Two years after its bipartisan introduction, HR 1318 is now law. The President signed the bill, known as The Preventing Maternal Deaths Act, after the bill’s unanimous passage in both the House of Representatives and the Senate.
The new law will establish and support Maternal Mortality Review Committees at the state level and provides $12 million a year in new funds for 5 years for states. The committees will be required to review every pregnancy-related death as well as develop recommendations to prevent future deaths.
The Preventing Maternal Deaths Act was cosponsored by a bipartisan group of Representatives which included Reps. Jaime Herera Beutler (R-WA), John Conyers, Jr. (D-MI), Ryan A. Costello (R-PA), and Diana DeGette (D-CO). It was first introduced to the House in March 2017 but remain stalled in committee despite having over 190 cosponsors.
The legislation has been a top priority of the American College of Obstetricians and Gynecologists (ACOG), which praised the House for passing the bill in mid-December. In a statement, ACOG President, Lisa Hollier, MD, MPH said, “The passage of the Preventing Maternal Deaths Act has been a long-held goal for ACOG and is a crucial step to reversing our country’s rising maternal mortality rate. No more pregnant and postpartum women should die from preventable causes.”
Several more maternal health-related bills have been introduced or passed, including the recently passed, Improving Access to Maternity Care Act, which will reduce chronic shortages of maternity care providers in certain parts of the country. The Ending Maternal Mortality Act of 2018 (HR 5761) directs the Secretary of Health and Human Services to submit a national plan to Congress to reduce the rate of maternal mortality on a biennial basis. It was introduced in May 2018 but has stalled. Outside of Washington, six states have passed bills in the past year to establish or strengthen their own maternal mortality review panels.
While maternal mortality rates have steadily decreased among the world’s developed nations, the United States has seen its rates increase with wide disparities among different races. The Centers for Disease Control (CDC) reports that pregnancy-related deaths rose from 7.2 per 100,000 in 1987 to 18 per 100,000 in 2014. In 2014, the rate was 12.4 pregnancy-related deaths among white women and 17.8 deaths among women of color. While the bulk of this increase is due to increased ascertainment, the CDC contends that 60% of these deaths are preventable.
While the maternal mortality issue is complex, several causes of death have been identified including cardiovascular diseases, infection, hemorrhage, thrombotic pulmonary embolism, and hypertensive disorders. Socioeconomic factors, such as lack of access to care, increased age of mothers, and rising rates of obesity, have also been identified as contributing factors.