I 
117TH CONGRESS 
2D SESSION 
H. R. 9602 
To improve the public health response to addressing maternal mortality and 
morbidity during the COVID–19 public health emergency. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 15, 2022 
Ms. UNDERWOOD introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees 
on Education and Labor, and Natural Resources, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To improve the public health response to addressing maternal 
mortality and morbidity during the COVID–19 public 
health emergency. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Maternal Health Pan-
demic Response Act of 2022’’. 
SEC. 2. FINDINGS. 
Congress finds as follows: 
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(1) The World Health Organization declared 
COVID–19 a ‘‘Public Health Emergency of Inter-
national Concern’’ on January 30, 2020. As of De-
cember 12, 2022, there have been over 643,875,000 
confirmed cases of, and over 6,630,000 deaths asso-
ciated with, COVID–19 worldwide. 
(2) In the United States, the number of cases 
of COVID–19 has quickly surpassed the number of 
such cases in every other nation, and as of Decem-
ber 12, 2022, over 99,000,000 cases and 1,080,000 
deaths have been reported by the United States 
alone. 
(3) Longstanding systemic health and social in-
equities have put communities of color at increased 
risk of contracting COVID–19 or experiencing se-
vere illness; age-adjusted hospitalization rates from 
COVID–19 are highest for American Indian and 
Alaska Native, Black, and Latinx people. 
(4) Prior to the start of the COVID–19 pan-
demic, the United States was facing a maternal mor-
tality and morbidity crisis, in which the United 
States has the highest maternal mortality rate in the 
developed world, and the crisis is worsening. 
(5) More than 50,000 women in the United 
States annually experience severe maternal mor-
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bidity, and much larger numbers experience more 
common harmful challenges, such as prenatal and 
postpartum mood disorders, including depression, 
anxiety disorder, and PTSD; limited access to pre-
natal and postpartum care, diagnosis, and treatment 
of complications; intimate partner violence; and lack 
of support for meeting breastfeeding goals. Many 
perinatal complications are preventable or treatable, 
and most injuries, long-term adverse effects, and 
deaths are preventable. 
(6) Compared to White women, Black and 
American Indian and Alaska Native women in the 
United States are 2 to 4 times more likely to die 
from pregnancy-related complications, and Black 
and American Indian and Alaska Native women suf-
fer disproportionately high rates of maternal mor-
bidity. The maternal mortality rate for Hispanic 
women, which historically has been lower than such 
rate for White women, is increasing and is now 
nearly the same as that of White women. 
(7) The causes of maternal mortality and mor-
bidity are complex and include racial, ethnic, socio-
economic, and geographic inequities; racism, bias, 
and discrimination; comorbidities; and inadequate 
access to the health care system, including behav-
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ioral health care, which are factors that have simi-
larly contributed to the racial disparities seen in 
COVID–19 outcomes. 
(8) The burden of morbidity and mortality in 
the United States for both COVID–19 and maternal 
health outcomes has also fallen disproportionately on 
Black, Latinx, and American Indian and Alaska Na-
tive communities, who suffer the most from great 
public health needs and are the most medically un-
derserved. Underserved women also include those liv-
ing in maternity care deserts, which lack obstetric 
providers and hospitals or birth centers offering ob-
stetric care. 
(9) According to the Centers for Disease Con-
trol and Prevention, ‘‘pregnant and recently preg-
nant people with COVID–19 are at increased risk 
for severe illness when compared with non-pregnant 
people’’. 
Additionally, 
‘‘pregnant 
people 
with 
COVID–19 are also at increased risk for preterm 
birth and some data suggest an increased risk for 
other adverse pregnancy complications and out-
comes, such as preeclampsia, coagulopathy, and still-
birth, compared with pregnant people without 
COVID–19’’. Research has also shown that COVID– 
19 infection during pregnancy may increase the risk 
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of preeclampsia; having preeclampsia and other 
pregnancy complications also increases the risks of 
serious COVID–19 infection. 
(10) As of December 2022, the latest informa-
tion from the Centers for Disease Control and Pre-
vention indicates that pregnant women are more 
likely to be hospitalized and are at higher risk for 
intensive care unit admissions than nonpregnant 
women due to COVID–19, and Latinx and Black 
pregnant people have been disproportionately in-
fected by COVID–19, as well as more likely to expe-
rience severe disease. 
(11) Our understanding of the specific impact 
of COVID–19 on pregnant people has grown signifi-
cantly. Pregnant and newly delivered women are 
more susceptible to serious infection from COVID– 
19, a direct impact. In addition, the COVID–19 
pandemic has further strained the health care sys-
tem and decreased access to preconception, prenatal, 
and postpartum care. The lack of access to care, in-
cluding mental health care, increases the risks of 
maternal mortality and morbidity, pregnancy loss, 
and infant mortality. It has also added another layer 
of fear and vulnerability for pregnant people, with 
disproportionate effects on people of color. 
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(12) As of March 7, 2022, over 180,000 preg-
nant people in the United States have tested positive 
for COVID–19 and 293 pregnant people have died 
as a result of COVID–19. 
(13) The World Health Organization states 
that everyone ‘‘has the right to safe and positive 
childbirth experience, whether or not they have a 
confirmed COVID–19 infection, this includes the 
right to respect and dignity, a companion of choice, 
clear communication by maternity staff, pain relief 
strategies, and mobility in labor when possible and 
the position of choice’’. 
(14) A COVID–19 public health response with-
out concerted Federal action and focus on maternal 
health care access and quality, research, data collec-
tion, mitigation of negative socioeconomic con-
sequences of the pandemic, and protection of the 
right to safe and positive childbirth experience has 
exacerbated the maternal mortality and morbidity 
crisis. Risk has also increased for pregnant women 
who have not been provided with a continuum of re-
spectful, responsive, and empowering care from pre-
conception through postpartum, during the pan-
demic and beyond. 
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SEC. 3. DEFINITIONS. 
In this Act: 
(1) COVID–19 PUBLIC HEALTH EMERGENCY.— 
The term ‘‘COVID–19 public health emergency’’ 
means the period beginning on the date that the 
public health emergency declared by the Secretary of 
Health and Human Services under section 319 of 
the Public Health Service Act (42 U.S.C. 247d) on 
January 31, 2020, with respect to COVID–19 took 
effect, and ending on the later of the end of such 
public health emergency or January 1, 2023. 
(2) CULTURALLY CONGRUENT.—The term ‘‘cul-
turally congruent’’, with respect to care or maternity 
care, means care that is anti-racist and is in agree-
ment with the preferred cultural values, beliefs, 
worldview, and practices of the health care consumer 
and other stakeholders. 
(3) INDIAN TRIBE, TRIBAL ORGANIZATION, AND 
URBAN INDIAN ORGANIZATION.—The terms ‘‘Indian 
Tribe’’ and ‘‘Tribal organization’’ have the meanings 
given the terms ‘‘Indian tribe’’ and ‘‘tribal organiza-
tion’’, respectively, in section 4 of the Indian Self- 
Determination and Education Assistance Act (25 
U.S.C. 5304), and the term ‘‘urban Indian organiza-
tion’’ has the meaning given such term in section 4 
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of the Indian Health Care Improvement Act (25 
U.S.C. 1603). 
(4) MATERNAL MORTALITY.—The term ‘‘mater-
nal mortality’’ means a death occurring during preg-
nancy or within one year of the end of pregnancy, 
from a pregnancy complication, a chain of events 
initiated by pregnancy, or the aggravation of an un-
related condition by the physiologic effects of preg-
nancy. 
(5) POSTPARTUM.—The term ‘‘postpartum’’ 
means the 1-year period beginning on the last day 
of a person’s pregnancy. 
(6) RESPECTFUL MATERNITY CARE.—The term 
‘‘respectful maternity care’’ means care organized 
for, and provided to, all pregnant and postpartum 
people in a manner that— 
(A) is culturally congruent and linguis-
tically appropriate; 
(B) maintains a person’s dignity, privacy, 
and confidentiality; 
(C) ensures freedom from harm and mis-
treatment; and 
(D) enables informed choice and contin-
uous support during labor, childbirth, and 
postpartum. 
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(7) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(8) SEVERE MATERNAL MORBIDITY.—The term 
‘‘severe maternal morbidity’’ means an unexpected 
outcome caused by labor and delivery that results in 
significant short-term or long-term consequences to 
the health of the pregnant person. 
SEC. 4. EMERGENCY FUNDING FOR FEDERAL DATA COL-
LECTION, SURVEILLANCE, AND RESEARCH 
ON MATERNAL HEALTH OUTCOMES DURING 
THE COVID–19 PUBLIC HEALTH EMERGENCY 
OR A FUTURE PUBLIC HEALTH EMERGENCY. 
To conduct or support data collection, surveillance, 
and research on maternal health as a result of the 
COVID–19 public health emergency or a future public 
health emergency, including support to assist in the capac-
ity building for State, Tribal, territorial, and local public 
health departments to collect and transmit racial, ethnic, 
and other demographic data related to maternal health, 
there are authorized to be appropriated— 
(1) $100,000,000 for the Surveillance for 
Emerging Threats to Mothers and Babies program 
of the Centers for Disease Control and Prevention, 
to support the Centers for Disease Control and Pre-
vention in its efforts to— 
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(A) work with public health, clinical, and 
community-based organizations to provide time-
ly, continually updated guidance to families and 
health care providers on ways to reduce health 
risks to mothers and babies and tailor interven-
tions to improve their long-term health; 
(B) partner with more State, Tribal, terri-
torial, and local public health programs in the 
collection and analysis of clinical data on the 
impact of COVID–19 and future public health 
emergencies on pregnant and postpartum pa-
tients and their newborns, including among 
pregnant people of color; and 
(C) establish regionally based centers of 
excellence to offer medical, public health, and 
other knowledge to ensure communities, espe-
cially communities of color, rural communities, 
and other underserved communities can help 
pregnant and postpartum patients and infants 
get the care they need; 
(2) $30,000,000 for the Enhancing Reviews 
and Surveillance to Eliminate Maternal Mortality 
program (commonly known as the ‘‘ERASE MM 
program’’) of the Centers for Disease Control and 
Prevention, to support the Centers for Disease Con-
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