more obstetrician-gynecologist or 

16 other physician who provides obstetric care, 

17 with special consideration for physicians who 

18 are from, or work in, communities experiencing 

19 the highest rates of COVID–19 mortality and 

20 morbidity; 

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

22 nurse-midwife, women’s health nurse practi23 tioner, or other nurse who provides obstetric 

24 care, with special consideration for nurses who 

25 are from, or work in, communities experiencing 


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1 the highest rates of COVID–19 mortality and 

2 morbidity; 

3 (G) 1 or more perinatal health workers 

4 who provide non-clinical support to people from 

5 pregnancy through postpartum period, such as 

6 a doula, community health worker, peer sup7 porter, lactation consultant, nutritionist or die8 titian, social worker, home visitor, or patient 

9 navigator; 

10 (H) 1 or more patients who were pregnant 

11 or gave birth during the COVID–19 public 

12 health emergency; 

13 (I) 1 or more patients who contracted 

14 COVID–19 and later gave birth; 

15 (J) 1 or more patients who have received 

16 support from a perinatal health worker who 

17 provides prenatal and postpartum support, such 

18 as a doula, community health worker, peer sup19 porter, lactation consultant, nutritionist or die20 titian, social worker, home visitor, or a patient 

21 navigator, or a spouse or family member of 

22 such patient; and 

23 (K) racially and ethnically diverse rep24 resentation from at least 3 independent experts 

25 with knowledge or field experience with racial 


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1 and ethnic disparities in public health, women’s 

2 health, or maternal mortality and severe mater3 nal morbidity. 

4 SEC. 8. GAO REPORT ON MATERNAL HEALTH AND PUBLIC 

5 HEALTH EMERGENCY PREPAREDNESS. 

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

7 health emergency declared by the Secretary of Health and 

8 Human Services under section 319 of the Public Health 

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

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

11 United States shall submit to the appropriate committees 

12 of Congress a report on maternal health and public health 

13 emergency preparedness, including prenatal, labor and de14 livery, and postpartum care during the COVID–19 public 

15 health emergency, including the following: 

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

17 and postpartum experiences of people during the 

18 COVID–19 public health emergency, which shall— 

19 (A) identify barriers to accessing preg20 nancy, birth, and postpartum care during a 

21 pandemic; 

22 (B) assess the extent to which public and 

23 private insurers were providing coverage for 

24 maternal health care during the public health 

25 emergency, including for telehealth services; 


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1 (C) to the extent practicable, analyze ma2 ternal and infant health outcomes by race and 

3 ethnicity (including quality of care, mortality, 

4 morbidity, cesarean section rates, preterm birth, 

5 prevalence of prenatal and postpartum anxiety 

6 and depression) during the COVID–19 public 

7 health emergency and the impact of Federal 

8 and State policy changes made in response to 

9 the COVID–19 pandemic on such outcomes; 

10 (D) identify contributors to population11 based disparities seen in COVID–19 outcomes, 

12 such as racial profiling of, and bias and dis13 crimination against Black, American Indian 

14 and Alaska Native, Latinx, and Asian American 

15 and Pacific Islander people; and 

16 (E) review the impact of increased unem17 ployment, paid family leave, changes in health 

18 care coverage, and other social determinants of 

19 health for pregnant and postpartum people dur20 ing the public health emergency. 

21 (2) Consultation with maternity care providers, 

22 maternal mental and behavioral health care special23 ists, researchers who specialize in women’s health or 

24 maternal mortality and severe maternal morbidity, 

25 people who experienced pregnancy or childbirth durVerDate Sep 11 2014 23:11 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H8027.IH H8027

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1 ing the COVID–19 public health emergency, rep2 resentatives from community-based organizations 

3 that address maternal health, and perinatal health 

4 workers who provide nonclinical support to pregnant 

5 and postpartum people (such as a doula, community 

6 health worker, peer support, certified lactation con7 sultant, nutritionist or dietician, social worker, home 

8 visitor, or navigator). 

9 (3) Recommendations to improve the public 

10 health emergency response and preparedness efforts 

11 of the Federal Government specific to maternal 

12 health, with a particular focus on outcomes for mi13 nority women, including— 

14 (A) ways to improve research, surveillance, 

15 and data collection of the Federal Government 

16 related to maternal health; 

17 (B) ways for the Federal Government to 

18 factor maternal health outcomes and disparities 

19 into decisions regarding distribution of re20 sources, including COVID–19 tests, personal 

21 protective equipment, and emergency funding; 

22 (C) the extent to which guidelines and rec23 ommendations of the Federal Government re24 lated to maternal health care during the 

25 COVID–19 public health emergency were culVerDate Sep 11 2014 23:11 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H8027.IH H8027

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1 turally congruent and linguistically competent 

2 for minority women; and 

3 (D) ways to improve the distribution of 

4 public health funds, data, and information to 

5 Indian Tribes and Tribal organizations with re6 gard to maternal health during the COVID–19 

7 public health emergency. 

Æ 


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