(13) There is extensive research demonstrating 
that certified nurse midwives, when compared to Ob-
stetrician-Gynecologists, provide high quality of care 
with comparable or better outcomes, high levels of 
patient satisfaction, and at lower costs due to fewer 
unnecessary, invasive, and expensive technologic 
interventions. 
(14) Approximately 1 percent of births in the 
United States take place in non-hospital settings. Of 
such births, 27 percent occur in birth centers and 65 
percent are home births. Hospitals remain the set-
ting of delivery for 99 percent of all births despite 
the following findings: 
(A) Multiple studies have demonstrated 
that for women who meet criteria to be consid-
ered at low risk for obstetrical complications, 
labor and delivery at a birth center can result 
in higher patient satisfaction and equivalent or 
better outcomes than in-hospital birth. 
(B) Studies have consistently found that 
for low-risk mothers, planned home birth had 
the same outcomes as hospital births for similar 
risk women, but with fewer costly and often 
preventable interventions. 
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(C) In a nationwide comparison of birth 
center costs to hospital costs, it is estimated 
that if 100,000 births were attended in birth 
centers, access to care would be greatly im-
proved, and annual savings would total more 
than $314,000,000. 
(15) Midwives serve as faculty at many of the 
Nation’s most prominent academic health centers, 
however, the time they spend training medical stu-
dents, residents, and midwifery students is not reim-
bursed as it is for physicians. As a result, medical 
students, residents, and midwifery students often 
fail to benefit from the practice experience and phys-
iologic birth expertise of midwives. 
TITLE I—HHS FOCUS ON THE 
PROMOTION OF OPTIMAL MA-
TERNITY CARE 
SEC. 101. ADDITIONAL FOCUS AREA FOR THE OFFICE ON 
WOMEN’S HEALTH. 
Section 229(b) of the Public Health Service Act (42 
U.S.C. 237a(b)) is amended— 
(1) in paragraph (6), at the end, by striking 
‘‘and’’; 
(2) in paragraph (7), at the end, by striking the 
period and inserting ‘‘; and’’; and 
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(3) by adding at the end the following new 
paragraph: 
‘‘(8) facilitate policy makers, health system 
leaders and providers, consumers, and other stake-
holders in their understanding optimal maternity 
care and support for the provision of such care, in-
cluding the priorities of— 
‘‘(A) protecting, promoting, and supporting 
the innate capacities of childbearing women and 
their newborns for childbirth, breast-feeding, 
and attachment; 
‘‘(B) using obstetric interventions only 
when such interventions are supported by 
strong, high-quality evidence, and minimizing 
overuse of maternity practices that have been 
shown to have benefit in limited situations and 
that can expose women, infants, or both to risk 
of harm if used routinely and indiscriminately, 
including continuous electronic fetal monitoring, 
labor induction, epidural analgesia, primary ce-
sarean section, and routine repeat cesarean 
birth; 
‘‘(C) reliably providing beneficial practices 
with no or minimal evidence of harm that are 
underused, including smoking cessation pro-
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grams in pregnancy, group model prenatal care, 
continuous labor support, non-supine positions 
for birth, and external version to turn breech 
babies at term; 
‘‘(D) a shared understanding of the quali-
fications of licensed providers of maternity care 
and the best evidence about the safety, satisfac-
tion, outcomes, and costs of their care, and ap-
propriate deployment of such caregivers within 
the maternity care workforce to address the 
needs of childbearing women and newborns and 
the growing shortage of maternity caregivers; 
‘‘(E) a shared understanding of the results 
of the best available research comparing hos-
pital, birth center, and planned home births, in-
cluding information about each setting’s safety, 
satisfaction, outcomes, and costs; and 
‘‘(F) informed decisionmaking by child-
bearing women.’’. 
SEC. 102. INTERAGENCY COORDINATING COMMITTEE ON 
THE PROMOTION OF OPTIMAL MATERNITY 
OUTCOMES. 
(a) IN GENERAL.—Part B of title II of the Public 
Health Service Act is amended by adding at the end the 
following new section: 
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‘‘SEC. 229A. INTERAGENCY COORDINATING COMMITTEE ON 
THE PROMOTION OF OPTIMAL MATERNITY 
OUTCOMES. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Deputy Assistant 
Secretary for Women’s Health under section 229 and in 
collaboration with the Federal officials specified in sub-
section (b), shall establish the Interagency Coordinating 
Committee on the Promotion of Optimal Maternity Out-
comes (referred to in this subsection as the ‘ICCPOM’). 
‘‘(b) OTHER AGENCIES.—The officials specified in 
this subsection are the Secretary of Labor, the Secretary 
of Defense, the Secretary of Veterans Affairs, the Surgeon 
General, the Director of the Centers for Disease Control 
and Prevention, the Administrator of the Health Re-
sources and Services Agency, the Administrator of the 
Centers for Medicare & Medicaid Services, the Director 
of the Indian Health Service, the Administrator of the 
Substance Abuse and Mental Health Services Administra-
tion, the Director of the National Institute on Child 
Health and Development, the Director of the Agency for 
Healthcare Research and Quality, the Assistant Secretary 
for Children and Families, the Deputy Assistant Secretary 
for Minority Health, the Director of the Office of Per-
sonnel Management, and such other Federal officials as 
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