I 

115TH CONGRESS 

2D SESSION H. R. 5977 

To improve Federal efforts with respect to the prevention of maternal 

mortality, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 25, 2018 

Ms. KELLY of Illinois introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To improve Federal efforts with respect to the prevention 

of maternal mortality, 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 ‘‘Mothers and Offspring 

5 Mortality and Morbidity Awareness Act’’ or the 

6 ‘‘MOMMA’s Act’’. 

7 SEC. 2. FINDINGS. 

8 Congress finds the following: 

9 (1) Every year, across the United States, four 

10 million women give birth, about 700 women suffer 


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1 fatal complications during pregnancy, while giving 

2 birth, or during the postpartum period, and 65,000 

3 women suffer near-fatal, partum-related complica4 tions. 

5 (2) The maternal mortality rate is often used as 

6 a proxy to measure the overall health of a popu7 lation. While the infant mortality rate in the United 

8 States has reached its lowest point, the risk of death 

9 for women in the United States during pregnancy, 

10 childbirth, or the postpartum period is higher than 

11 such risk in any all other developed nations. The es12 timated maternal mortality rate (per 100,000 live 

13 births) for the 48 contiguous States and Washington 

14 DC increased from 18.8 percent in 2000 to 23.8 

15 percent in 2014 to 26.6 percent in 2018. This esti16 mated rate is on par with such rate for under17 developed nations such as Iraq and Afghanistan. 

18 (3) International studies estimate the 2015 

19 U.S. maternal mortality rate as 26.4 per 100,000 

20 live births, which is almost twice the 2015 World 

21 Health Organization (WHO) estimation of 14 per 

22 100,000 live births. 

23 (4) It is estimated that almost half of all mater24 nal mortalities in the United States are preventable. 


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1 (5) African-American women experience mater2 nal-related deaths at three to four times the rate of 

3 non-Hispanic White women. 

4 (6) The findings described in paragraphs (1) 

5 through (5) are of major concern to researchers, 

6 academicians, and epidemiologists at the Centers for 

7 Disease Control and Prevention (CDC); providers 

8 across the obstetrical continuum represented by or9 ganizations such as the Preeclampsia Foundation; 

10 the American College of Obstetricians and Gyne11 cologists; the Association of Women’s Health, Ob12 stetric, and Neonatal Nurses; the California Mater13 nal Quality Care Collaborative; Black Women’s 

14 Health Imperative; the National Birth Equity Col15 laborative; Black Mamas Matter Alliance; the Na16 tional Association of Certified Professional Midwives; 

17 and the American College of Nurse Midwives. 

18 (7) According to the CDC, the maternal mor19 tality rate varies drastically for women by race and 

20 ethnicity. There are 12.7 deaths per 100,000 live 

21 births for White women, 43.5 deaths per 100,000 

22 live births for African-American women, and 14.4 

23 deaths per 100,000 live births for women of other 

24 ethnicities. While maternal mortality disparately im25 pacts African-American women, the phenomenon 


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1 traverses race, ethnicity, socioeconomic status, edu2 cational background, and geography. 

3 (8) Hemorrhage, cardiovascular and coronary 

4 conditions, cardiomyopathy, infection, embolism, 

5 mental health conditions, preeclampsia and eclamp6 sia, infection or sepsis, and anesthesia complications 

7 are the predominant causes of maternal-related 

8 deaths and complications. Such conditions are large9 ly preventable or manageable. 

10 (9) The United States has not been able to sub11 mit a formal maternal mortality rate to international 

12 data repositories since 2007. Thus, no official ma13 ternal mortality rate exists for the Nation. There 

14 can be no maternal mortality rate without stream15 lining maternal mortality-related data from the 

16 State level and extrapolating such data to the Fed17 eral level. 

18 (10) In the United States, death reporting and 

19 analysis is a State function rather than a Federal 

20 process. States report all deaths—including mater21 nal deaths—on a semi-voluntary basis, without 

22 standardization across States. While the CDC has 

23 the capacity and system for collecting death-related 

24 data based on death certificates, these data are not 

25 sufficiently reported by States in an organized and 


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1 standard format across States such that the CDC is 

2 able to identify causes of maternal death and best 

3 practices for the prevention of such death. 

4 (11) Vital registration systems often underesti5 mate maternal mortality and are insufficient data 

6 sources from which to derive a full scope of medical 

7 and social determinant factors contributing to ma8 ternal deaths. While the addition of pregnancy 

9 checkboxes on death certificates since 2003 have 

10 likely improved States’ abilities to identify preg11 nancy-related deaths, they are not generally com12 pleted by obstetrical providers or persons trained to 

13 recognize pregnancy-related mortality. Thus, these 

14 vital forms may be missing information or may cap15 ture inconsistent data. Due to varying maternal 

16 mortality-related analyses, lack of reliability, and 

17 granularity in data, current maternal mortality 

18 informatics do not fully encapsulate the myriad med19 ical and socially determinant factors that contribute 

20 to such high maternal mortality rates within the 

21 United States compared to other developed nations. 

22 Non-standardization of data and lack of data shar23 ing across States and between Federal entities, 

24 health networks, and research institutions keep the 


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1 Nation in the dark about ways to prevent maternal 

2 deaths. 

3 (12) Having reliable and valid State data ag4 gregated at the Federal level are critical to the Na5 tion’s ability to quell surges in maternal death and 

6 imperative for researchers to identify long-lasting 

7 interventions. 

8 (13) Leaders in maternal wellness highly rec9 ommend that maternal deaths be investigated at the 

10 State level first. Then, have data regarding maternal 

11 deaths be standardized across States, streamlined, 

12 de-identified, and sent once a year to a federally su13 pervised database, managed by a Federal agency at 

14 the discretion of the Secretary of Health and 

15 Human Services. Such data standardization and col16 lection would be similar in operation and effect to 

17 the National Program of Cancer Registries housed 

18 at the CDC and akin to the Confidential Enquiry in 

19 Maternal Deaths Programme in the United King20 dom. Such a maternal mortality and morbidities reg21 istry and surveillance would help providers, academi22 cians, lawmakers, and the public to address ques23 tions concerning the types of, causes of, and best 

24 practices to thwart, pregnancy-related or pregnancy25 associated mortalities and morbidities. 


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1 (14) The United Nations’ Millennium Develop2 ment Goal 5a aimed to reduce by three quarters, be3 tween 1990 and 2015, the maternal mortality rate, 

4 yet this metric has not been achieved. In fact, the 

5 maternal mortality rate in the United States has 

6 been estimated to have more than doubled between 

7 2000 and 2014. Yet, because national data are not 

8 fully available, the United States does not have an 

9 official maternal mortality rate. 

10 (15) Many States have struggled to establish or 

11 maintain Maternal Mortality Review Committees 

12 (MMRC). On the State level, MMRCs have lagged 

13 because States have not had the resources to mount 

14 local reviews. State-level reviews are necessary as 

15 only the State departments of health have the au16 thority to request medical records, autopsy reports, 

17 and police reports critical to the function of the 

18 MMRC. 

19 (16) The United Kingdom regards maternal 

20 deaths as a health systems failure and a national 

21 committee of obstetrics experts review each maternal 

22 death or near-fatal childbirth complication. Such 

23 committee also establishes the predominant course of 

24 maternal-related deaths from conditions such as 

25 preeclampsia. Consequently, the United Kingdom 


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1 has been able to reduce their incidences of 

2 preeclampsia to less than one in 10,000 women—its 

3 lowest rate since 1952. 

4 (17) The United States has no comparable, co5 ordinated Federal process by which to review cases 

6 of maternal mortality, systems failures, or best prac7 tices. Many States have active MMRCs and leverage 

8 their work to impact maternal wellness. For exam9 ple, the State of California has worked extensively 

10 with their State health departments, health and hos11 pital systems, and research collaborative organiza12 tions, including the California Maternal Quality Care 

13 Collaborative and the Alliance for Innovation on Ma14 ternal Health, to establish MMRCs, wherein they 

15 have determined the most prevalent causes of mater16 nal mortality and recorded and shared data with 

17 providers and researchers, who have developed and 

18 implemented safety bundles and care protocols re19 lated to preeclampsia, maternal hemorrhage, and the 

20 like. In this way, the State of California has been 

21 able to leverage its maternal mortality review board 

22 system, generate data, and apply those data to effect 

23 changes in maternal care-related protocol. To date, 

24 the State of California has stymied its maternal 


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1 mortality rate, which is now comparable to the low 

2 rates of the United Kingdom. 

3 (18) Hospitals and health systems across the 

4 United States lack standardization of emergency ob5 stetrical protocols before, during, and after delivery. 

6 Consequently, many providers are delayed in recog7 nizing critical signs indicating maternal distress that 

8 quickly escalate into fatal or near-fatal incidences. 

9 Moreover, any attempt to address an obstetrical 

10 emergency that does not take into account both clin11 ical and public health approaches falls woefully 

12 under the mark of excellent care delivery. State13 based maternal quality collaborative organizations, 

14 including the Alliance for Innovation on Maternal 

15 Health (AIMs) and California Maternal Quality 

16 Care Collaborative, have formed obstetrical proto17 cols, tool kits, and other resources to improve system 

18 care and response as they relate to maternal com19 plications and warning signs for such conditions as 

20 maternal hemorrhage, hypertension, and 

21 preeclampsia. State perinatal quality collaboratives 

22 are working to identify health care processes that 

23 need to be improved and use the best available meth24 ods to make those changes as quickly as possible, 

25 while the Alliance for Innovation on Maternal 


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1 Health is working with States and health systems to 

2 align national, State, and hospital level quality im3 provement efforts through the creation and dissemi4 nation of maternal safety bundles to improve overall 

5 maternal health outcomes. 

6 (19) The CDC reports that more than half of 

7 all maternal deaths occur in the immediate 

8 postpartum period—between 42 days up to a full 

9 year—whereas more than one-third of pregnancy-re10 lated or pregnancy-associated deaths occur while a 

11 person is still pregnant. Yet, for pregnant women, 

12 Medicaid coverage lapses at the end of the month on 

13 which the 60th postpartum day lands. 

14 (20) A growing body of evidence-based research 

15 has shown the correlation between the stress associ16 ated with one’s race—the stress of racism—and 

17 one’s birthing outcomes. The stress of sex and race 

18 discrimination and institutional racism has been 

19 demonstrated to contribute to a higher risk of ma20 ternal mortality, irrespective of one’s gestational 

21 age, maternal age, socioeconomic status, or indi22 vidual-level health risk factors, including poverty, 

23 limited access to prenatal care, and poor physical 

24 and mental health (although these are not nominal 

25 factors). African-American women remain the most 


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1 at risk for pregnancy-associated or pregnancy-re2 lated causes of death. When it comes to 

3 preeclampsia, for example—which is related to obe4 sity—African-American women of normal weight re5 main the most at risk of dying during the perinatal 

6 period compared to non-African-American obese 

7 women. 

8 (21) The rising U.S. maternal mortality rate is 

9 predominantly driven by the disproportionately high 

10 rates of African-American maternal mortality. 

11 (22) African-American women are three to four 

12 times more likely to die from pregnancy or maternal13 related distress than are White women, yielding one 

14 of the greatest and most disconcerting racial dispari15 ties in public health. 

16 (23) Compared to women from other racial and 

17 ethnic demographics, African-American women 

18 across the socioeconomic spectrum experience pro19 longed, unrelenting stress related to racial and gen20 der discrimination, contributing to higher rates of 

21 maternal mortality, giving birth to low-weight ba22 bies, and experiencing pre-term birth. Racism is a 

23 risk-factor for these aforementioned experiences. 

24 This cumulative stress often extends across the life 

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1 can-American women establish livelihood. Structural 

2 barriers, lack of access to care, and genetic pre3 dispositions to health vulnerabilities exacerbate Afri4 can-American women’s likelihood to experience poor 

5 or fatal birthing outcomes, but do not fully account 

6 for the great disparity. 

7 (24) African-American women are twice as like8 ly to experience postpartum depression, and dis9 proportionately higher rates of preeclampsia com10 pared to White women. 

11 (25) Racism is deeply ingrained in United 

12 States systems, including in health care delivery sys13 tems between patients and providers, often resulting 

14 in disparate treatment for pain, irreverence for cul15 tural norms with respect to health, and 

16 dismissiveness. Research has demonstrated that pa17 tients respond more warmly and adhere to medical 

18 treatment plans at a higher degree with providers of 

19 the same race or ethnicity or with providers with 

20 great ability to exercise empathy. However, the pro21 vider pool is not primed with many people of color, 

22 nor are providers (whether student-doctors in train23 ing or licensed practitioners) consistently required to 

24 undergo implicit bias, cultural competency, or empa25 thy training on a consistent, on-going basis. 


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1 SEC. 3. IMPROVING FEDERAL EFFORTS WITH RESPECT TO 

2 PREVENTION OF MATERNAL MORTALITY. 

3 (a) TECHNICAL ASSISTANCE FOR STATES WITH RE4 SPECT TO REPORTING MATERNAL MORTALITY.—Not 

5 later than one year after the date of enactment of this 

6 Act, the Director of the Centers for Disease Control and 

7 Prevention (referred to in this section as the ‘‘Director’’) 

8 shall provide technical assistance to States that elect to 

9 report on maternal mortality for the purpose of encour10 aging uniformity in the reporting of such data and to en11 courage the sharing of such data among the respective 

12 States. 

13 (b) BEST PRACTICES RELATING TO PREVENTION OF

14 MATERNAL MORTALITY.—Not later than one year after 

15 the date of enactment of this Act, the Director shall issue 

16 best practices to State maternal mortality review commit17 tees on how best to identify, review, and prevent maternal 

18 mortality. In issuing such best practices, the Director shall 

19 take into account any data made available by States relat20 ing to maternal mortality. 

21 (c) ALLIANCE FOR INNOVATION ON MATERNAL

22 HEALTH GRANT PROGRAM.— 

23 (1) IN GENERAL.—Not later than one year 

24 after the date of enactment of this Act, the Sec25 retary of Health and Human Services, acting 

26 through the Associate Administrator of the Maternal 


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1 and Child Health Bureau of the Health Resources 

2 and Services Administration, shall establish a grant 

3 program to be known as the Alliance for Innovation 

4 on Maternal Health Grant Program (referred to in 

5 this subsection as ‘‘AIM’’) under which the Sec6 retary shall award grants to eligible entities for the 

7 purpose of directing widespread adoption and imple8 mentation of maternal safety bundles through col9 laborative State-based teams and collecting and ana10 lyzing process, structure, and outcome data to drive 

11 continuous improvement in the implementation of 

12 such safety bundles by such State-based teams with 

13 the ultimate goal of eliminating preventable mater14 nal mortality and severe maternal morbidity in the 

15 United States. 

16 (2) ELIGIBLE ENTITIES.—In order to be eligi17 ble for a grant under paragraph (1), an entity 

18 shall— 

19 (A) submit to the Secretary an application 

20 at such time, in such manner, and containing 

21 such information as the Secretary may require; 

22 and 

23 (B) demonstrate in such application that 

24 the entity is an interdisciplinary, multi-stake25 holder national organization with a national 


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1 data-driven maternal safety and quality im2 provement initiative based on implementation 

3 approaches that have been proven to improve 

4 maternal safety and outcomes in the United 

5 States. 

6 (3) USE OF FUNDS.—An eligible entity that re7 ceives a grant under paragraph (1) shall use such 

8 grant funds— 

9 (A) to develop and implement, through a 

10 robust, multi-stakeholder process, maternal 

11 safety bundles to assist States and health care 

12 systems in aligning national, State, and hos13 pital-level quality improvement efforts to im14 prove maternal health outcomes, specifically the 

15 reduction of maternal mortality and severe ma16 ternal morbidity; 

17 (B) to ensure, in developing and imple18 menting maternal safety bundles under sub19 paragraph (A), that such maternal safety bun20 dles— 

21 (i) satisfy the quality improvement 

22 needs of a State or health care system by 

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1 ducted by a State maternal mortality re2 view committee; and 

3 (ii) address topics such as— 

4 (I) obstetric hemorrhage; 

5 (II) maternal mental health; 

6 (III) the maternal venous system; 

7 (IV) obstetric care for women 

8 with opioid use disorder; 

9 (V) postpartum care basics for 

10 maternal safety; 

11 (VI) reduction of peripartum ra12 cial and ethnic disparities; 

13 (VII) reduction of primary cae14 sarean birth; 

15 (VIII) severe hypertension in 

16 pregnancy; 

17 (IX) severe maternal morbidity 

18 reviews; 

19 (X) support after a several ma20 ternal morbidity event; and 

21 (XI) thromboembolism; and 

22 (C) to provide ongoing technical assistance 

23 at the national and State levels to support im24 plementation of maternal safety bundles under 

25 subparagraph (A). 


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1 (4) MATERNAL SAFETY BUNDLE DEFINED.— 

2 For purposes of this subsection, the term ‘‘maternal 

3 safety bundle’’ means standardized, evidence-in4 formed processes to improve variation in response to 

5 maternal care. 

6 (5) AUTHORIZATION OF APPROPRIATIONS.—For 

7 purposes of carrying out this subsection, there is au8 thorized to be appropriated $5,000,000 for each of 

9 fiscal years 2019 through 2023. 

10 (d) EXPANSION OF MEDICAID AND CHIP COVERAGE

11 FOR PREGNANT AND POSTPARTUM WOMEN.— 

12 (1) EXTENDING MEDICAID COVERAGE FOR

13 PREGNANT AND POSTPARTUM WOMEN.—Section 

14 1902 of the Social Security Act (42 U.S.C. 1396a) 

15 is amended— 

16 (A) in subsection (e)— 

17 (i) in paragraph (5), by striking ‘‘60- 

18 day’’ and inserting ‘‘one-year’’; and 

19 (ii) in paragraph (6), by striking ‘‘60- 

20 day’’ and inserting ‘‘one-year’’; and 

21 (B) in subsection (l)(1)(A), by striking 

22 ‘‘60-day’’ and inserting ‘‘one-year’’. 

23 (2) EXTENDING MEDICAID COVERAGE FOR

24 LAWFUL RESIDENTS.—Section 1903(v)(4)(A) of the 

25 Social Security Act (42 U.S.C. 1396b(v)(4)(A)) is 


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1 amended by striking ‘‘60-day’’ and inserting ‘‘one2 year’’. 

3 (3) EXTENDING CHIP COVERAGE FOR PREG4 NANT AND POSTPARTUM WOMEN.—Section 

5 2112(d)(2)(A) of the Social Security Act (42 U.S.C. 

6 1397ll(d)(2)(A)) is amended by striking ‘‘60-day’’ 

7 and inserting ‘‘one-year’’. 

8 (4) MAINTENANCE OF EFFORT.— 

9 (A) MEDICAID.—Section 1902(l) of the So10 cial Security Act (42 U.S.C. 1396a(l)) is 

11 amended by adding at the end the following 

12 new paragraph: 

13 ‘‘(5)(A) Subject to subparagraph (B), during the pe14 riod that begins on the date of enactment of this para15 graph and ends on the date that is five years after such 

16 date of enactment, as a condition for receiving any Federal 

17 payments under section 1903(a) for calendar quarters oc18 curring during such period, a State, including a State de19 scribed in paragraph (4)(B) that elects to meet the re20 quirement of subsection (a)(10)(A)(i)(IV), shall not have 

21 in effect, with respect to women who are eligible for med22 ical assistance because of such subsection 

23 (a)(10)(A)(i)(IV) or section 1903(v)(4)(A)(i), eligibility 

24 standards, methodologies, or procedures under the State 

25 plan (or a waiver of such plan) that are more restrictive 


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1 than the eligibility standards, methodologies, or proce2 dures, respectively, under such plan (or waiver) that are 

3 in effect on the date of enactment of this paragraph. 

4 ‘‘(B) A State’s determination of income in accordance 

5 with subsection (e)(14) shall not be considered to be eligi6 bility standards, methodologies, or procedures that are 

7 more restrictive than the standards, methodologies, or pro8 cedures in effect under the State plan (or a waiver of such 

9 plan) on the date of enactment of this paragraph for pur10 poses of determining compliance with the requirement of 

11 subparagraph (A).’’. 

12 (B) CHIP.—Section 2105(d) of the Social 

13 Security Act (42 U.S.C. 1397ee(d)) is amended 

14 by adding at the end the following new para15 graph: 

16 ‘‘(4) IN ELIGIBILITY STANDARDS FOR TAR17 GETED LOW-INCOME PREGNANT WOMEN.—During 

18 the period that begins on the date of enactment of 

19 this paragraph and ends on the date that is five 

20 years after such date of enactment, as a condition 

21 of receiving payments under subsection (a) and sec22 tion 1903(a), a State that elects to provide preg23 nancy-related assistance to targeted low-income 

24 pregnant women (as defined in section 2112(d)), or 

25 women who are eligible for such assistance through 


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1 the application of section 1903(v)(4)(A)(i) under 

2 section 2107(e)(1), shall not have in effect, with re3 spect to such women, eligibility standards, meth4 odologies, or procedures under the State child health 

5 plan (or a waiver of such plan) that are more re6 strictive than the eligibility standards, methodolo7 gies, or procedures, respectively, under such plan (or 

8 waiver) that are in effect on the date of enactment 

9 of this paragraph.’’. 

10 (5) EFFECTIVE DATE.— 

11 (A) IN GENERAL.—Except as otherwise 

12 provided and subject to subparagraph (B), the 

13 amendments made by this subsection shall take 

14 effect with respect to eligibility determinations 

15 made with respect to a State plan under title 

16 XIX of the Social Security Act or a State child 

17 health plan under title XXI of such Act on or 

18 after the date that is one year after the date of 

19 enactment of this Act. 

20 (B) EXCEPTION FOR STATE LEGISLA21 TION.—In the case of a State plan under title 

22 XIX of the Social Security Act or a State child 

23 health plan under title XXI of such Act that 

24 the Secretary of Health and Human Services 

25 determines requires State legislation in order 


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1 for the respective plan to meet any requirement 

2 imposed by amendments made by this sub3 section, the respective plan shall not be re4 garded as failing to comply with the require5 ments of such title solely on the basis of its fail6 ure to meet such an additional requirement be7 fore the first day of the first calendar quarter 

8 beginning after the close of the first regular 

9 session of the State legislature that begins after 

10 the date of enactment of this Act. For purposes 

11 of the previous sentence, in the case of a State 

12 that has a 2-year legislative session, each year 

13 of the session shall be considered to be a sepa14 rate regular session of the State legislature. 

15 (e) REGIONAL CENTERS OF EXCELLENCE.—Part P 

16 of title III of the Public Health Service Act is amended 

17 by adding at the end the following new section: 

18 ‘‘SEC. 399V–7. REGIONAL CENTERS OF EXCELLENCE AD19 DRESSING IMPLICIT BIAS AND CULTURAL 

20 COMPETENCY IN PATIENT-PROVIDER INTER21 ACTIONS EDUCATION. 

22 ‘‘(a) IN GENERAL.—Not later than one year after the 

23 date of enactment of this section, the Secretary, in con24 sultation with such other agency heads as the Secretary 

25 determines appropriate, shall, subject to the availability of 


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1 appropriations, award cooperative agreements for the es2 tablishment or support of regional centers of excellence ad3 dressing implicit bias and cultural competency in patient4 provider interactions education for the purpose of enhanc5 ing and improving how health care professionals are edu6 cated in implicit bias and delivering culturally competent 

7 health care. 

8 ‘‘(b) ELIGIBILITY.—To be eligible to receive a cooper9 ative agreement under subsection (a), an entity shall— 

10 ‘‘(1) be an entity specified by the Secretary that 

11 provides educational opportunities for students in a 

12 health care profession, which may include a health 

13 system, teaching hospital, birthing center, commu14 nity health center, physician’s office, medical school, 

15 school of public health, or any other health profes16 sional school or a program at an institution of high17 er education focused on the prevention, treatment, 

18 or recovery of health conditions that contribute to 

19 maternal mortality and the prevention of maternal 

20 mortality; 

21 ‘‘(2) demonstrate community engagement and 

22 participation through community partners such as 

23 mental health counselors and social workers; and 


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1 ‘‘(3) provide to the Secretary such information, 

2 at such time and in such manner, as the Secretary 

3 may require. 

4 ‘‘(c) DIVERSITY.—In awarding a cooperative agree5 ment under subsection (a), the Secretary shall take into 

6 account any regional differences among eligible entities 

7 and make an effort to ensure geographic diversity among 

8 award recipients. 

9 ‘‘(d) DISSEMINATION OF INFORMATION.— 

10 ‘‘(1) PUBLIC AVAILABILITY.—The Secretary 

11 shall make publicly available on the Internet website 

12 of the Department of Health and Human Services 

13 information submitted to the Secretary under sub14 section (b)(3). 

15 ‘‘(2) EVALUATION.—The Secretary shall evalu16 ate each regional center of excellence established or 

17 supported pursuant to subsection (a) and dissemi18 nate the findings resulting from each such evalua19 tion to the appropriate public and private entities. 

20 ‘‘(e) MATERNAL MORTALITY DEFINED.—In this sec21 tion, the term ‘maternal mortality’ means death that oc22 curs to a woman during pregnancy or within the one-year 

23 period following the end of such pregnancy. 

24 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For 

25 purposes of carrying out this section, there is authorized 


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1 to be appropriated $5,000,000 for each of fiscal years 

2 2019 through 2023.’’. 

3 (f) DEFINITIONS.—In this section: 

4 (1) MATERNAL MORTALITY.—The term ‘‘mater5 nal mortality’’ means death that occurs to a woman 

6 during pregnancy or within the one-year period fol7 lowing the end of such pregnancy. 

8 (2) SEVERE MATERNAL MORBIDITY.—The term 

9 ‘‘severe maternal morbidity’’ includes unexpected 

10 outcomes of labor and delivery that result in signifi11 cant short-term or long-term consequences to a 

12 woman’s health. 

Æ 


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