August 10, 2020

Warren, Underwood, Colleagues Announce Bicameral Legislation to Combat Maternal Mortality and Morbidity Crisis During COVID-19 Pandemic

Both public health crises are fueled by racial, ethnic, and socioeconomic inequities, comorbidities, inadequate health care access, and structural racism; The Maternal Health Pandemic Response Act would ensure pregnant people - especially pregnant people of color - are included in federal government's coronavirus public health response

Bill Text | One-Pager

Washington, DC - Today, United States Senator Elizabeth Warren (D-Mass.), member of the Senate Health, Education, Labor, and Pensions Committee (HELP), Representative Lauren Underwood, Co-Chair of the Black Maternal Health Caucus, and Senators Cory Booker (D-N.J.), Kamala Harris (D-Calif.), Kirsten Gillibrand (D-N.Y.), and Tina Smith (D-Minn.), member of HELP, introduced the Maternal Health Pandemic Response Act to improve research and data collection, safeguard the health of pregnant and postpartum individuals, and dedicate resources to combat the maternal mortality and morbidity crisis during the COVID-19 pandemic. This legislation confronts the structural racism that drives disparities in maternal health outcomes by prioritzing racial equity and tasking the federal government with improving the delivery of and access to anti-racist, culturally congruent, and respectful maternity care. 

Currently, the Centers for Disease Control and Prevention's (CDC) understanding of the specific impact of COVID-19 on pregnant people is limited, in part due to a lack of robust data collection. The data CDC has managed to collect suggests that pregnant women are more likely to be hospitalized and are at a higher risk for intensive care unit admissions than nonpregnant women. The CDC has also found that Hispanic and Black pregnant women were disproportionately affected by COVID-19. As of August 4, 2020, over 15,000 pregnant women have tested positive for COVID-19 and 37 pregnant women have died.

"COVID-19 and the maternal mortality and morbidity crises are hitting our country hard - and hitting Black communities and Indian Country the hardest," said Senator Warren. "Our bill will ensure the federal government's response to the coronavirus pandemic centers pregnant people and confronts the systemic racism and discrimination in our health care system." 

"The coronavirus pandemic has further exacerbated our nation's maternal mortality crisis- increasing health risks for moms, especially Black women and other women of color who have been disproportionately affected, said Rep. Lauren Underwood. "We must take swift and serious action to better understand and respond to the new threats facing moms. I'm proud to join Senator Warren to introduce the Maternal Health Pandemic Response Act, which makes critical investments to combat our nation's maternal health crisis during COVID-19. By dedicating resources for improved data collection, inclusive coronavirus vaccine and therapeutic development, and safety in maternity care, we can keep moms protected during this pandemic and beyond."

"We know the pandemic has exacerbated the deep-seated structural inequities in maternal health care access and outcomes that are putting pregnant people of color disproportionately at risk," said Sen. Booker. "Maternal healthcare is essential healthcare, and now more than ever, we have a responsibility to work to ensure that as we respond to this pandemic we are prioritizing the health of pregnant people."

"COVID-19 has deepened existing racial inequalities in public health, and we must take decisive action to combat the maternal mortality and morbidity crises," said Senator Gillibrand. "The Maternal Health Pandemic Response Act will ensure the federal government develops and implements policies to help end the racial disparities in maternal health during the pandemic and beyond."

"The potential dangers that come with giving birth during a pandemic - and specifically a pandemic that is disproportionately impacting Black and brown people - is of particular concern to women of color," said Senator Harris. "As our nation continues to address the coronavirus crisis, we must prioritize steps to improve maternal health outcomes. That is why I am proud to join my colleagues to introduce this legislation that ensures COVID-19 response efforts include comprehensive and inclusive care for pregnant and postpartum individuals."

"We need to prevent maternal mortality and morbidity during the COVID-19 pandemic by helping individuals-especially people of color-access excellent health care," said Senator Smith. "That requires bold action to root out systemic racism, injustice and inequalities in health care and beyond. This bill is an important step in making sure pregnant people get better support and are included in the federal government's coronavirus public health response."

This maternal mortality and morbidity crisis is fueled by racial, ethnic, and socioeconomic inequities, comorbidities, inadequate access to the health care system, and structural racism - the same factors that have contributed to the substantial racial and ethnic disparities in COVID-19 outcomes. 

The Maternal Health Pandemic Response Act would: 

  • Improve Data Collection, Research, and Surveillance Initiatives. The bill requires the CDC to coordinate, collect, and publicly post data related to COVID-19 and pregnancy disaggregated by race, ethnicity, state, and tribal location. The bill also authorizes funding for CDC's pregnancy surveillance programs and the National Institutes of Health's research programs. It also mandates CDC tribal consultation and confer with urban Indian organizations, in collaboration with the Indian Health Service.
  • Ensure the Inclusion of Pregnant People in Vaccine and Therapeutic Development for COVID-19. This bill directs the NIH to ensure that at least one COVID-19 vaccine is developed and made available for use in pregnancy and lactation. It adds reporting and data collection requirements for COVID-19 therapeutic and vaccine developers regarding their product's use in pregnancy and lactation. And it emphasizes the inclusion of pregnant people, including those from underrepresented populations, in clinical trials when safe and appropriate.
  • Improve Public Health Information and Communication for Pregnant People. The bill directs the CDC to undertake a robust public health education effort aimed at informing pregnant people, their employers, and their providers about the latest evidence-based health information. It also requires the Secretary of Labor to issue an emergency temporary standard for pregnant workers and all workers.
  • Ensure Lasting Maternal Health Care and Birthing Experience Improvements. The bill defines anti-racist, culturally congruent, and respectful maternity care and seeks to improve the provision of this type of care. It creates a Task Force on Birthing Experience and Safe, Respectful Maternity Care to develop federal recommendations to ensure the provision of quality, nondiscriminatory maternity care and the improvement of maternal health outcomes during the COVID-19 public health emergency. It also mandates a Government Accountability Office (GAO) report after the end of the COVID-19 public health emergency to assess the delivery of maternal care during the pandemic and make recommendations for future pandemic preparedness and response related to maternal care.

The legislation is endorsed by American College of Obstetricians and Gynecologists,  Association of Maternal and Child Health Programs, Black Mamas Matter Alliance, Center for American Progress, Center for Reproductive Rights, In Our Own Voice: National Black Women's Reproductive Justice Agenda, Every Mother Counts, March of Dimes, March for Moms, National Asian Pacific American Women's Forum, National Birth Equity Collaborative, National Partnership for Women and Families, Planned Parenthood Federation of America, and Society for Maternal-Fetal Medicine.

"ACOG proudly endorses the Maternal Health Pandemic Response Act of 2020. We thank Senator Warren and Representative Underwood for prioritizing initiatives to improve maternal health at a time when the COVID-19 pandemic risks exacerbating our nation's maternal mortality crisis and existing racial health inequities.This bill aims to mitigate the impacts of the pandemic on pregnant women, with a focus on addressing the needs of communities of color, including by investing in important public health programs, ensuring that pregnant women are included in vaccine and therapeutic development for COVID-19, and bolstering culturally congruent maternity care. We applaud Senator Warren and Representative Underwood for making these very important societal issues a continued priority." - Eva Chalas, MD, FACOG, FACS, President of the American College of Obstetricians and Gynecologists (ACOG) 

"The Center for Reproductive Rights commends Senator Elizabeth Warren and Congresswoman Lauren Underwood on the introduction of the Maternal Health Pandemic Response Act. The COVID-19 pandemic has only exacerbated the underlying maternal health crisis in this country - a human rights failing  that disproportionately impacts Black and Indigenous birthing people. We are proud to endorse this legislation, which prioritizes access to safe and respectful maternal health care." - Jennifer Jacoby, Federal Policy Counsel at the Center for Reproductive Rights

"We commend Senator Elizabeth Warren and Representative Lauren Underwood for introducing the Maternal Health Pandemic Response Act, which will dedicate resources to combat the maternal mortality and morbidity crisis during the COVID-19 pandemic. Before the pandemic, the United States was facing a maternal mortality crisis that disproportionately impacted women of color. These disparities that pregnant and lactating women of color face are exacerbated by COVID-19. Data has shown that pregnant women are disproportionately impacted by the virus than nonpregnant women - impacting pregnant Latina and Black women at significantly higher rates than white women. It is imperative that the needs of pregnant and lactating women are not overlooked during COVID-19. We applaud the introduction of this bill that includes policies to better respond to the needs of pregnant and lactating women of color." -  Ariel González, March of Dimes Senior Vice President of Public Policy and Government Affairs

"The United States currently has the highest documented number of COVID-19 cases in the world, but in the rush to understand the spread of COVID-19 and develop a vaccine, we cannot forget about the virus' impact on pregnant people. Nor can we ignore the disparate impact the virus is having on Black and Brown communities due to decades of systemic racism and inequities. That's why Sen. Warren and Rep. Underwood's Maternal Health Pandemic Response Act is so important. This legislation would require that pregnant people are included in the development of a COVID-19 vaccine, while creating new federal recommendations to  ensure quality, nondiscriminatory maternity care for all. We thank Sen. Warren and Rep. Underwood for leading on this important bill, and for ensuring that pregnant people are not left behind in our COVID-19 response." -  Jacqueline Ayers, Vice President of Government Relations & Public Policy, Planned Parenthood Federation of America

"We cannot end the coronavirus pandemic if our response does not work for everyone. The Maternal Health Pandemic Response Act takes critical steps to ensure that a vaccine and treatment for the COVID-19 are safe and effective for pregnant and lactating people - including people of color - and that data are disaggregated to understand the impact of COVID-19 on maternal health. Even more, steps must be taken to ensure the coronavirus pandemic does not exacerbate the maternal health crisis that was already disproportionately affecting Black and Native American communities."  - Jamille Fields Allsbrook, JD/MPH, Director of Women's Health and Rights at the Center for American Progress

"The multiple crises and related traumas of the pandemic, systemic racism, and economic injustice have exacerbated the inequities and poor outcomes that moms and birthing people have faced in this country for years. Senator Warren and Representative Underwood have listened to mothers and growing families and introduced a comprehensive and timely bill to address their immediate needs, creating a foundation for long-term improvements to maternal care. We are proud to support this critical bill."  - Katie Shea Barrett, founding Executive Director, March for Moms, founding Steering Committee member, Massachusetts COVID-19 Maternal Equity Coalition