II 

116TH CONGRESS 

1ST SESSION S. 116 

To address maternal mortality and morbidity. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 15, 2019 

Mrs. GILLIBRAND (for herself, Mr. BOOKER, and Ms. HARRIS) introduced the 

following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To address maternal mortality and morbidity. 

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 ‘‘Modernizing Obstetric 

5 Medicine Standards Act of 2019’’ or the ‘‘MOMS Act’’. 

6 SEC. 2. MATERNAL MORTALITY AND MORBIDITY PREVEN7 TION. 

8 Section 317K of the Public Health Service Act (42 

9 U.S.C. 247b–12) is amended— 

10 (1) by redesignating subsection (d) as sub11 section (g); and 


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1 (2) by inserting after subsection (c) the fol2 lowing: 

3 ‘‘(d) PREGNANCY AND POSTPARTUM SAFETY AND

4 MONITORING PRACTICES AND MATERNAL MORTALITY

5 AND MORBIDITY PREVENTION.— 

6 ‘‘(1) ALLIANCE FOR INNOVATION ON MATERNAL

7 HEALTH.—The Secretary, acting through the Asso8 ciate Administrator of the Maternal and Child 

9 Health Bureau of the Health Resources and Services 

10 Administration, shall establish a program, known as 

11 the Alliance for Innovation on Maternal Health pro12 gram, to— 

13 ‘‘(A) enter into a contract with an inter14 disciplinary, multi-stakeholder, national organi15 zation promulgating a national data-driven ma16 ternal safety and quality improvement initiative 

17 based on evidence-based best practices to im18 prove maternal safety and outcomes; 

19 ‘‘(B) assist States with the development 

20 and implementation of postpartum safety and 

21 monitoring practices and maternal mortality 

22 and morbidity prevention, based on the best 

23 practices developed under paragraph (2); and 

24 ‘‘(C) improve State-specific maternal 

25 health outcomes and reduce variation in reVerDate Sep 11 2014 00:13 Jan 23, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S116.IS S116

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1 sponse to maternity and postpartum care, in 

2 order to eliminate preventable maternal mor3 tality and severe maternal morbidity. 

4 ‘‘(2) BEST PRACTICES.— 

5 ‘‘(A) IN GENERAL.—Not later than 1 year 

6 after the date of enactment of the Modernizing 

7 Obstetric Medicine Standards Act of 2019, the 

8 Secretary, acting through the Administrator of 

9 the Health Resources and Services Administra10 tion, shall work with the contracting entity 

11 under paragraph (1)(A) to— 

12 ‘‘(i) create and assist State-based col13 laborative teams in the implementation of 

14 standardized best practices, to be known as 

15 ‘maternal safety bundles’, for the purpose 

16 of maternal mortality and morbidity pre17 vention; and 

18 ‘‘(ii) collect and analyze data related 

19 to process structure and patient outcomes 

20 to drive continuous quality improvement in 

21 the implementation of the maternal safety 

22 bundles by such State-based teams. 

23 ‘‘(B) MATERNAL SAFETY BUNDLES.—The 

24 best practices issued under subparagraph (A) 

25 may address the following topics: 


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1 ‘‘(i) Obstetric hemorrhage. 

2 ‘‘(ii) Maternal mental, behavioral, and 

3 emotional health. 

4 ‘‘(iii) Maternal venous and thrombo5 embolism. 

6 ‘‘(iv) Severe hypertension in preg7 nancy, including preeclampsia. 

8 ‘‘(v) Obstetric care for women with 

9 substance abuse disorder. 

10 ‘‘(vi) Postpartum care basics for ma11 ternal safety. 

12 ‘‘(vii) Reduction of racial and ethnic 

13 disparities in maternity care. 

14 ‘‘(viii) Safe reduction of primary ce15 sarean birth. 

16 ‘‘(ix) Severe maternal morbidity re17 view. 

18 ‘‘(x) Support after a severe maternal 

19 morbidity event. 

20 ‘‘(xi) Ways to empower and listen to 

21 women before, during, and after childbirth 

22 to ensure better communication between 

23 patients and health care providers. 


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1 ‘‘(xii) Other leading causes of mater2 nal mortality and morbidity, including in3 fection or sepsis and cardiomyopathy. 

4 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

5 To carry out this subsection, in addition to amounts 

6 appropriated under subsection (g), there are author7 ized to be appropriated $5,000,000 for each of fiscal 

8 years 2020 through 2024.’’. 

9 SEC. 3. MATERNAL MORTALITY AND MORBIDITY PREVEN10 TION GRANTS. 

11 Section 317K of the Public Health Service Act (42 

12 U.S.C. 247b–12), as amended by section 2, is further 

13 amended by inserting after subsection (d) the following: 

14 ‘‘(e) MATERNAL MORTALITY AND MORBIDITY PRE15 VENTION GRANT PROGRAM.— 

16 ‘‘(1) IN GENERAL.—The Secretary, acting 

17 through the Associate Administrator of the Maternal 

18 and Child Health Bureau of the Health Resources 

19 and Services Administration, shall award grants to 

20 States or hospitals to assist in the development and 

21 implementation of the maternal safety bundles de22 scribed in subsection (d)(2). 

23 ‘‘(2) USE OF FUNDS.— 


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1 ‘‘(A) IN GENERAL.—A State or hospital re2 ceiving a grant under this subsection may use 

3 such funds— 

4 ‘‘(i) to purchase equipment and sup5 plies to effectively implement and execute 

6 the maternal safety bundles described in 

7 subsection (d)(2); and 

8 ‘‘(ii) to develop training on, and eval9 uation of the effectiveness of, such mater10 nal safety bundles. 

11 ‘‘(B) PRIORITY USE OF FUNDS FOR STATE

12 GRANTEES.—A State receiving a grant under 

13 this subsection shall allocate such funds giving 

14 priority to the hospitals in such State that serve 

15 high volumes of low-income, at-risk, or rural 

16 populations. 

17 ‘‘(3) PRIORITIZATION OF GRANT APPLICA18 TIONS.—In awarding grants under this subsection, 

19 the Secretary shall prioritize applications from 

20 States, or hospitals within States, that— 

21 ‘‘(A) have a functioning maternal mortality 

22 review committee in accordance with best prac23 tices promulgated by the Building U.S. Capac24 ity to Review and Prevent Maternal Deaths Ini25 tiative of the Centers for Disease Control and 


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1 Prevention, the CDC Foundation, and the Asso2 ciation of Maternal and Child Health Programs; 

3 or 

4 ‘‘(B) serve high volumes of low-income, at5 risk, or rural populations. 

6 ‘‘(4) REPORTING REQUIREMENTS.— 

7 ‘‘(A) IN GENERAL.—Not later than 2 years 

8 after receipt of a grant under this subsection, 

9 each recipient of such a grant shall submit a re10 port to the Secretary describing— 

11 ‘‘(i) implementation of the maternal 

12 safety bundles with use of the grant funds; 

13 ‘‘(ii) any incidents of pregnancy-re14 lated deaths or pregnancy-associated 

15 deaths, and any pregnancy-related com16 plications or pregnancy-associated com17 plications occurring in the 1-year period 

18 prior to implementation of such proce19 dures; and 

20 ‘‘(iii) any incidents of pregnancy-re21 lated deaths or pregnancy-associated 

22 deaths, and any pregnancy-related com23 plications or pregnancy-associated com24 plications occurring after implementation 

25 of such procedures. 


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1 ‘‘(B) PUBLIC AVAILABILITY; REPORT TO

2 CONGRESS.—Within 1 year of receiving the re3 ports under subparagraph (A), the Secretary 

4 shall— 

5 ‘‘(i) make the reports submitted under 

6 subparagraph (A) publicly available; and 

7 ‘‘(ii) submit a report to Congress that 

8 describes the grants awarded under this 

9 subsection, the effectiveness of the grant 

10 program under this subsection, the activi11 ties for which grant funds were used, and 

12 any recommendations to further prevent 

13 maternal mortality and morbidity. 

14 ‘‘(C) AUTHORIZATION OF APPROPRIA15 TIONS.—To carry out this subsection, in addi16 tion to amounts appropriated under subsection 

17 (g), there are authorized to be appropriated 

18 $40,000,000 for each of fiscal years 2020 

19 through 2024. 

20 ‘‘(f) DEFINITIONS.—In this section— 

21 ‘‘(1) the terms ‘pregnancy-associated death’ and 

22 ‘pregnancy-associated complication’ mean the death 

23 or medical complication, respectively, of a woman 

24 that occurs during, or within 1 year following, her 


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1 pregnancy, regardless of the outcome, duration, or 

2 site of the pregnancy; 

3 ‘‘(2) the terms ‘pregnancy-related death’ and 

4 ‘pregnancy-related complication’ mean the death or 

5 medical complication, respectively, of a woman 

6 that— 

7 ‘‘(A) occurs during, or within 1 year fol8 lowing, her pregnancy, regardless of the out9 come, duration, or site of the pregnancy; 

10 ‘‘(B) is from any cause related to, or ag11 gravated by, the pregnancy or its management; 

12 and 

13 ‘‘(C) is not from an accidental or inci14 dental cause; and 

15 ‘‘(3) the term ‘severe maternal morbidity’ 

16 means the unexpected outcomes of labor and deliv17 ery that result in significant short- or long-term con18 sequences to a woman’s health.’’. 

19 SEC. 4. REPORTING ON PREGNANCY-RELATED AND PREG20 NANCY-ASSOCIATED DEATHS AND COMPLICA21 TIONS. 

22 (a) IN GENERAL.—The Secretary of Health and 

23 Human Services shall encourage each State to voluntarily 

24 submit to the Secretary each year a report containing the 

25 findings of a State maternal mortality review committee 


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1 with respect to each maternal death in the State that the 

2 committee reviewed during the year. 

3 (b) MATERNAL AND INFANT HEALTH.—The Director 

4 of the Centers for Disease Control and Prevention shall— 

5 (1) update the Pregnancy Mortality Surveil6 lance System or develop a separate system so that 

7 such system is capable of including data obtained 

8 from State maternal mortality review committees; 

9 and 

10 (2) provide technical assistance to States in re11 viewing cases of pregnancy-related complications and 

12 pregnancy-associated complications. 

13 (c) DEFINITIONS.—In this section, the terms ‘‘preg14 nancy-associated complication’’ and ‘‘pregnancy-related 

15 complication’’ have the meanings given such terms in sec16 tion 317K of the Public Health Service Act, as amended 

17 by section 3. 

Æ 


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