I 
117TH CONGRESS 
1ST SESSION 
H. R. 958 
To codify maternity care coordination programs at the Department of 
Veterans Affairs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 8, 2021 
Ms. UNDERWOOD (for herself, Mr. BILIRAKIS, Ms. BROWNLEY, and Mr. 
FITZPATRICK) introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To codify maternity care coordination programs at the 
Department of Veterans Affairs, and for other purposes. 
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 ‘‘Protecting Moms Who 
Served Act’’. 
SEC. 2. SUPPORT FOR MATERNITY CARE COORDINATION. 
(a) PROGRAM
ON MATERNITY CARE COORDINA-
TION.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall carry out the maternity care coordina-
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tion program described in Veterans Health Adminis-
tration Handbook 1330.03, or any successor hand-
book. 
(2) TRAINING AND SUPPORT.—In carrying out 
the program under paragraph (1), the Secretary 
shall provide to community maternity care providers 
training and support with respect to the unique 
needs of pregnant and postpartum veterans, particu-
larly regarding mental and behavioral health condi-
tions relating to the service of the veterans in the 
Armed Forces. 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized 
to 
be 
appropriated 
to 
the 
Secretary 
$15,000,000 for fiscal year 2022 for the maternity care 
coordination program. Such amounts are authorized in ad-
dition to any other amounts authorized for such purpose. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘community maternity care pro-
viders’’ means maternity care providers located at 
non-Department facilities who provide maternity 
care to veterans under section 1703 of title 38, 
United States Code, or other provisions of law ad-
ministered by the Secretary of Veterans Affairs. 
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(2) The term ‘‘non-Department facilities’’ has 
the meaning given that term in section 1701 of title 
38, United States Code. 
SEC. 3. REPORT ON MATERNAL MORTALITY AND SEVERE 
MATERNAL MORBIDITY AMONG PREGNANT 
AND POSTPARTUM VETERANS. 
(a) GAO REPORT.—Not later than two years after 
the date of the enactment of this Act, the Comptroller 
General of the United States shall submit to the Commit-
tees on Veterans’ Affairs of the Senate and the House of 
Representatives, and make publicly available, a report on 
maternal mortality and severe maternal morbidity among 
pregnant and postpartum veterans, with a particular focus 
on racial and ethnic disparities in maternal health out-
comes for veterans. 
(b) MATTERS INCLUDED.—The report under sub-
section (a) shall include the following: 
(1) To the extent practicable— 
(A) the number of pregnant and postpar-
tum veterans who have experienced a preg-
nancy-related death or pregnancy-associated 
death in the most recent 10 years of available 
data; 
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(B) the rate of pregnancy-related deaths 
per 100,000 live births for pregnant and post-
partum veterans; 
(C) the number of cases of severe maternal 
morbidity among pregnant and postpartum vet-
erans in the most recent year of available data; 
(D) the racial and ethnic disparities in ma-
ternal mortality and severe maternal morbidity 
rates among pregnant and postpartum veterans; 
(E) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to veterans, including post-traumatic 
stress disorder, military sexual trauma, and in-
fertility or miscarriages that may be caused by 
such service; 
(F) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to veterans from racial and ethnic 
minority groups and other at-risk populations 
as deemed appropriate; 
(G) identification of any correlations be-
tween the former rank of veterans and their 
maternal health outcomes; 
(H) the number of veterans who have been 
diagnosed with infertility by Veterans Health 
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Administration providers each year in the most 
recent five years, disaggregated by age, race, 
ethnicity, sex, marital status, sexual orientation, 
gender identity, and geographical location; 
(I) the number of veterans who receive a 
clinical diagnosis of unexplained infertility by 
Veterans Health Administration providers each 
year in the most recent five years; and 
(J) the extent to which the rate of inci-
dence of clinically diagnosed infertility among 
veterans compare or differ to the rate of inci-
dence of clinically diagnosed infertility among 
the civilian population. 
(2) An assessment of the barriers to deter-
mining the information required under paragraph 
(1) and recommendations for improvements in track-
ing maternal health outcomes among pregnant and 
postpartum veterans— 
(A) who have health care coverage through 
the Department; 
(B) enrolled in the TRICARE program; 
(C) who are eligible to use the Indian 
Health Service, Tribal health programs, or 
urban Indian health organizations; 
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(D) with employer-based or private insur-
ance; 
(E) enrolled in the Medicaid program; and 
(F) who are uninsured. 
(3) Recommendations for legislative and admin-
istrative actions to increase access to mental and be-
havioral health care for pregnant and postpartum 
veterans who screen positively for maternal mental 
or behavioral health conditions. 
(4) Recommendations to address homelessness, 
food insecurity, poverty, and related issues among 
pregnant and postpartum veterans. 
(5) Recommendations on how to effectively edu-
cate maternity care providers on best practices for 
providing maternity care services to veterans that 
addresses the unique maternal health care needs of 
the veteran population. 
(6) Recommendations to reduce maternal mor-
tality and severe maternal morbidity among preg-
nant and postpartum veterans and to address racial 
and ethnic disparities in maternal health outcomes 
for each of the groups described in subparagraphs 
(A) through (E) of paragraph (2). 
(7) Recommendations to improve coordination 
of care between the Department and non-Depart-
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ment facilities for pregnant and postpartum vet-
erans, including recommendations to improve— 
(A) health record interoperability; and 
(B) training for the directors of the Vet-
erans Integrated Service Networks, directors of 
medical facilities of the Department, chiefs of 
staff of such facilities, maternity care coordina-
tors, and staff of relevant non-Department fa-
cilities. 
(8) An assessment of the authority of the Sec-
retary of Veterans Affairs to access maternal health 
data collected by the Department of Health and 
Human Services and, if applicable, recommendations 
to increase such authority. 
(9) To the extent applicable, an assessment of 
potential causes of or explanations for lower mater-
nal mortality rates among veterans who have health 
coverage through the Department of Veterans Af-
fairs compared to maternal mortality rates in the 
general United States population. 
(10) Any other information the Comptroller 
General determines appropriate with respect to the 
reduction of maternal mortality and severe maternal 
morbidity among pregnant and postpartum veterans 
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and to address racial and ethnic disparities in ma-
ternal health outcomes for veterans. 
SEC. 4. DEFINITIONS. 
In this Act: 
(1) MATERNAL MORTALITY.—The term ‘‘mater-
nal mortality’’ means a death occurring during or 
within a one-year period after pregnancy, caused by 
pregnancy-related or childbirth complications, in-
cluding a suicide, overdose, or other death resulting 
from a mental health or substance use disorder at-
tributed to or aggravated by pregnancy-related or 
childbirth complications. 
(2) POSTPARTUM AND POSTPARTUM PERIOD.— 
The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 
refer to the 1-year period beginning on the last day 
of the pregnancy of an individual. 
(3) 
PREGNANCY-ASSOCIATED
DEATH.—The 
term ‘‘pregnancy-associated death’’ means a death of 
a pregnant or postpartum individual, by any cause, 
that occurs during, or within 1 year following, the 
individual’s pregnancy, regardless of the outcome, 
duration, or site of the pregnancy. 
(4) PREGNANCY-RELATED
DEATH.—The term 
‘‘pregnancy-related death’’ means a death of a preg-
nant or postpartum individual that occurs during, or 
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within 1 year following, the individual’s 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) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given such term in section 1707(g)(1) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)(1)). 
(6) SEVERE MATERNAL MORBIDITY.—The term 
‘‘severe maternal morbidity’’ means a health condi-
tion, including mental health conditions and sub-
stance use disorders, attributed to or aggravated by 
pregnancy or childbirth that results in significant 
short-term or long-term consequences to the health 
of the individual who was pregnant. 
Æ 
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