II 

117TH CONGRESS 

1ST SESSION S. 2588 

To study the extent to which individuals are more at risk of maternal 

mortality or severe maternal morbidity as a result of being a victim 

of intimate partner violence, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 3, 2021 

Mrs. SHAHEEN (for herself and Ms. KLOBUCHAR) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To study the extent to which individuals are more at risk 

of maternal mortality or severe maternal morbidity as 

a result of being a victim of intimate partner violence, 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protect Moms From 

5 Domestic Violence Act’’. 


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1 SEC. 2. STUDY BY DEPARTMENT OF HEALTH AND HUMAN 

2 SERVICES. 

3 (a) STUDY.—The Secretary, in collaboration with the 

4 Health Resources and Services Administration, the Sub5 stance Abuse and Mental Health Services Administration, 

6 and the Administration for Children and Families, and in 

7 consultation with the Attorney General, the Director of 

8 the Indian Health Service, and stakeholders (including 

9 community-based organizations and culturally specific or10 ganizations), shall conduct a study on the extent to which 

11 individuals are more at risk for maternal mortality or se12 vere maternal morbidity as a result of being a victim of 

13 domestic violence, dating violence, sexual assault, stalking, 

14 human trafficking, sex trafficking, child sexual abuse, or 

15 forced marriage. 

16 (b) REPORTS.—Not later than 2 years after the date 

17 of enactment of this Act, the Secretary shall complete the 

18 study under subsection (a) and submit a report to Con19 gress on the results of such study. Such report shall in20 clude— 

21 (1) an analysis of the extent to which domestic 

22 violence, dating violence, sexual assault, stalking, 

23 human trafficking, sex trafficking, child sexual 

24 abuse, and forced marriage contribute to, or result 

25 in, maternal mortality; 


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1 (2) an analysis of the impact of domestic vio2 lence, dating violence, sexual assault, stalking, 

3 human trafficking, sex trafficking, child sexual 

4 abuse, and forced marriage on access to health care 

5 (including mental health care) and substance use 

6 disorder treatment and recovery support; 

7 (3) a breakdown (including by race and eth8 nicity) of categories of individuals who are dis9 proportionately victims of domestic violence, dating 

10 violence, sexual assault, stalking, human trafficking, 

11 sex trafficking, child sexual abuse, or forced mar12 riage that contributes to, or results in, pregnancy-re13 lated death; 

14 (4) an analysis of the impact on health, mental 

15 health, and substance use resulting from domestic 

16 violence, dating violence, sexual assault, stalking, 

17 human trafficking, sex trafficking, child sexual 

18 abuse, and forced marriage among Alaskan Natives, 

19 Native Hawaiians, and American Indians during the 

20 prenatal and postpartum period; 

21 (5) an assessment of the factors that increase 

22 or decrease risks for maternal mortality or severe 

23 maternal morbidity among victims of domestic vio24 lence, dating violence, sexual assault, stalking, 


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1 human trafficking, sex trafficking, child sexual 

2 abuse, or forced marriage; 

3 (6) an assessment of increased risk of maternal 

4 mortality or severe maternal morbidity stemming 

5 from suicide, substance use disorders, or drug over6 dose due to domestic violence, dating violence, sexual 

7 assault, stalking, human trafficking, sex trafficking, 

8 child sexual abuse, or forced marriage; 

9 (7) recommendations for legislative or policy 

10 changes— 

11 (A) to reduce maternal mortality rates; 

12 and 

13 (B) to address health inequities that con14 tribute to disparities in such rates and deaths; 

15 (8) best practices to reduce maternal mortality 

16 and severe maternal morbidity among victims of do17 mestic violence, dating violence, sexual assault, 

18 stalking, human trafficking, sex trafficking, child 

19 sexual abuse, and forced marriage, including— 

20 (A) reducing reproductive coercion, mental 

21 health conditions, and substance use coercion; 

22 and 

23 (B) routinely assessing pregnant people for 

24 domestic violence and other forms of reproduc25 tive violence; and 


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1 (9) any other information on maternal mor2 tality or severe maternal morbidity the Secretary de3 termines appropriate to include in the report. 

4 SEC. 3. STUDY BY NATIONAL ACADEMY OF MEDICINE. 

5 (a) IN GENERAL.—The Secretary shall seek to enter 

6 into an arrangement with the National Academy of Medi7 cine (or, if the Academy declines to enter into such ar8 rangement, another appropriate entity) to study the im9 pact of domestic violence, dating violence, sexual assault, 

10 stalking, human trafficking, sex trafficking, child sexual 

11 abuse, and forced marriage on an individual’s health rel12 ative to maternal mortality and severe maternal morbidity. 

13 (b) TOPICS.—The study under subsection (a) shall— 

14 (1) examine— 

15 (A) whether domestic violence, dating vio16 lence, sexual assault, stalking, human traf17 ficking, sex trafficking, child sexual abuse, or 

18 forced marriage, or generational intimate part19 ner violence, trauma, and psychiatric disorders, 

20 increase the risk of suicide, substance use, and 

21 drug overdose among pregnant and postpartum 

22 persons; and 

23 (B) the intersection of domestic violence, 

24 dating violence, sexual assault, stalking, human 

25 trafficking, sex trafficking, child sexual abuse, 


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1 and forced marriage as a social determinant of 

2 health; and 

3 (2) give particular focus to impacts among Afri4 can-American, American Indian, Native Hawaiian, 

5 Alaskan Native, and LGBTQ populations. 

6 SEC. 4. GRANTS FOR INNOVATIVE APPROACHES. 

7 (a) IN GENERAL.—The Secretary, acting through the 

8 Administrator of the Health Resources and Services Ad9 ministration, and in collaboration with the Administration 

10 for Children and Families, the Indian Health Service, and 

11 the Substance Abuse and Mental Health Services Admin12 istration, shall award grants to eligible entities for devel13 oping and implementing innovative approaches to improve 

14 maternal and child health outcomes of victims of domestic 

15 violence, dating violence, sexual assault, stalking, human 

16 trafficking, sex trafficking, child sexual abuse, or forced 

17 marriage. 

18 (b) ELIGIBLE ENTITY.—To seek a grant under this 

19 section, an entity shall be— 

20 (1) a State, local, or federally recognized Tribal 

21 government; 

22 (2) a nonprofit organization or community23 based organization that provides prevention or inter24 vention services related to domestic violence, dating 

25 violence, sexual assault, stalking, human trafficking, 


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1 sex trafficking, child sexual abuse, or forced mar2 riage; 

3 (3) a Tribal organization or urban Indian orga4 nization (as such terms are defined in section 4 of 

5 the Indian Health Care Improvement Act (25 U.S.C. 

6 1603)); 

7 (4) an entity, the principal purpose of which is 

8 to provide health care, such as a hospital, clinic, 

9 health department, freestanding birthing center, 

10 perinatal health worker, or maternity care provider; 

11 (5) an institution of higher education; or 

12 (6) a comprehensive substance use disorder par13 enting program. 

14 (c) PRIORITY.—In awarding grants under this sec15 tion, the Secretary shall give priority to applicants pro16 posing to address— 

17 (1) mental health and substance use disorders 

18 among pregnant persons; or 

19 (2) pregnant and postpartum persons experi20 encing intimate partner violence. 

21 (d) FREESTANDING BIRTH CENTER DEFINED.—In 

22 this section, the term ‘‘freestanding birth center’’ has the 

23 meaning given that term in section 1905(l) of the Social 

24 Security Act (42 U.S.C. 1396d(1)). 


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1 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there is authorized to be appropriated 

3 $25,000,000 for the period of fiscal years 2022 through 

4 2024. 

5 SEC. 5. GUIDANCE. 

6 Not later than 2 years after the date of enactment 

7 of this Act, the Secretary shall issue and disseminate guid8 ance to States, Tribes, Territories, maternity care pro9 viders, and managed care entities on— 

10 (1) providing universal education on healthy re11 lationships and intimate partner violence; 

12 (2) developing protocols on— 

13 (A) routine assessment of intimate partner 

14 violence; and 

15 (B) health promotion and strategies for 

16 trauma-informed care plans; and 

17 (3) creating sustainable partnerships with com18 munity-based organizations that address domestic vi19 olence, dating violence, sexual assault, stalking, 

20 human trafficking, sex trafficking, child sexual 

21 abuse, or forced marriage. 

22 SEC. 6. DEFINITIONS. 

23 In this Act: 

24 (1) The term ‘‘maternal mortality’’— 

25 (A) means death that— 


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1 (i) occurs during, or within the 1-year 

2 period after, pregnancy; and 

3 (ii) is attributed to or aggravated by 

4 pregnancy-related or childbirth complica5 tions; and 

6 (B) includes a suicide, drug overdose 

7 death, homicide (including a domestic violence8 related homicide), or other death resulting from 

9 a mental health or substance use disorder at10 tributed to or aggravated by pregnancy-related 

11 or childbirth complications. 

12 (2) The term ‘‘maternity care provider’’ means 

13 a health care provider who— 

14 (A) is a physician, physician assistant, 

15 nurse, midwife who meets at a minimum the 

16 international definition of the midwife and glob17 al standards for midwifery education as estab18 lished by the International Confederation of 

19 Midwives, nurse practitioner, or clinical nurse 

20 specialist; and 

21 (B) has a focus on maternal or perinatal 

22 health. 

23 (3) The term ‘‘perinatal health worker’’ means 

24 a worker who— 


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1 (A) is a doula, community health worker, 

2 peer supporter, breastfeeding and lactation edu3 cator or counselor, nutritionist or dietitian, 

4 childbirth educator, social worker, home visitor, 

5 language interpreter, or navigator; and 

6 (B) provides assistance with perinatal 

7 health. 

8 (4) The term ‘‘postpartum’’ means the 12- 

9 month period following childbirth. 

10 (5) The term ‘‘Secretary’’ means the Secretary 

11 of Health and Human Services. 

12 (6) The term ‘‘severe maternal morbidity’’ 

13 means a health condition, including a mental health 

14 condition or substance use disorder, that— 

15 (A) is attributed to or aggravated by preg16 nancy or childbirth; and 

17 (B) results in significant short-term or 

18 long-term consequences to the health of the in19 dividual who was pregnant. 

Æ 


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