I 
115TH CONGRESS 
2D SESSION 
H. R. 6698 
To support States in their work to end preventable morbidity and mortality 
in maternity care by using evidence-based quality improvement to protect 
the health of mothers during pregnancy, childbirth, and in the 
postpartum period and to reduce neonatal and infant mortality, to elimi-
nate racial disparities in maternal health outcomes, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 4, 2018 
Ms. ADAMS (for herself and Ms. CLARKE of New York) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To support States in their work to end preventable morbidity 
and mortality in maternity care by using evidence-based 
quality improvement to protect the health of mothers 
during pregnancy, childbirth, and in the postpartum pe-
riod and to reduce neonatal and infant mortality, to 
eliminate racial disparities in maternal health outcomes, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Maternal Care Access 
and Reducing Emergencies Act’’ or the ‘‘Maternal CARE 
Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) In the United States, maternal mortality 
rates are among the highest in the developed world 
and increased by 26.6 percent between 2000 and 
2014. 
(2) Of the 4,000,000 American women who give 
birth each year, about 700 suffer fatal complications 
during pregnancy, while giving birth, or during the 
postpartum period, and an additional 50,000 are se-
verely injured. 
(3) It is estimated that half of the maternal 
mortalities in the United States could be prevented 
and half of the maternal injuries in the United 
States could be reduced or eliminated with better 
care. 
(4) Data from the Centers for Disease Control 
and Prevention show that Black women are 3 to 4 
times more likely to die from pregnancy-related 
causes than White women. There are 40 deaths per 
100,000 live births for Black women, compared to 
12.4 deaths per 100,000 live births for White women 
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and 17.8 deaths per 100,000 live births for women 
of other races. 
(5) Black women’s risk of maternal mortality 
has remained higher than White women’s risk for 
the past 6 decades. 
(6) Black women in the United States suffer 
from life-threatening pregnancy complications twice 
as often as their White counterparts. 
(7) High rates of maternal mortality among 
Black women span income and education levels, as 
well as socioeconomic status; moreover, risk factors 
such as a lack of access to prenatal care and phys-
ical health conditions do not fully explain the racial 
disparity in maternal mortality. 
(8) A growing body of evidence indicates that 
stress from racism and racial discrimination results 
in conditions—including hypertension and pre-ec-
lampsia—that contribute to poor maternal health 
outcomes among Black women. 
(9) Pervasive racial bias against Black women 
and unequal treatment of Black women exist in the 
health care system, often resulting in inadequate 
treatment for pain and dismissal of cultural norms 
with respect to health. A 2016 study by University 
of Virginia researchers found that White medical 
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students and residents often believed biological 
myths about racial differences in patients, including 
that Black patients have less-sensitive nerve endings 
and thicker skin than their White counterparts. Pro-
viders, however, are not consistently required to un-
dergo implicit bias, cultural competency, or empathy 
training. 
(10) North Carolina has established a statewide 
Pregnancy Medical Home (PMH) program, which 
aims to reduce adverse maternal health outcomes 
and maternal deaths by incentivizing maternal 
health care providers to provide integral health care 
services to pregnant women and new mothers. Ac-
cording to the North Carolina Department of Health 
and Human Services Center for Health Statistics, 
the pregnancy-related mortality rate for Black 
women was approximately 5.1 times higher than 
that of White women in 2004. Almost a decade 
later, in 2013, the pregnancy-related mortality rates 
for Black women and White women were 24.3 and 
24.2 deaths per 100,000 live births, respectively. 
The PMH program has been credited with the con-
vergence in pregnancy-related mortality rates be-
cause the program partners each high-risk pregnant 
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