I

106TH CONGRESS

1ST SESSION H. R. 2316

To amend the Public Health Service Act to develop monitoring systems

to promote safe motherhood.

IN THE HOUSE OF REPRESENTATIVES

JUNE 23, 1999

Mrs. EMERSON (for herself, Ms. MCKINNEY, Mrs. LOWEY, Mrs. KELLY, Mrs.

MALONEY of New York, and Ms. ROS-LEHTINEN) introduced the following bill; which was referred to the Committee on Commerce

A BILL

To amend the Public Health Service Act to develop

monitoring systems to promote safe motherhood.

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; FINDINGS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Safe Motherhood Monitoring and Prevention Research

6 Act of 1999’’.

7 (b) FINDINGS.—The Congress finds as follows:

8 (1) The total maternal mortality has not de9 clined in the United States since 1982.
2

•HR 2316 IH

1 (2) The four-fold increase in risk of maternal

2 death among black women compared to white women

3 is one of the largest racial disparities among the

4 public health indicators.

5 (3) United States vital statistics data indicate

6 that between 1987 and 1996 at least 3,086 women

7 died as a consequence of pregnancy or its complica8 tions in the United States.

9 (4) Misclassification on death certificates causes

10 these data to underestimate maternal mortality, and

11 the true number of maternal deaths is estimated to

12 be 1.3 to 3 times higher than that reported in vital

13 statistics records, indicating a need for improved

14 surveillance and public monitoring of this outcome.

15 (5) Early diagnosis and effective treatment of

16 pregnancy complications are critical to reduce ma17 ternal mortality.

18 (6) Underserved populations many times live in

19 socioeconomic conditions that lack the support sys20 tems and financial resources necessary to ensure

21 quality health care for expectant mothers and infant

22 newborns.

23 (7) By investing in public health surveillance

24 and prevention research to monitor and identify

25 causes of maternal mortality and in maternal health
3

•HR 2316 IH

1 programs to promote maternal health, the risk of

2 maternal mortality and morbidity can be reduced in

3 the United States.

4 SEC. 2. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

5 Title III of the Public Health Service Act (42 U.S.C.

6 241 et seq.) is amended by adding at the end the fol7 lowing:

8 ‘‘PART Q—SAFE MOTHERHOOD PROMOTION

9 ‘‘SEC. 399L. SAFE MOTHERHOOD MONITORING.

10 ‘‘(a) PURPOSE.—It is the purpose of this section to

11 develop monitoring systems at the local, State, and na12 tional level to better understand the burden of maternal

13 complications and mortality and to decrease the disparities

14 among population at risk of death and complications from

15 pregnancy.

16 ‘‘(b) ACTIVITIES.—For the purpose described in sub17 section (a), the Secretary may carry out the following ac18 tivities:

19 ‘‘(1) The Secretary, acting through the Centers

20 for Disease Control and Prevention, may establish

21 and implement a national monitoring and surveil22 lance program to identify and promote the investiga23 tion of deaths and severe complications that occur

24 during pregnancy.
4

•HR 2316 IH

1 ‘‘(2) The Secretary, acting through the Centers

2 for Disease Control and Prevention, may expand the

3 Pregnancy Risk Assessment Monitoring System to

4 provide surveillance and collect data in each of the

5 50 States.

6 ‘‘(3) The Secretary, acting through the Centers

7 for Disease Control and Prevention, may expand the

8 Maternal and Child Health Epidemiology Program

9 to provide technical support, financial assistance, or

10 the time-limited assignment of senior epidemiologists

11 to maternal and child health programs in each of the

12 50 States.

13 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

14 is authorized to be appropriated to carry out this section

15 such sums as may be necessary for each fiscal year (begin16 ning with fiscal year 2000).’’.

17 ‘‘SEC. 399M. PREVENTION RESEARCH TO ENSURE SAFE

18 MOTHERHOOD.

19 ‘‘(a) PURPOSE.—It is the purpose of this section to

20 provide the Centers for Disease Control and Prevention

21 with the authority to further expand research concerning

22 risk factors, prevention strategies, and the roles of the

23 family, health care providers and the community in safe

24 motherhood.
5

•HR 2316 IH

1 ‘‘(b) RESEARCH.—The Secretary, acting through the

2 Centers for Disease Control and Prevention, may carry

3 out activities to expand research relating to—

4 ‘‘(1) encouraging preconception counseling, es5 pecially for at risk populations such as diabetics;

6 ‘‘(2) the identification of critical components of

7 prenatal delivery and postpartum care;

8 ‘‘(3) the identification of outreach and support

9 services, such as folic acid education, that are avail10 able for pregnant women;

11 ‘‘(4) the identification of women who are at

12 high risk for complications;

13 ‘‘(5) preventing preterm delivery;

14 ‘‘(6) preventing urinary tract infections;

15 ‘‘(7) preventing unnecessary caesarean sections;

16 ‘‘(8) an examination of the higher rates of ma17 ternal mortality among African American women;

18 ‘‘(9) an examination of the relationship between

19 domestic violence and maternal complications and

20 mortality;

21 ‘‘(10) preventing smoking, alcohol and illegal

22 drug usage before, during and after pregnancy;

23 ‘‘(11) preventing infections that cause maternal

24 and infant complications; and
6

•HR 2316 IH

1 ‘‘(12) other areas determined appropriate by

2 the Secretary.

3 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

4 is authorized to be appropriated to carry out this section

5 such sums as may be appropriate for each fiscal year (be6 ginning with fiscal year 2000).

7 ‘‘SEC. 399N. PREVENTION PROGRAMS TO ENSURE SAFE

8 MOTHERHOOD.

9 ‘‘(a) IN GENERAL.—The Secretary, acting through

10 the Centers for Disease Control and Prevention may carry

11 out activities to promote safe motherhood, including—

12 ‘‘(1) public education campaigns on healthy

13 pregnancies and the building of partnerships with

14 outside organizations concerned about safe mother15 hood;

16 ‘‘(2) education programs for physicians, nurses

17 and other health care providers; and

18 ‘‘(3) activities to promote community support

19 services for pregnant women.

20 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There

21 is authorized to be appropriated to carry out this section

22 such sums as may be appropriate for each fiscal year (be23 ginning with fiscal year 2000).’’.

Æ