(2) The four-fold increase in risk of maternal
death among black women compared to white women
is one of the largest racial disparities among the
public health indicators.
(3) United States vital statistics data indicate
that between 1987 and 1996 at least 3,086 women
died as a consequence of pregnancy or its complica-
tions in the United States.
(4) Misclassification on death certificates causes
these data to underestimate maternal mortality, and
the true number of maternal deaths is estimated to
be 1.3 to 3 times higher than that reported in vital
statistics records, indicating a need for improved
surveillance and public monitoring of this outcome.
(5) Early diagnosis and effective treatment of
pregnancy complications are critical to reduce ma-
ternal mortality.
(6) Underserved populations many times live in
socioeconomic conditions that lack the support sys-
tems and financial resources necessary to ensure
quality health care for expectant mothers and infant
newborns.
(7) By investing in public health surveillance
and prevention research to monitor and identify
causes of maternal mortality and in maternal health
programs to promote maternal health, the risk of
maternal mortality and morbidity can be reduced in
the United States.
SEC. 2. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.
Title III of the Public Health Service Act (42 U.S.C.
241 et seq.) is amended by adding at the end the fol-
lowing:
‘‘PART Q—SAFE MOTHERHOOD PROMOTION
‘‘SEC. 399L. SAFE MOTHERHOOD MONITORING.
‘‘(a) PURPOSE.—It is the purpose of this section to
develop monitoring systems at the local, State, and na-
tional level to better understand the burden of maternal
complications and mortality and to decrease the disparities
among population at risk of death and complications from
pregnancy.
‘‘(b) ACTIVITIES.—For the purpose described in sub-
section (a), the Secretary may carry out the following ac-
tivities:
‘‘(1) The Secretary, acting through the Centers
for Disease Control and Prevention, may establish
and implement a national monitoring and surveil-
lance program to identify and promote the investiga-
tion of deaths and severe complications that occur
during pregnancy.
‘‘(2) The Secretary, acting through the Centers
for Disease Control and Prevention, may expand the
Pregnancy Risk Assessment Monitoring System to
provide surveillance and collect data in each of the
50 States.
‘‘(3) The Secretary, acting through the Centers
for Disease Control and Prevention, may expand the
Maternal and Child Health Epidemiology Program
to provide technical support, financial assistance, or
the time-limited assignment of senior epidemiologists
to maternal and child health programs in each of the
50 States.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section
such sums as may be necessary for each fiscal year (begin-
ning with fiscal year 2000).’’.
‘‘SEC. 399M. PREVENTION RESEARCH TO ENSURE SAFE
MOTHERHOOD.
‘‘(a) PURPOSE.—It is the purpose of this section to
provide the Centers for Disease Control and Prevention
with the authority to further expand research concerning
risk factors, prevention strategies, and the roles of the
family, health care providers and the community in safe
motherhood.
‘‘(b) RESEARCH.—The Secretary, acting through the
Centers for Disease Control and Prevention, may carry
out activities to expand research relating to—
‘‘(1) encouraging preconception counseling, es-
pecially for at risk populations such as diabetics;
‘‘(2) the identification of critical components of
prenatal delivery and postpartum care;
‘‘(3) the identification of outreach and support
services, such as folic acid education, that are avail-
able for pregnant women;
‘‘(4) the identification of women who are at
high risk for complications;
‘‘(5) preventing preterm delivery;
‘‘(6) preventing urinary tract infections;
‘‘(7) preventing unnecessary caesarean sections;
‘‘(8) an examination of the higher rates of ma-
ternal mortality among African American women;
‘‘(9) an examination of the relationship between
domestic violence and maternal complications and
mortality;
‘‘(10) preventing smoking, alcohol and illegal
drug usage before, during and after pregnancy;
‘‘(11) preventing infections that cause maternal
and infant complications; and
‘‘(12) other areas determined appropriate by
the Secretary.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section
such sums as may be appropriate for each fiscal year (be-
ginning with fiscal year 2000).
‘‘SEC. 399N. PREVENTION PROGRAMS TO ENSURE SAFE
MOTHERHOOD.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Centers for Disease Control and Prevention may carry
out activities to promote safe motherhood, including—
‘‘(1) public education campaigns on healthy
pregnancies and the building of partnerships with
outside organizations concerned about safe mother-
hood;
‘‘(2) education programs for physicians, nurses
and other health care providers; and
‘‘(3) activities to promote community support
services for pregnant women.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section
such sums as may be appropriate for each fiscal year (be-
ginning with fiscal year 2000).’’.
Æ