I 
115TH CONGRESS 
1ST SESSION H. R. 1318 
To support States in their work to save and sustain the health of mothers 
during pregnancy, childbirth, and in the postpartum period, to eliminate 
disparities in maternal health outcomes for pregnancy-related and preg-
nancy-associated deaths, to identify solutions to improve health care 
quality and health outcomes for mothers, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 2, 2017 
Ms. HERRERA BEUTLER (for herself, Mr. CONYERS, Mr. COSTELLO of Penn-
sylvania, and Ms. DEGETTE) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce 
A BILL 
To support States in their work to save and sustain the 
health of mothers during pregnancy, childbirth, and in 
the postpartum period, to eliminate disparities in mater-
nal health outcomes for pregnancy-related and preg-
nancy-associated deaths, to identify solutions to improve 
health care quality and health outcomes for mothers, 
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 ‘‘Preventing Maternal 
Deaths Act of 2017’’. 
SEC. 2. FINDINGS; PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
(1) The United States is ranked 50th globally 
for its maternal mortality rate, and it is one of eight 
countries in which the maternal mortality rate has 
been on the rise. 
(2) In recent studies, the estimated maternal 
mortality rate in the United States increased by ap-
proximately 26.6 percent from 2000 to 2014, with 
the rate increasing in nearly all States. This re-
ported increase, along with no improvement in pre-
vious years, remains a source of great concern for 
the Centers for Disease Control and Prevention 
(CDC), health care providers, and patient advocates 
such as the American Congress of Obstetricians and 
Gynecologists, the Association of Women’s Health, 
Obstetric, 
and 
Neonatal 
Nurses, 
and 
the 
Preeclampsia Foundation. 
(3) Maternal deaths in the United States result 
from pregnancy-related causes such as hemorrhage, 
hypertensive disease and preeclampsia, embolic dis-
ease, sepsis, and substance use disorder and over-
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dose, and violent causes such as motor vehicle acci-
dents, homicide, and suicide. 
(4) Review of pregnancy-related and pregnancy- 
associated deaths is essential to determining strate-
gies for developing prevention efforts and quality im-
provement and quality control programs. The United 
States must identify at-risk populations and under-
stand how to support them to make pregnancy and 
the postpartum period safer. 
(5) The most severe complications of preg-
nancy, generally referred to as severe maternal mor-
bidity (SMM), affect more than 65,000 women in 
the United States every year. The CDC uses ICD– 
9–CM codes, which indicate a potentially life-threat-
ening maternal condition or complication, to define 
SMM. 
(6) Data from the CDC shows Black women 
are three times more likely to die from complications 
of pregnancy or childbirth than White women: 42.8 
Black women per 100,000 live births, as opposed to 
12.5 White women and 17.3 women of other races. 
(7) The CDC recommends that maternal deaths 
be investigated through State collaboratives. These 
State collaboratives would bring together leaders in 
obstetric and neonatal health care from private, aca-
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demic, and public health care settings to make rec-
ommendations for preventing pregnancy-related and 
pregnancy-associated deaths and health complica-
tions and identify ways to improve quality of care 
for women and infants. 
(8) A few States, including California, have 
worked to develop and strengthen maternal mor-
bidity and mortality review systems and utilize data 
to reduce maternal deaths and injuries to address 
leading issues such as maternal hemorrhage, hyper-
tension and preeclampsia, and health and racial dis-
parities. 
(b) PURPOSES.—The purposes of this Act are the fol-
lowing: 
(1) To establish a shared responsibility between 
States and the Federal Government to identify op-
portunities for improvement in quality of care and 
system changes, and to educate and inform health 
institutions and professionals, women, and families 
about preventing pregnancy-related and pregnancy- 
associated deaths and complications and reducing 
disparities. 
(2) To develop a model for States to operate 
maternal mortality reviews and assess the various 
factors that may have contributed to maternal mor-
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tality, including quality of care, racial disparities, 
and systemic problems in the delivery of health care, 
and to develop appropriate interventions to reduce 
and prevent such deaths. 
SEC. 3. STATE MATERNAL MORTALITY REVIEW COMMIT-
TEES ON PREGNANCY-RELATED AND PREG-
NANCY-ASSOCIATED DEATHS. 
(a) PROGRAM AUTHORIZED.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services, through the Director of the Cen-
ters for Disease Control and Prevention, shall estab-
lish a grant program under which the Secretary may 
make grants to States for the purpose of— 
(A) carrying out the activities described in 
subsection (b)(1); 
(B) establishing and sustaining a State 
maternal mortality review committee, in accord-
ance with subsection (b)(2); 
(C) ensuring that the State department of 
health carries out the activities described in 
subsection (b)(3); 
(D) disseminating the case abstraction 
form developed under subsection (c); and 
(E) providing for the public disclosure of 
information, in accordance with subsection (d). 
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(2) CRITERIA.—The Secretary shall establish 
criteria for determining eligibility for, and the 
amount of a grant awarded to, a State under para-
graph (1). Such criteria shall provide that in the 
case of a State that receives a grant under para-
graph (1) for a fiscal year and is determined by the 
Secretary to have not used such grant in accordance 
with this section, such State may not be eligible for 
such a grant for any subsequent fiscal year. 
(b) USE OF FUNDS.— 
(1) REVIEW
OF
PREGNANCY-RELATED
AND 
PREGNANCY-ASSOCIATED DEATHS.—With respect to 
a State that receives a grant under subsection 
(a)(1), the following shall apply: 
(A) PROCESS FOR MANDATORY REPORTING 
OF PREGNANCY-RELATED AND PREGNANCY-AS-
SOCIATED DEATHS.— 
(i) IN GENERAL.—The State, through 
the State maternal mortality review com-
mittee established under subsection (a)(1), 
shall develop a process that provides for 
mandatory and confidential case reporting 
to the State department of health by indi-
viduals and entities described in clause (ii) 
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with respect to pregnancy-related and 
pregnancy-associated deaths. 
(ii) INDIVIDUALS AND ENTITIES DE-
SCRIBED.—Individuals and entities de-
scribed in this clause include each of the 
following: 
(I) Health care professionals. 
(II) Medical examiners. 
(III) Medical coroners. 
(IV) Hospitals. 
(V) Birth centers. 
(VI) Other health care facilities. 
(VII) Other individuals respon-
sible for completing death records. 
(VIII) Other appropriate individ-
uals or entities specified by the Sec-
retary. 
(B) PROCESS FOR VOLUNTARY REPORTING 
OF PREGNANCY-RELATED AND PREGNANCY-AS-
SOCIATED
DEATHS.—The State, through the 
State maternal mortality review committee es-
tablished under subsection (a)(1), shall develop 
a process that provides for voluntary and con-
fidential case reporting to the State department 
of health by family members of the deceased 
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