II 

110TH CONGRESS 

2D SESSION S. 3142 

To amend the Public Health Service Act to enhance public health activities 

related to stillbirth and sudden unexpected infant death. 

IN THE SENATE OF THE UNITED STATES 

JUNE 17, 2008 

Mr. REID (for Mr. OBAMA) introduced the following bill; which was read twice 

and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to enhance public 

health activities related to stillbirth and sudden unexpected infant death. 

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 ‘‘Preventing Stillbirth 

5 and SUID Act of 2008’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Every year, more than 25,000 women in the 

9 United States experience stillbirth. 


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1 (2) Common diagnosable causes for stillbirth 

2 include genetic abnormalities, umbilical cord acci3 dents, infections, and placental problems, however, 

4 more than half of all stillbirths remain unexplained. 

5 (3) A number of risk factors for stillbirth have 

6 been described in pregnant women such as maternal 

7 age, obesity, smoking, diabetes, hypertension, and 

8 previous stillbirth. 

9 (4) Good prenatal care, not smoking, and not 

10 drinking alcohol are helpful strategies for pregnant 

11 women to reduce the risk of stillbirth, however, re12 searchers continue to perform studies into other ef13 fective modes of reducing the risk, including moni14 toring fetal activity or ‘‘in utero’’ movement starting 

15 at approximately 28 weeks. 

16 (5) Half of the more than 4,500 sudden, unex17 pected infant deaths (SUID) that occur each year in 

18 the United States are due to sudden infant death 

19 syndrome (SIDS), which is the leading cause of 

20 SUID and of all deaths among infants aged 1 to 12 

21 months. 

22 (6) Sudden infant death syndrome is a diag23 nosis of exclusion and is only determined after all 

24 known causes are excluded by a thorough examina25 tion of the death scene, a review of the clinical hisVerDate Aug 31 2005 23:49 Jun 18, 2008 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3142.IS S3142

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1 tory, and performance of an autopsy. However, some 

2 SUID are not investigated and, even when they are, 

3 cause-of-death data are not collected and reported 

4 consistently. 

5 (7) Inaccurate classification of cause and man6 ner of death impedes prevention efforts and com7 plicates our ability to understand risk factors related 

8 to these deaths. 

9 (8) Death certificate data cannot fully charac10 terize the sudden, unexpected infant deaths nor 

11 identify potential risk factors amenable to preven12 tion. 

13 SEC. 3. ENHANCING PUBLIC HEALTH ACTIVITIES RELATED 

14 TO STILLBIRTH. 

15 (a) IN GENERAL.—Part B of title XI of the Public 

16 Health Service Act (42 U.S.C. 300c–12 et seq.) is amend17 ed by adding at the end the following: 

18 ‘‘SEC. 1123. NATIONAL REGISTRY AND PUBLIC HEALTH 

19 PROGRAMS FOR STILLBIRTH. 

20 ‘‘(a) DETERMINATION OF STANDARD STILLBIRTH

21 DEFINITION AND PROTOCOL.— 

22 ‘‘(1) IN GENERAL.—For purposes of this sec23 tion, the Secretary shall provide for the development 

24 of— 

25 ‘‘(A) a standard definition of stillbirth; and 


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1 ‘‘(B) a standard protocol for stillbirth data 

2 collection and surveillance, including— 

3 ‘‘(i) enhancing the National Vital Sta4 tistics System for the reporting of still5 births; and 

6 ‘‘(ii) expanding active population7 based surveillance efforts currently under8 way at the Centers for Disease Control and 

9 Prevention, including utilizing the infra10 structure of existing birth defects surveil11 lance registries to collect thorough and 

12 complete epidemiologic information on still13 births. 

14 ‘‘(2) CONSULTATION.—The Secretary shall en15 sure that the standard definition and protocol de16 scribed in paragraph (1) are developed in a manner 

17 that ensures the consultation of representatives of 

18 health and advocacy organizations, State and local 

19 governments, and other interested entities specified 

20 by the Secretary. 

21 ‘‘(b) ESTABLISHMENT.—The Secretary, acting 

22 through the Administrator of the Health Resources and 

23 Services Administration, the Director of the Centers for 

24 Disease Control and Prevention, and the Director of the 

25 National Institutes of Health, and in consultation with naVerDate Aug 31 2005 23:49 Jun 18, 2008 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3142.IS S3142

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1 tional health organizations and professional societies with 

2 expertise relating to reducing stillbirths and infant mor3 tality, shall establish— 

4 ‘‘(1) a national registry that can facilitate the 

5 understanding of root causes, rates, and trends of 

6 stillbirth; and 

7 ‘‘(2) public education and prevention programs 

8 aimed at reducing the occurrence of stillbirth. 

9 ‘‘(c) NATIONAL REGISTRY.—The national registry es10 tablished under subsection (b)(1) shall facilitate the collec11 tion, analysis, and dissemination of data by— 

12 ‘‘(1) implementing a surveillance and moni13 toring system based on the protocols developed in 

14 subsection (a)(1)(B); 

15 ‘‘(2) developing standardized protocols for thor16 ough and complete investigation of stillbirth, includ17 ing protocols for autopsy and pathological examina18 tions of the fetus and placenta, and other post19 mortem tests for surveillance of stillbirth; 

20 ‘‘(3) identifying trends, potential risk factors 

21 for further study, and methods for the evaluation of 

22 prevention efforts; and 

23 ‘‘(4) supporting efforts in collection of vital 

24 records, active case finding, linkage studies, and 


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1 other epidemiologic efforts to identify potential risk 

2 factors and prevention opportunities. 

3 ‘‘(d) PUBLIC EDUCATION AND PREVENTION PRO4 GRAMS.—The Secretary, acting through the Director of 

5 the Centers for Disease Control and Prevention and the 

6 Director of the National Institutes of Health, shall directly 

7 or through grants, cooperative agreements, or contracts 

8 to eligible entities, develop and conduct public education 

9 and prevention programs established under subsection 

10 (b)(2), including— 

11 ‘‘(1) public education programs, services, and 

12 demonstrations which are designed to increase gen13 eral awareness of stillbirths; and 

14 ‘‘(2) the development of tools for the education 

15 of health professionals and pregnant women about 

16 the early-warning signs of stillbirth, which may in17 clude monitoring of fetal movement or baby in-utero. 

18 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

19 are authorized to be appropriated to carry out this section, 

20 $5,000,000 for fiscal year 2009 and such sums as may 

21 be necessary for each of fiscal years 2010 through 2013.’’. 

22 (b) CONFORMING AMENDMENT.—The heading of 

23 part B of title XI of the Public Health Service Act (42 

24 U.S.C. 300c–12 et seq.) is amended by adding at the end 

25 the following: ‘‘AND STILLBIRTH’’. 


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1 SEC. 4. ENHANCING PUBLIC HEALTH ACTIVITIES RELATED 

2 TO SUDDEN UNEXPECTED INFANT DEATH. 

3 (a) IN GENERAL.—Part B of title XI of the Public 

4 Health Service Act (42 U.S.C. 300c–12 et seq.), as 

5 amended by section 3, is further amended by adding at 

6 the end the following: 

7 ‘‘SEC. 1124. NATIONAL REGISTRY FOR SUDDEN UNEX8 PECTED INFANT DEATHS. 

9 ‘‘(a) DEFINITION.—In this section, the term ‘sudden, 

10 unexpected infant deaths’ (referred to in this section as 

11 ‘SUID’) means infant deaths that have no obvious cause 

12 of death, are not the result of a chronic disease or known 

13 illness, are unexpected, and not explainable without a 

14 more careful examination. These deaths may include 

15 deaths due to suffocation, poisoning, injuries, falls, sudden 

16 infant death syndrome, or previously unrecognized illness 

17 or disorder. 

18 ‘‘(b) ESTABLISHMENT.—The Secretary, acting 

19 through the Administrator of the Health Resources and 

20 Services Administration, the Director of the Centers for 

21 Disease Control and Prevention, and the Director of the 

22 National Institutes of Health, and in consultation with na23 tional health organizations and professional societies with 

24 experience and expertise relating to reducing SUID, shall 

25 establish a population-based SUID case registry that can 


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1 facilitate the understanding of the root causes, rates, and 

2 trends of SUID. 

3 ‘‘(c) NATIONAL REGISTRY.—The national registry es4 tablished under subsection (b) shall facilitate the collec5 tion, analysis, and dissemination of data by— 

6 ‘‘(1) implementing a surveillance and moni7 toring system based on thorough and complete death 

8 scene investigation data, clinical history, and au9 topsy findings; 

10 ‘‘(2) collecting standardized information about 

11 the environmental, medical, social, and genetic cir12 cumstances that may correlate with infant deaths 

13 (including sleep environment and the quality of the 

14 death scene investigation) from the SUID Initiative 

15 Reporting Form or equivalent, as well as other law 

16 enforcement, medical examiner, coroner, emergency 

17 medical services (EMS), and medical records; 

18 ‘‘(3) promoting the use of Centers for Disease 

19 Control and Prevention standardized SUID death 

20 investigation and reporting tools as well as standard21 ized autopsy protocols; 

22 ‘‘(4) establishing a standardized classification 

23 system for defining subcategories of SIDS and 

24 SUID for surveillance and prevention research ac25 tivities; 


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1 ‘‘(5) supporting multidisciplinary infant death 

2 reviews such as those performed by child death re3 view committees and fetal infant mortality commit4 tees to collect and review the standardized informa5 tion and accurately and consistently classify and 

6 characterize SUID; and 

7 ‘‘(6) improving public reporting of surveillance 

8 and descriptive epidemiology of SUID by 

9 supplementing vital statistics data. 

10 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated to carry out this section, 

12 $5,000,000 for fiscal year 2009 and such sums as nec13 essary for each of fiscal years 2010 through 2013.’’. 

14 (b) CONFORMING AMENDMENT.—The heading of 

15 part B of title XI of the Public Health Service Act (42 

16 U.S.C. 300c–12 et seq.), as amended by section 3, is fur17 ther amended by adding at the end the following: ‘‘, AND

18 SUDDEN UNEXPECTED INFANT DEATH’’. 

Æ 


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