Professional tennis champion Serena Williams shocked the media after revealing that she nearly lost her life due to complications following the birth of her first daughter last fall.[1]  Many people struggled to understand how this could happen to a wealthy, world class athlete.  If not for her medical history with pulmonary embolisms, Williams might not have been able to detect that something was wrong hours following her delivery.[2]  Unfortunately, this nightmare is the reality for a majority of African American mothers, most of whom do not have Williams’ access to quality care or knowledge of the symptoms indicating serious health concerns.

According to the Centers for Disease Control (CDC), African American mothers die at rates three to four times higher than that of white women.[3]  This accounts for one of the widest racial disparities within women’s health.  Many medical and social science experts agree that the issue is not the direct result of race itself, but racism.  From systemic issues causing a lack of access to healthy food or drinking water, to the overall unconscious biases of medical providers who downplay complaints of pain or health concerns, African American expectant and new mothers are suffering from complications of childbirth at an alarming rate.[4]  

After decades of ignoring the issue, Congress is beginning to take action to address the issue through appropriations measures and new legislation.  The original version of the U.S. Senate Appropriations Bill for Fiscal Year 2019 included a $50 million initiative aimed at reducing maternal mortality rates.[5]  $12 million dollars of the proposed funding was directed to the CDC to expand data collection and surveillance at State Maternal Mortality Review Boards.[6]  Another $38 million would go to the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau to expand evidence-based programs that prevent maternal mortality and advance maternal health equity.[7]  Not all of these funding proposals made it into the final spending package. Of the proposals listed, the final Fiscal Year 2019 spending bill included only a $26 million increase in spending from fiscal year 2018 for the HRSA Maternal and Child Health Block Grant directed towards promoting and improving maternal and child health.[8]  

Additionally, on August 28, 2018, Senators Kristen Gillibrand, Cory Booker, and Kamala Harris introduced legislation to combat maternal mortality risks directly.[9]  The Modernizing Obstetric Medicine Standards “MOMS” Act seeks to reduce maternal deaths and help hospitals implement best practices focusing on the prevention of women dying before, during, and following child birth.  The legislation would provide funding for states and hospitals with obstetrics and gynecology practices to incentivize improvements in their response to pregnancy-related complications.[10]  The bill lays out three primary components to achieve this.

First, the legislation would amend the Public Health Service Act to create an Alliance for Innovation on Maternal Health Program within the Department of Health and Human Services.[11]  The program creates a national initiative towards the development of “maternal safety bundles,” which are standardized best practices addressing a wide array of topics aimed at the prevention of maternal mortality and morbidity.[12]  Next, the legislation would create a grant program for states to further develop standardized practices, purchase requisite supplies, and conduct training to ensure full implementation of the maternal safety bundles.[13]  Finally, the statute would expand the CDC Mortality Surveillance System to include reports from the State Maternal Mortality Review Committee’s (MMRC) investigations regarding pregnancy-related deaths.[14]            

On its surface, this Senate proposal contains progressive steps toward accountable care for new and expecting mothers.  However, the bill seemingly fails to directly address the wide disparities causing African American women to suffer at particularly higher rates than white women.  The only portion of the bill that seeks to redress this disparity is the provision requiring MOMS grant program funding to be prioritized for hospitals serving low-income, at-risk, and rural populations.[15]  Despite the bill’s shortcomings, the legislation is a step in the right direction, as the implementation of standardized best practices would ideally eliminate racial bias within the healthcare system.  Only time will tell if the MOMS Act can live up to its expectations and bring the nation into a modernized era of equal maternal care, as the realities of Congress’ political climate make the bill’s chance of passage slim.

[1] Serena Williams, Serena Williams: What my life-threatening experience taught me about giving birth, CNN (Feb. 20, 2018, 3:32 PM),

[2] Id.

[3] Ctrs. for Disease Control & Prevention, Pregnancy Mortality Surveillance System (Aug. 7, 2018), available at

[4] Nina Martin, Black Mothers Keep Dying After Giving Birth, NPR (Dec. 7, 2017, 7:51 PM),

[5] Summary of the Labor, Health and Human Services. Education and Related Programs FY19 Appropriations Bill, U.S. S. Comm. on Appropriations (Jun. 28, 2018),

[6] Id.

[7] Id.

[8] Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019, H.R. 6157, 115th Cong. (2018); Staff of H. Comm. On Appropriations, 115th Cong., Minibus #2 Summary: The Fiscal Year 2019 Labor, Health and Human Services,

Education Funding Bill (Comm. Print 2018).

[9] Press Release, Kirsten Gillibrand, Senator, Senate, With Maternal Mortality Rates On The Rise In The United States, Gillibrand Announces New Legislation To Help Reduce Maternal Deaths, Help Hospitals Implement Best Practices To Prevent Women From Dying Before, During And After Childbirth(Aug. 28, 2017),

[10] Id.

[11] Modernizing Obstetric Medicine Standards Act of 2018, S. 3392, 115th Cong. § 2 (2018).

[12] Id.

[13] Id. at § 3.

[14] Id. at § 4.

[15] Id. at § 3.