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house Bill H.R. 1318

Should the Feds Give States Money to Study Maternal Mortality?

Argument in favor

Maternal mortality in the U.S. is much worse than that of many other developed nations — and it’s getting worse. This is a public health crisis that must be addressed through rigorous study and federal funding to help develop a better understanding of its causes.

burrkitty's Opinion
···
12/11/2018
We are a first world country with a third world maternal mortality rate. How about a UNIVERSAL SINGLE PAYER HEALTHCARE SYSTEM FOR ALL, CRADLE TO GRAVE!
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Lexpost's Opinion
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12/11/2018
It is an utter sin that here, in the richest, most advanced country with (allegedly) the highest quality healthcare in the world, that we have maternal mortality rates that rival the third world. Where are all the family values, pro birth supporters on this issue? Working for ill-considered trickle down tax cuts? A country is only as healthy as its citizenship.
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Marc's Opinion
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12/11/2018
And they need to fund planned parenthood because they are at the center of prevention.
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Argument opposed

State committees aren’t the solution to investigating maternal mortality. In many cases, MMRC committees focus on the wrong issues, leading to incorrect and useless conclusions about maternal health.

Christina's Opinion
···
12/11/2018
This won't fix the problem anyway. The bigger picture here is this: Healthcare here in America is among the most expensive, yet one of the worst in quality in the developed world. It's not just poor maternal healthcare, it's all of our so-called "healthcare".
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Bernie's Opinion
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12/11/2018
Sounds like an excellent job for Planned Parenthood. THEY get federal funds for “healthcare.”
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Aaron's Opinion
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12/11/2018
You don’t need a study! I’ll give you a study! POVERTY! Wanna end crime, address poverty! Wanna end abortion, address poverty! Wanna improve healthcare, address poverty! Education? Yep...poverty! Raise wages! The little people down here don’t care about how well the rich are doing! We see no trickle down, down here!
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
    IntroducedMarch 2nd, 2017

What is House Bill H.R. 1318?

This bill — the Preventing Maternal Deaths Act of 2017 — would direct the Dept. of Health and Human Services (HHS) to establish a program giving states grants to: 1) review pregnancy-related and pregnancy-associated deaths (maternal deaths); 2) establish and sustain a Maternal Mortality Review Committee (MMRC) to review relevant information; 3) ensure that the state department of health develops a plan for ongoing health care provider education in order to improve the quality of maternal care, disseminate findings, and implement recommendations; 4) disseminate a case abstraction form to aid information collection for HHS review and preserve its uniformity; and 5) provide for the public disclosure of information included in state reports.

The bill would require states to develop mandatory reporting procedures for health facilities and professionals, who’d be required to report to the state department of health concerning maternal deaths. It’d also establish voluntary reporting of maternal deaths by family members. States would investigate each maternal death and prepare a case summary for each case, to be reviewed by a committee and included in applicable reports. Finally, states would develop uniform procedures reflecting the best practices identified by the Centers for Disease Control and Prevention (CDC).

This bill would also amend the Public Health Service Act to direct HHS to take specified steps to eliminate disparities in maternal health outcomes.

"Pregnancy-associated death" would be defined as the death of a woman while pregnant or during the one-year period following the date of the end of pregnancy, irrespective of the cause of death. A "pregnancy-related death" would be defined as the death of a woman while pregnant or during the one-year period following the date of the end of pregnancy, irrespective of the pregnancy's duration, from any cause related to, or aggravated by, the pregnancy or its management, excluding any accidental or incidental cause.

Impact

Pregnant women; postpartum women; maternal mortality; hospitals; healthcare providers; states; state health departments; HHS; CDC; and Public Health Service Act

Cost of House Bill H.R. 1318

A CBO cost estimate is unavailable.

More Information

In-DepthRep. Jaime Herrera Beutler (R-WA) introduced this bill to help save women’s lives and improve the quality of healthcare and health outcomes for moms and babies by helping states establish or support Maternal Mortality Review Committees (MMRCs) to examine pregnancy-related and pregnancy-associated deaths and identify ways to reduce them:

“Unlike in any other industrialized nation, the U.S. is seeing a rise in pregnancy-related deaths. For the sake of so many mothers and babies, we have to do better. Helping to establish and support Maternity Mortality Review Committees in states is a direct way to reverse this trend.  I hope that through this legislative effort, we can help save the lives of women and children during pregnancy, childbirth, and in the postpartum period.”

Rep. Herrera Beutler adds that the U.S. has a higher maternal death rate than some developing countries, and argues that the multifaceted nature of maternal death requires careful study:

“The U.S. right now is worse than Iran. Their maternal death rate is lower than ours per hundred thousand births. For African-American women in New Jersey, the death rate was around 79 per hundred thousand births. On average nationwide, it’s around 40. For white women, it’s around 14 per hundred thousand… In every state, we would investigate every maternal death. It’s shocking to think in 21st century America, we don’t have the answers to this… What I’ve found is it’s racial, it’s regional, it’s class, it’s gender — there are disparities throughout health care and depending on where you’re at, we find the answer, which is why we have to investigate each and every maternal death.”

In a joint op-ed in The Hill, Reps. Herrera Beutler and Raja Krishnamoorthi (D-IL) argue that it’s time for an ambitious plan to address maternal mortality:

“The time has come for an ambitious plan to stem the rising tide of tragic death and illness our nation is facing. Eliminating all preventable maternal deaths is a lofty goal to be sure, but that is precisely why our nation should pursue it. We cannot be satisfied until we have the lowest maternal mortality rate in the world and we can prevent any woman from dying in childbirth due to preventable conditions for lack of proper care.”

Dr. Thomas M. Gellhaus, President of the American Congress of Obstetricians and Gynecologists (ACOG), supports MMRCs as a key to reducing maternal mortality:

“Our nation’s ob-gyns are extremely concerned by the alarming rates of maternal death in the United States, especially among communities of color, but we know MMRCs are a key component to reversing this trend. This legislation will allow us to understand what is driving these tragic incidents by providing the needed funding to create review committees that will collect standardized data in order to inform effective and cost-saving solutions that fit each community.”

The American Academy of Family Physicians supports this bill as a life-saving initiative that’d help gather more information about maternal mortality:

“We are pleased to support a bill that addresses a vital public health issue because family physicians play an important role in providing pre- and postnatal care for women. Research indicates that preeclampsia and hypertension are leading causes of maternal mortality and contribute to infant mortality. Despite advances in medicine and public health, America has the highest maternal mortality rate in the developed world. Maternal deaths are more likely to occur among African-American, rural, and low-income women. We know that many of these deaths are preventable, but more can be done to understand why the nation’s maternal mortality rates spiked in every state and increased nationally by 26.6 percent from 2000 to 2014. [This bill] would establish or support state maternal mortality review committees to examine the causes of pregnancy-related deaths and identify the best strategies for improving pregnancy health outcomes. The data collected from these activities will be shared with the U.S. Centers for Disease Control and Prevention.”

A USA TODAY investigation called state investigations of maternal health outcomes into question, finding that:

“Turns out, well-meaning states across the country have been doing it wrong. At least 30 states have avoided scrutinizing medical care provided to mothers who died, or they haven't been studying deaths at all.. Instead, many state committees emphasized lifestyle choices and societal ills in their reports on maternal deaths. They weighed in on women smoking too much or getting too fat or on their failure to seek prenatal medical care. Virginia published entire reports about cancer, opioid abuse and motor vehicle crashes among moms who died. Minnesota’s team recommended more education for pregnant women on seat belt use and guns in the home. Michigan’s team urged landlords to make sure pregnant women’s homes have smoke detectors… women’s lives could be saved if doctors and nurses took simple steps, including measuring blood loss during and after delivery and giving timely treatment for high blood pressure. Yet state panels across the country have focused a fraction of their attention on the quality of care hospitals provide or on advocating for improvements.”

This bill has been referred to the House Subcommittee on Health with the support of 185 cosponsors, including 137 Democrats and 48 Republicans.

It also has the support of ACOG, the Preeclampsia Foundation, Every Mother Counts, the Amniotic Fluid Embolism Foundation, the American Academy of Family Physicians, March of Dimes, and others. The ACOG and Preeclampsia Foundation are this bill’s supporting organizations.

There’s a companion version of this bill in the Senate co-sponsored by Sens. Heidi Heitkamp (D-ND) and Shelley Moore Capito (R-WV). That bill passed the Senate Committee on Health, Education, Labor and Pensions (HELP) with a funding level increase from $7 million to $12 million each year for five years. The Senate bill has 42 cosponsors, including 36 Democrats, five Republicans, and one Independent.


Of NoteThe U.S. is ranked 47th globally for maternal mortality. Additionally, it stands out among industrialized nations as the only one in which maternal deaths are on the rise. In 2014, the maternal mortality rate (measured in maternal deaths per 100,000 live births) increased from 18.8 in 2000 to 23.8 that year (excluding California and Texas). While maternal mortality is significantly more common among African-Americans, low-income women and rural residents, pregnancy and childbirth complications kill women of every race and ethnicity, education and income level, in every part of the U.S.

Yet, it doesn’t have to be this way. According to the CDC, 60% of maternal deaths are preventable — and women in other countries are much less likely than American women to die due to motherhood. In a joint investigation, NPR and ProPublica found:

“American women are more than three times as likely as Canadian women to die in the maternal period (defined by the Centers for Disease Control as the start of pregnancy to one year after delivery or termination), six times as likely to die as Scandinavians. In every other wealthy country, and many less affluent ones, maternal mortality rates have been falling; in Great Britain, the journal Lancet recently noted, the rate has declined so dramatically that ‘a man is more likely to die while his partner is pregnant than she is.’ But in the U.S., maternal deaths increased from 2000 to 2014.”

The NPR/ProPublica investigation points out that unlike the U.K., the U.S. has no centralized government effort to investigate maternal deaths:

“[In the U.K.] maternal deaths are regarded as systems failures. A national committee of experts scrutinizes every death of a woman from pregnancy or childbirth complications, collecting medical records and assessments from caregivers, conducting rigorous analyses of the data, and publishing reports that help set policy for hospitals throughout the country. Coroners also sometimes hold public inquests, forcing hospitals and their staffs to answer for their mistakes. The U.K. process is largely responsible for the stunning reduction in preeclampsia deaths in Britain… [Meanwhile], the U.S. has no comparable federal effort. Instead, maternal mortality reviews are left up to states. As of [spring 2017], 26 states (and one city, Philadelphia) had a well-established process in place; another five states had committees that were less than a year old. In almost every case, resources are tight, the reviews take years, and the findings get little attention.”

This bill is the product of a several years-long process in which dozens of stakeholders contributed ideas and legislative language to the bill text. Ultimately, this process identified providing greater federal support for MMRCs as a key policy solution, and a group of interested members of Congress wrote a bill to help states expand their efforts. A coalition of national organizations, including the Association of Maternal & Child Health Programs, ACOG, the Association of Women's Health, Obstetric & Neonatal Nurses (AWHONN), March of Dimes, Preeclampsia Foundation, and the Society for Maternal-Fetal Medicine (SMFM), provided technical assistance and rallied behind the bill's introduction.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / KatarzynaBialasiewicz)

AKA

Preventing Maternal Deaths Act of 2017

Official Title

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 pregnancy-associated deaths, to identify solutions to improve health care quality and health outcomes for mothers, and for other purposes.

    We are a first world country with a third world maternal mortality rate. How about a UNIVERSAL SINGLE PAYER HEALTHCARE SYSTEM FOR ALL, CRADLE TO GRAVE!
    Like (76)
    Follow
    Share
    This won't fix the problem anyway. The bigger picture here is this: Healthcare here in America is among the most expensive, yet one of the worst in quality in the developed world. It's not just poor maternal healthcare, it's all of our so-called "healthcare".
    Like (38)
    Follow
    Share
    It is an utter sin that here, in the richest, most advanced country with (allegedly) the highest quality healthcare in the world, that we have maternal mortality rates that rival the third world. Where are all the family values, pro birth supporters on this issue? Working for ill-considered trickle down tax cuts? A country is only as healthy as its citizenship.
    Like (42)
    Follow
    Share
    And they need to fund planned parenthood because they are at the center of prevention.
    Like (35)
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    Sounds like an excellent job for Planned Parenthood. THEY get federal funds for “healthcare.”
    Like (15)
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    Spend the taxpayer's money on ”the Wall.”
    Like (14)
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    We are in debt. We must not borrow money.
    Like (10)
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    You don’t need a study! I’ll give you a study! POVERTY! Wanna end crime, address poverty! Wanna end abortion, address poverty! Wanna improve healthcare, address poverty! Education? Yep...poverty! Raise wages! The little people down here don’t care about how well the rich are doing! We see no trickle down, down here!
    Like (10)
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    There is no reason that this country should have one of the highest stillborn and maternal deaths in the world.
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    In Texas we have next to the top maternal and infant mortality rate in the world. It’s ridiculous that in this day and age we have a problem of this magnitude in our state! Time for your individual offices to step up and change that.
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    At the least this nation owes Mother’s appropriate health care and intervention.
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    Mother's shouldn't have to worry about dying on what should be one of the happiest days of their life.
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    I have been doing a lot of reading lately on maternal deaths in childbirth and the stats are astounding to me. The fact that we are an extremely developed country with some of the best doctors and nurses in the world, the number of childbirth deaths is criminal. We need more review panels to hold those accountable who ignore textbook signs of childbirth complications and we need to start providing more training to doctors about the signs and symptoms of childbirth problems and how to help save those mothers
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    The lives of mothers are just as important as the lives of infants. As maternal mortality rates fall in all other developed countries, maternal mortality rates are on the rise in the US. On average, 60% of those pregnancy related deaths are preventable. We can and should require a higher standard of health care for mothers. Please read the article inked below for more details about why we as a nation MUST support this bill. https://www.propublica.org/article/die-in-childbirth-maternal-death-rate-health-care-system?utm_campaign=sprout&utm_medium=social&utm_source=twitter&utm_content=1494566022
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    The fact that each state contributes to the coffers of the federal government and this bill would serve for the betterment of society I say yes. Once again the idiots gave away a lot of tax money to the wealthy. So yes they should support the states.
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    Rising maternal mortality is supposed to be a problem in the third world not the world superpower.
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    How about the federal government should just give us our stolen money back without dictating what we must do to earn it? How about that's my money in the first place and let's see YOU dance for ME?
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    MATERNAL MORTALITY DESERVES RESEARCH 2B DONE Maternal mortality is a public health crisis that should be addressed through a rigorous study 📖 effort, and federal funding, to help develop a better understanding of its causes. SneakyPete..... 👍🏻👍🏻👍🏻. 12*11*18.....
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    Please support this bill.
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    Maternal death rates should not be going up. This is a disgrace. We must do better.
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