,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #bbhf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #f1 #bjac ,ms4  
,roybal-,all>d 7= h]self1 ,mrs4 ,capps1 
,mrs4 ,*ri/5s51 ,ms4 ,lee ( ,cali=nia1  
,ms4 ,mc,collum1 ,ms4 ,p+ree ( ,ma9e1 & 
,mr4 ,rangel7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to promote optimal 
mat]nity outcomes by mak+ evid5ce-bas$  
mat]nity c>e a national priority1 & =   
o!r purposes4  #a4 ,%ort title2 table ( 
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,maximiz+ ,optimal ,mat]nity
 ,s]vices = ! #ba/ ,c5tury or ! ,,moms =
 ! #ba/ ,c5tury ,act4  7b7 ,table (     
cont5ts ,! table ( cont5ts = ?is ,act is
 z foll[s3  ,sec4 #a4 ,%ort title2 table
 ( cont5ts4 ,sec4 #b4 ,f9d+s4 ,title    
,i--,,hhs ,focus on ! ,promotion (      

,optimal ,mat]nity ,c>e ,sec4 #aja4     
,additional focus area = ! ,(fice on    
,wom5's ,heal?4 ,sec4 #ajb4 ,int]ag5cy  
,coord9at+ ,committee on ! ,promotion ( 
,optimal ,mat]nity ,outcomes4 ,sec4     
#ajc4 ,consum] education campaign4 ,sec4
 #ajd4 ,bibliographic database (        
sy/ematic reviews = c>e ( *ildbe>+ wom5 
& newborns4 ,title ,,ii--,rese>* & data 
collection on ,mat]nity ,c>e ,sec4 #bja4
 ,mat]nity c>e heal? pr(essional %ortage
 areas4 ,sec4 #bjb4 ,expansion ( ,,cdc  
,prev5tion ,rese>* ,c5t]s program to    
include ,c5t]s on ,optimal ,mat]nity    
,outcomes4 ,sec4 #bjc4 ,exp&+ models to 
be te/$ by ,c5t] = ,m$ic>e & ,m$icaid   
,innovation to include mat]nity c>e     
models4 ,title ,,iii--,enhancem5t ( a   
,geographically1 ,racially1 & ,e?nically
 ,div]se ,int]pr(essional ,mat]nity     
,work=ce ,sec4 #cja4 ,developm5t (      
int]pr(essional mat]nity c>e educational
 models & tools4 ,sec4 #cjb4            
,int]pr(essional tra9+ ( m$ical /ud5ts1 
resid5ts1 & /ud5t midwives 9 academic   

heal? c5t]s & free/&+ bir? c5t]s4 ,sec4 
#cjc4 ,grants to pr(essional            
organizations to increase div]sity 9    
mat]nity c>e pr(essionals4  #b4 ,f9d+s  
,congress f9ds ! foll[+3  7#a7 ,mat]nity
 exp5ditures 9 ! ,unit$ ,/ates surpass  
all o!r develop$ c\ntries1 b *ildbir?   
cont9ues to c>ry significant risks =    
mo!rs 9 ! ,unit$ ,/ates1 z demon/rat$ by
 ! foll[+3  7,a7 ,m ?an two wom5 die e  
day 9 ! ,unit$ ,/ates f pregnancy-relat$
 causes & ! mat]nal mortality rate 9 !  
,unit$ ,/ates has r\ghly d\bl$ 9 ! pa/  
#be ye>s4 ,accord+ to data releas$ 9    
#bjaj1 ! mat]nal mortality ratio 0 #ab4g
 p]c5t z comp>$ to #f4f p]c5t 9 #aihg4  
7,b7 ,m ?an "o-?ird ( all wom5 :o give  
bir? 9 ! ,unit$ ,/ates 7#a1gjj1jjj wom5 
ea* ye>7 exp]i5ce "s type ( complication
 t has an adv]se effect on _! heal?4    
7,c7 ,sev]e complications t result 9    
wom5 ne>ly dy+1 kn[n z a ne> miss or    
sev]e morbidity1 increas$ by #be p]c5t  
betwe5 #aiih & #bjje1 to approximately  
#cd1jjj cases a ye>4  7,d7              

,african-,am]ican wom5 h ne>ly a f\r    
times great] risk ( dy+ f               
pregnancy-relat$ complications ?an ,:ite
 wom51 & ^! disp>ities h n improv$ 9 #ej
 ye>s4  7#b7 ,9 spite ( ! consid]able   
inve/m5t ( ! ,unit$ ,/ates 9 mat]nity   
c>e1 ! ,unit$ ,/ates is fail+ to ensure 
t all infants h a heal?y />t 9 life1 z  
demon/rat$ by ! foll[+3  7,a7 ,despite  
five ye>s ( mode/ r$uction 9 pre-t]m    
bir?s betwe5 #bjjf & #bjaa1 ! ,unit$    
,/ates cont9ues to lag beh9d mo/ o!r    
c\ntries 9 pre-t]m bir? rates1 rank+    
#aca out ( #ahd c\ntries1 accord+ to a  
#bjaa report by ! ,m>* ( ,dimes & ! ,_w 
,heal? ,organization4  7,b7 ,!          
proportion ( l[ bir? weight babies      
increas$ by #ba p]c5t betwe5 #aiha &    
#bjjh4  7,c7 ,non-,hispanic ,black      
infants cont9ue to exp]i5ce             
significantly high] rates ( bo? pre-t]m 
bir? & l[ bir?weight1 two ( ! lead+     
causes ( infant mortality 9 ?is c\ntry4 
7#c7 ,despite %ortcom+s 9 ! ,unit$      
,/ates /atewide data collections sy/ems1

 :i* make int]national comp>isons m     
*all5g+1 int]national heal?             
organizations h rank$ ! ,unit$ ,/ates f>
 beh9d almo/ all develop$ c\ntries 9    
important p]9atal & mat]nal outcomes1 z 
demon/rat$ by ! foll[+3  7,a7 ,! ,_w    
,heal? ,organization id5tifi$ #di       
nations ) l[] rates ( mat]nal dea?s ?an 
! ,unit$ ,/ates 9 #bjjh4  7,b7 ,9 ! ,_w 
,heal? ,report #bjje1 ! ,_w ,heal?      
,organization id5tifi$ #ce nations ) l[]
 e>ly neonatal mortality rates          
7#d_/a1jjj live bir?s7 & #cc ) l[]      
neonatal mortality rates 7#e_/a1jjj live
 bir?s7 ?an ! ,unit$ ,/ates4  7,c7      
,accord+ to data f ! ,organisation =    
,economic ,co-op]ation & ,developm5t    
7,,oecd71 #bf c\ntries 7out ( #bi       
report+7 _h l[ bir?weight rates l[] ?an 
t ( ! ,unit$ ,/ates4  7,d7 #ba ,,oecd   
c\ntries 7out ( #bg report+7 _h l[]     
ces>ean section rates ?an ! ,unit$      
,/ates4  7#d7 ,mat]nity c>e is a major  
compon5t ( ! escalat+ heal? c>e co/s 9 !
 ,unit$ ,/ates1 z demon/rat$ by !       

foll[+3  7,a7 ,) #d1jjj1jjj deliv]ies   
ye>ly1 ! va/ majority ( :i* occur 9     
hospitals1 mat]nity c>e = mo!rs & _!    
newborns is ! numb] "o reason =         
hospitalization 9 ! ,unit$ ,/ates1      
exce$+ su* preval5t conditions z        
pneumonia1 canc]1 fracture1 & he>t      
disease4 ,( ^? dis*>g$ f hospitals 9 !  
,unit$ ,/ates 9 #bjji1 ne>ly "o 9 f\r 7 
*ildbe>+ wom5 & newborns4  7,b7 ,comb9$ 
"m & baby *>ges = hospitalization1 :i* 0
 #ih1jjj1jjj1jjj 9 #bjjh1 f> exce$$     
*>ges = any o!r hospital condition 9 !  
,unit$ ,/ates4  7#e7 ,mat]nity c>e also 
acc\nts = a significant proportion (    
exp5ditures "u ! ,m$icaid program1 :i*  
cov]s #db p]c5t ( bir?s 9 ?is c\ntry1 z 
demon/rat$ by ! foll[+3  7,a7 ,9 #bjjh1 
#bf p]c5t ( all hospital *>ges = :i*    
paym5t 0 made "u ! ,m$icaid program     
7total+ #da1jjj1jjj1jjj7 0 = bir?+ wom5 
& newborns4  7,b7 ,! two mo/ common     
conditions = :i* paym5ts 7 made "u !    
,m$icaid program 9 #bjjg 7 pregnancy &  
*ildbir? 7con/itut+ #bh p]c5t ( su*     

paym5ts7 & newborns 7con/itut+ #bf p]c5t
 ( su* paym5ts71 :i* toge!r acc\nt$ =   
#ec p]c5t ( hospital dis*>ges bill$ to  
,m$icaid4  7,c7 ,! two mo/ co/ly        
conditions = :i* paym5t 0 made "u !     
,m$icaid program 9 #bjjh 7 "m's         
pregnancy & deliv]y & c>e = newborn     
infants1 :i* toge!r acc\nt$ = #bf p]c5t 
( all ,m$icaid exp5ditures4  7#f7       
,mat]nity c>e facility *>ges v>y        
significantly by sett+ & type ( bir?4   
,"p ( ! *>ge diff]5tials betwe5         
facilities are attributable to high     
ov]head ( hospitals--  7,a7 9 #bjjh1 !  
av]age *>ge = a hospital ces>ean bir? ) 
complications 0 #bj1jhj1 & )\t          
complications 0 #ad1ijj2  7,b7 9 #bjjh1 
! av]age *>ge = a hospital vag9al bir? )
 complications 0 #aa1daj1 & )\t         
complications 0 #h1ibj2 &  7,c7 9 #bjaj1
 ! av]age *>ge = a bir? c5t] vag9al bir?
 0 #b1bgg4  7#g7 ,! proc$ure-int5sity ( 
bir?-relat$ hospital /ays also helps to 
expla9 ! high co/s ( su* hospital /ays4 
,9 #bjjh1 #f ( ! #aj mo/ commonly p]=m$ 

hospital proc$ures = all pati5ts ) all  
diagnoses involv$ *ildbir? & newborn    
c>e4 ,ces>ean section 0 ! mo/ common    
op]at+ room proc$ure4  7#h7 ,two        
non-invasive mat]nity practices1 smok+  
cessation programs dur+ pregnancy &     
ext]nal v]sion to turn bree* babies at  
t]m1 h /rong prov5 correlation )        
consid]able improvem5t 9 outcomes ) no  
detrim5tal side effects1 b are          
significantly und]us$ 9 ! ,unit$ ,/ates4
  7#i7 ,!re is a gr[+ body ( evid5ce t  
o!r non-invasive practices :i* are      
und]us$ 9 curr5t practice may also be   
associat$ ) improv$ outcomes4 ,^!       
non-invasive practices include gr\p     
model pr5atal c>e 7su* z !              
,centering,pregnancy model71 cont9u\s   
labor support1 & non-sup9e positions =  
bir?4  7#aj7 ,! gr[+ %ortage ( mat]nity 
heal? c>e pr(essionals & *ildbir?       
facilities is creat+ a s]i\s ob/acle to 
timely & adequate mat]nity heal? c>e =  
wom51 p>ticul>ly 9 rural areas & ! inn] 
cities4  7#aa7 ,!re are significant     

racial & e?nic disp>ities across !      
mat]nity c>e work=ce creat+ additional  
access b>ri]s to culturally &           
l+ui/ically compet5t mat]nity s]vices4  
,i ,,hhs ,focus on ! ,promotion (       
,optimal ,mat]nity ,c>e  #aja4          
,additional focus area = ! ,(fice on    
,wom5's ,heal? ,section #bbi7;b7 ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bcg;a7b77 is am5d$--  7#a7 9 
p>agraph 7#f71 at ! end1 by /rik+ &2    
7#b7 9 p>agraph 7#g71 at ! end1 by /rik+
 ! p]iod & ins]t+ 2 &2 &  7#c7 by add+  
at ! end ! foll[+ new p>agraph3  7#h7   
facilitate policy mak]s1 heal? sy/em    
lead]s & provid]s1 consum]s1 & o!r      
/akehold]s 9 _! und]/&+ optimal mat]nity
 c>e & support = ! provision ( su* c>e1 
includ+ ! priorities (--  7,a7 protect+1
 promot+1 & support+ ! innate capacities
 ( *ildbe>+ wom5 & _! newborns =        
*ildbir?1 brea/-fe$+1 & atta*m5t2  7,b7 
us+ ob/etric int]v5tions only :5 su*    
int]v5tions are support$ by /rong1      
high-quality evid5ce1 & m9imiz+ ov]use (

 mat]nity practices t h be5 %[n to h    
b5efit 9 limit$ situations & t c expose 
wom51 infants1 or bo? to risk ( h>m if  
us$ r\t9ely & indiscrim9ately1 includ+  
cont9u\s electronic fetal monitor+1     
labor induction1 epidural analgesia1    
prim>y ces>ean section1 & r\t9e repeat  
ces>ean bir?2  7,c7 reliably incorporat+
 non-invasive1 evid5ce-bas$ practices t 
h docum5t$ correlation ) consid]able    
improvem5t 9 outcomes ) no detrim5tal   
side effects1 su* z smok+ cessation     
programs 9 pregnancy & prov5 models (   
gr\p pr5atal c>e t integrate heal?      
assessm5t1 education1 & support into a  
unifi$ program2  7,d7 a %>$ und]/&+ ( ! 
qualifications ( lic5s$ provid]s (      
mat]nity c>e & ! be/ evid5ce ab\t !     
safety1 satisfaction1 outcomes1 & co/s (
 _! c>e1 & appropriate deploym5t ( su*  
c>egiv]s )9 ! mat]nity c>e work=ce to   
address ! ne$s ( *ildbe>+ wom5 &        
newborns & ! gr[+ %ortage ( mat]nity    
c>egiv]s2  7,e7 a %>$ und]/&+ ( !       
results ( ! be/ available rese>* comp>+ 

hospital1 bir? c5t]1 & plann$ home      
bir?s1 includ+ in=mation ab\t ea*       
sett+'s safety1 satisfaction1 outcomes1 
& co/s2 &  7,f7 high-quality1           
evid5ce-bas$ *ildbir? education t       
promotes a natural1 heal?y1 & safe      
approa* to pregnancy1 *ildbir?1 & e>ly  
p>5t+2 is taught by c]tifi$ educators1  
pe] c\nselors1 & heal? pr(essionals2 &  
promotes in=m$ decisionmak+ by *ildbe>+ 
wom54  4  #ajb4 ,int]ag5cy ,coord9at+   
,committee on ! ,promotion ( ,optimal   
,mat]nity ,outcomes  7a7 ,9 g5]al ,"p ,a
 ( title ,,ii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bjb et seq47 is   
am5d$ by add+ at ! end ! foll[+ new     
section3  #bbi;,a4 ,int]ag5cy ,coord9at+
 ,committee on ! ,promotion ( ,optimal  
,mat]nity ,outcomes  7a7 ,9 g5]al ,!    
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,deputy ,assi/ant ,secret>y
 = ,wom5's ,heal? "u section #bbi & 9   
collaboration ) ! ,f$]al (ficials       
specifi$ 9 subsection 7b71 %all e/abli% 
! ,int]ag5cy ,coord9at+ ,committee on ! 

,promotion ( ,optimal ,mat]nity         
,outcomes 7ref]r$ to 9 ?is subsection z 
! ,,iccpom74  7b7 ,o!r ag5cies ,!       
(ficials specifi$ 9 ?is subsection are !
 ,secret>y ( ,labor1 ! ,secret>y (      
,def5se1 ! ,secret>y ( ,vet]ans         
,affairs1 ! ,surgeon ,g5]al1 ! ,director
 ( ! ,c5t]s = ,disease ,control &       
,prev5tion1 ! ,adm9i/rator ( ! ,heal?   
,res\rces & ,s]vices ,ag5cy1 !          
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices1 ! ,director ( !      
,indian ,heal? ,s]vice1 ! ,adm9i/rator (
 ! ,sub/ance ,abuse & ,m5tal ,heal?     
,s]vices ,adm9i/ration1 ! ,director ( ! 
,national ,in/itute on ,*ild ,heal? &   
,developm5t1 ! ,director ( ! ,ag5cy =   
,heal?c>e ,rese>* & ,quality1 !         
,assi/ant ,secret>y = ,*ildr5 &         
,families1 ! ,deputy ,assi/ant ,secret>y
 = ,m9ority ,heal?1 ! ,director ( !     
,(fice ( ,p]sonnel ,managem5t1 & su* o!r
 ,f$]al (ficials z ! ,secret>y ( ,heal? 
& ,human ,s]vices det]m9es to be        
appropriate4  7c7 ,*air ,! ,deputy      

,assi/ant ,secret>y = ,wom5's ,heal?    
%all s]ve z ! *air ( ! ,,iccpom4  7d7   
,duties ,! ,,iccpom %all guide policy & 
program developm5t across ! ,f$]al      
,gov]nm5t ) respect to promotion (      
optimal mat]nity c>e1 provid$1 h[ev]1 t 
no?+ 9 ?is section %all be con/ru$ z    
transf]r+ regulatory or program au?ority
 f an ,ag5cy to ! ,coord9at+ ,committee4
  7e7 ,consultations ,! ,,iccpom %all   
actively seek ! input (1 & %all consult 
)1 all appropriate & int]e/$ /akehold]s1
 includ+ ,/ate ,heal? ,dep>tm5ts1 public
 heal? rese>* & int]e/ gr\ps1           
f\ndations1 *ildbe>+ wom5 & _!          
advocates1 & mat]nity c>e pr(essional   
associations & organizations1 reflect+  
racially1 e?nically1 demographically1 & 
geographically div]se communities4  7f7 
,annual report  7#a7 ,9 g5]al ,!        
,secret>y1 on behalf ( ! ,,iccpom1 %all 
annually submit to ,congress a report t 
summ>izes--  7,a7 all programs &        
policies ( ,f$]al ag5cies 7includ+ !    
,m$ic>e program "u title ,,xviii ( !    

,social ,security ,act & ! ,m$icaid     
program "u title ,,xix ( su* ,act7      
design$ to promote optimal mat]nity c>e1
 focus+ p>ticul>ly on programs &        
policies t support ! adoption ( evid5ce 
bas$ mat]nity c>e1 z def9$ by timely1   
sci5tifically s\nd sy/ematic reviews2   
7,b7 all programs & policies ( ,f$]al   
ag5cies 7includ+ ! ,m$ic>e program "u   
title ,,xviii ( ! ,social ,security ,act
 & ! ,m$icaid program "u title ,,xix (  
su* ,act7 design$ to address ! problems 
( mat]nal mortality & morbidity1 infant 
mortality1 prematurity1 & l[ bir?       
weight1 includ+ su* programs & policies 
design$ to address racial & e?nic       
disp>ities ) respect to ea* ( su*       
problems2  7,c7 ! ext5t ( progress 9    
r$uc+ mat]nal mortality & infant        
mortality1 l[ bir? weight1 & prematurity
 at ,/ate & national levels2 &  7,d7 su*
 o!r in=mation reg>d+ optimal mat]nity  
c>e z ! ,secret>y det]m9es to be        
appropriate4  ,! in=mation specifi$ 9   
subp>agraph 7,c7 %all be includ$ 9 ea*  

su* report 9 a mann] t disaggregates su*
 in=mation by race1 e?nicity1 & indig5\s
 /atus 9 ord] to det]m9e ! ext5t (      
progress 9 r$uc+ racial & e?nic         
disp>ities & disp>ities relat$ to       
indig5\s /atus4  7#b7 ,c]ta9 in=mation  
,ea* report "u p>agraph 7#a7 %all       
include in=mation 7disaggregat$ by race1
 e?nicity1 & indig5\s /atus1 z          
applicable7 on ! foll[+ rates & co/s by 
,/ate3  7,a7 ,! rate ( prim>y ces>ean   
deliv]ies & repeat ces>ean deliv]ies4   
7,b7 ,! rate ( vag9al bir?s aft]        
ces>ean4  7,c7 ,! rate ( vag9al bree*   
bir?s4  7,d7 ,! rate ( induction (      
labor4  7,e7 ,! rate ( free/&+ bir? c5t]
 bir?s4  7,f7 ,! rate ( plann$ &        
unplann$ home bir?4  7,g7 ,! rate (     
att5d$ bir?s by provid]1 includ+ by an  
ob/etrician-gynecologi/1 family practice
 physician1 ob/etrician-gynecologi/     
physician assi/ant1 c]tifi$             
nurse-midwife1 c]tifi$ midwife1 &       
c]tifi$ pr(essional midwife4  7,h7 ,!   
co/ ( mat]nity c>e disaggregat$ by place

 ( bir? & provid] ( c>e1 includ+--  7i7 
uncomplicat$ vag9al bir?2  7ii7         
complicat$ vag9al bir?2  7iii7          
uncomplicat$ ces>ean bir?2 &  7iv7      
complicat$ ces>ean bir?4  7g7           
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$1 9 addition  
to su* am\nts au?oriz$ to be appropriat$
 "u section #bbi7;e71 to c>ry out ?is   
section #a1jjj1jjj = ea* ( ! fiscal ye>s
 #bjad ?r\gh #bjah4  4  7b7 ,con=m+     
am5dm5ts  7#a7 ,inclusion z duty ( ,,hhs
 ,(fice on ,wom5's ,heal? ,section      
#bbi7;b7 ( su* ,act 7#db ,u4,s4,c4      
#bcg;a7b771 z am5d$ by section #aja1 is 
am5d$--  7,a7 9 p>agraph 7#g71 at ! end1
 by /rik+ &2  7,b7 9 p>agraph 7#h71 at !
 end1 by /rik+ ! p]iod & ins]t+ 2 &2 &  
7,c7 by add+ at ! end ! foll[+ new      
p>agraph3  7#i7 e/abli% ! ,int]ag5cy    
,coord9at+ ,committee on ! ,promotion ( 
,optimal ,mat]nity ,outcomes 9          
accordance ) section #bbi;,a4  4  7#b7  
,treatm5t ( bi5nial reports ,section    
#bbi7;d7 ( su* ,act 7#db ,u4,s4,c4      

#bcg;a7d77 is am5d$ by ins]t+ 7o!r ?an  
"u subsection 7b77#i77 aft] "u ?is      
section4  #ajc4 ,consum] education      
campaign ,section #bbi ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bcg;a71 z am5d$ by sections #aja &     
#ajb1 is fur!r am5d$--  7#a7 9          
subsection 7b7--  7,a7 9 p>agraph 7#h71 
at ! end1 by /rik+ &2  7,b7 9 p>agraph  
7#i71 at ! end1 by /rik+ ! p]iod &      
ins]t+ 2 &2 &  7,c7 by add+ at ! end !  
foll[+ new p>agraph3  7#aj7 n lat] ?an  
"o ye> aft] ! date ( ! enactm5t ( !     
,,moms = ! #ba/ ,c5tury ,act1 develop & 
implem5t a #d-ye> culturally &          
l+ui/ically appropriate multi-m$ia      
consum] education campaign to promote   
und]/&+ & acceptance ( evid5ce bas$     
mat]nity practices & models ( c>e =     
optimal mat]nity outcomes among wom5 (  
*ildbe>+ ages & families ( su* wom5 &   
t--  7,a7 highlights ! importance (     
protect+1 promot+1 & support+ ! innate  
capacities ( *ildbe>+ wom5 & _! newborns
 = *ildbir?1 brea/-fe$+1 & atta*m5t2    

7,b7 promotes und]/&+ ( ! importance (  
us+ ob/etric int]v5tions :5 m$ically    
necess>y & :5 support$ by /rong1        
high-quality evid5ce2  7,c7 highlights !
 widespread ov]use ( mat]nity practices 
t h be5 %[n to h b5efit :5 us$          
appropriately 9 situations ( m$ical     
necessity1 b :i* c expose wom51 infants1
 or bo? to risk ( h>m if us$ r\t9ely &  
indiscrim9ately1 includ+ cont9u\s fetal 
monitor+1 labor induction1 epidural     
ane/hesia1 elective prim>y ces>ean      
section1 & repeat ces>ean deliv]y2  7,d7
 emphasizes ! non-invasive mat]nity     
practices t h /rong prov5 correlation or
 may be associat$ ) consid]able         
improvem5t 9 outcomes ) no detrim5tal   
side effects1 & are significantly       
und]us$ 9 ! ,unit$ ,/ates1 includ+ smok+
 cessation programs 9 pregnancy1 gr\p   
model pr5atal c>e1 cont9u\s labor       
support1 non-sup9e positions = bir?1 &  
ext]nal v]sion to turn bree* babies at  
t]m2  7,e7 educates consum]s ab\t !     
qualifications ( lic5s$ provid]s (      

mat]nity c>e & ! be/ evid5ce ab\t _!    
safety1 satisfaction1 outcomes1 & co/s2 
7,f7 in=ms consum]s ab\t ! be/ available
 rese>* comp>+ bir? c5t] bir?s1 plann$  
home bir?s1 & hospital bir?s1 includ+   
in=mation ab\t ea* sett+'s safety1      
satisfaction1 outcomes1 & co/s2  7,g7   
fo/]s p>ticipation 9 high-quality1      
evid5ce-bas$ *ildbir? education t       
promotes a natural1 heal?y1 & safe      
approa* to pregnancy1 *ildbir?1 & e>ly  
p>5t+2 is taught by c]tifi$ educators1  
pe] c\nselors1 & heal? pr(essionals2 &  
promotes in=m$ decisionmak+ by *ildbe>+ 
wom52 &  7,h7 is pilot te/$ = consum]   
compreh5sion1 cultural s5sitivity1 &    
acceptance ( ! messages across          
geographically1 racially1 e?nically1 &  
l+ui/ically div]se populations4  4      
#ajd4 ,bibliographic database (         
sy/ematic reviews = c>e ( *ildbe>+ wom5 
& newborns  7a7 ,9 g5]al ,n lat] ?an "o 
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 ! ,secret>y ( ,heal? & ,human ,s]vices1
 ?r\gh ! ,ag5cy = ,heal?c>e ,rese>* &   

,quality1 %all--  7#a7 make publicly    
available an onl9e bibliographic        
database id5tify+ sy/ematic reviews1    
includ+ an explanation ( ! level &      
quality ( evid5ce1 = c>e ( *ildbe>+ wom5
 & newborns2 &  7#b7 initiate regul>    
updates t incorporate newly issu$ &     
updat$ sy/ematic reviews4  7b7 ,s\rces  
,to aim = a compreh5sive inv5tory (     
sy/ematic reviews relevant to mat]nal & 
newborn c>e1 ! database %all id5tify    
reviews f div]se s\rces1 includ+--  7#a7
 sci5tific pe]-review$ j\rnals2  7#b7   
databases1 includ+ ,co*rane ,database ( 
,sy/ematic ,reviews1 ,cl9ical ,evid5ce1 
& ,database ( ,ab/racts ( ,reviews (    
,effects2 &  7#c7 ,int]net ,web sites ( 
ag5cies & organizations ?r\gh\t ! _w t  
produce su* sy/ematic reviews4  7c7     
,features ,! database %all--  7#a7      
provide bibliographic citations = ea*   
record )9 ! database1 & = ea* su*       
citation include an explanation ( !     
level & quality ( evid5ce2  7#b7 include
 ab/racts1 z available2  7#c7 provide   

ref]5ce to companion docum5ts z may exi/
 = ea* review1 su* z evid5ce tables &   
guidel9es or consum] educational        
mat]ials develop$ f ! review2  7#d7     
provide l9ks to ! s\rce ( ! full review 
& to any companion docum5ts2  7#e7      
provide l9ks to ! s\rce ( a previ\s     
v]sion or update ( ! review2  7#f7 be   
se>*able by int]v5tion or o!r topic ( ! 
review1 report$ outcomes1 au?or1 title1 
& s\rce2 &  7#g7 (f] to us]s p]iodic    
electronic notification ( database      
updates relat+ to us]s' topics ( int]e/4
  7d7 ,outrea* ,n lat] ?an ! fir/ date !
 database is made publicly available &  
p]iodically !reaft]1 ! ,secret>y (      
,heal? & ,human ,s]vices %all publicize 
! availability1 features1 & uses ( !    
database "u ?is section to ! /akehold]s 
describ$ 9 subsection 7e74  7e7         
,consultation ,= purposes ( develop+ !  
database "u ?is section & ma9ta9+ &     
updat+ su* database1 ! ,secret>y (      
,heal? & ,human ,s]vices %all conv5e &  
consult ) an advisory committee compos$ 

( relevant /akehold]s1 includ+--  7#a7  
,f$]al ,m$icaid adm9i/rators & ,/ate    
ag5cies adm9i/rat+ ,/ate plans "u title 
,,xix ( ! ,social ,security ,act        
pursuant to section #aijb7;a77#e7 ( su* 
,act 7#db ,u4,s4,c4 #acif;a7a77#e772    
7#b7 provid]s ( mat]nity & newborn c>e f
 bo? academic & community-bas$ sett+s1  
includ+ ob/etrician-gynecologi/s1 family
 physicians1 c]tifi$ nurse midwives1    
c]tifi$ midwives1 c]tifi$ pr(essional   
midwives1 physician assi/ants1 p]9atal  
nurses1 p$iatricians1 & nurse           
practition]s2  7#c7 mat]nal-fetal m$ic9e
 speciali/s2  7#d7 neonatologi/s2  7#e7 
*ildbe>+ wom5 & advocates = su* wom51   
includ+ *ildbir? educators c]tifi$ by a 
nationally accr$it$ program1 repres5t+  
communities t are div]se 9 t]ms ( race1 
e?nicity1 indig5\s /atus1 & geographic  
area2  7#f7 employ]s & pur*as]s2  7#g7  
heal? facility & sy/em lead]s1 includ+  
bo? hospital & bir? c5t] facilities2    
7#h7 j\rnali/s2 &  7#i7 bibliographic   
in=matics speciali/s4  7f7 ,au?orization

 ( appropriations ,!re is au?oriz$ to be
 appropriat$ #b1ejj1jjj = ea* ( ! fiscal
 ye>s #bjad ?r\gh #bjaf = ! purpose (   
develop+ ! database & su* sums z may be 
necess>y = ea* subsequ5t fiscal ye> =   
updat+ ! database & provid+ outrea* &   
notification to us]s1 z describ$ 9 ?is  
section4  ,,ii ,rese>* & data collection
 on ,mat]nity ,c>e  #bja4 ,mat]nity c>e 
heal? pr(essional %ortage areas ,section
 #ccb ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bed;e7 is am5d$ by add+ 
at ! end ! foll[+ new subsection3  7k7  
7#a7 ,! ,secret>y1 act+ ?r\gh !         
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 %all designate  
mat]nity c>e heal? pr(essional %ortage  
areas 9 ! ,/ates1 publi% a descriptive  
li/ ( ! area's population gr\ps1 m$ical 
facilities1 & o!r public facilities s   
designat$1 & at lea/ annually review &1 
z necess>y1 revise su* designations4    
7#b7 ,= purposes ( p>agraph 7#a71 a     
complete descriptive li/ %all be publi%$
 9 ! ,f$]al ,regi/] n lat] ?an "o ye>   

aft] ! date ( ! enactm5t ( ! ,,moms = ! 
#ba/ ,c5tury ,act & annually !reaft]4   
7#c7 ,! provisions ( subsections 7b71   
7c71 7e71 7f71 7g71 7h71 7i71 & 7j7 7o!r
 ?an 7j77#a77;,b77 ( ?is section %all   
apply to ! designation ( a mat]nity c>e 
heal? pr(essional %ortage area 9 a      
simil> mann] & ext5t z su* provisions   
apply to ! designation ( heal?          
pr(essional %ortage areas1 except 9     
apply+ subsection 7b77#c71 ! ref]5ce 9  
su* subsection to physicians %all be    
deem$ to be a ref]5ce to nationally     
c]tifi$ & ,/ate lic5s$ ob/etricians1    
family practice physicians :o practice  
full-scope mat]nity c>e1 c]tifi$        
nurse-midwives1 c]tifi$ midwives1       
c]tifi$ pr(essional midwives1 &         
physician's assi/ants :o practice full  
scope mat]nity c>e4  7#d7 ,= purposes ( 
?is subsection1 ! t]m mat]nity c>e heal?
 pr(essional %ortage area means--  7,a7 
an area 9 an urban or rural area 7:i*   
ne$ n con=m to ! geographic b\nd>ies ( a
 political subdivision & :i* is a       

rational area = ! deliv]y ( heal?       
s]vices7 :i* ! ,secret>y det]m9es has a 
%ortage ( provid]s ( mat]nity c>e heal? 
s]vices includ+ ^? ref]5c$ 9 p>agraph   
7#c7 or an urban or rural area t !      
,secret>y det]m9es has lo/ a significant
 numb] ( su* provid]s dur+ ! #aj-ye>    
p]iod beg9n+ ) #bjjd or has no          
ob/etrical provid]s lic5s$ to provide   
op]ative ob/etrical s]vices2  7,b7 an   
area 9 an urban or rural area 7:i* ne$ n
 con=m to ! geographic b\nd>ies ( a     
political subdivision & :i* is a        
rational area = ! deliv]y ( heal?       
s]vices7 :i* ! ,secret>y det]m9es has a 
%ortage ( hospital or labor & deliv]y   
units1 hospital bir? c5t] units1 or     
free/&+ bir? c5t]s or an area t lo/ a   
significant numb] ( ^! units dur+ !     
#aj-ye> p]iod beg9n+ ) #bjjc2 or  7,c7 a
 population gr\p :i* ! ,secret>y        
det]m9es has su* a %ortage ( provid]s or
 facilities4  4  #bjb4 ,expansion (     
,,cdc ,prev5tion ,rese>* ,c5t]s program 
to include ,c5t]s on ,optimal ,mat]nity 

,outcomes  7a7 ,9 g5]al ,n lat] ?an "o  
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 ! ,secret>y ( ,heal? & ,human ,s]vices1
 %all support ! e/abli%m5t ( #b         
additional ,prev5tion ,rese>* ,c5t]s "u 
! ,prev5tion ,rese>* ,c5t] ,program     
adm9i/]$ by ! ,c5t]s = ,disease ,control
 & ,prev5tion4 ,su* additional c5t]s    
%all ea* be kn[n z a ,c5t] = ,excell5ce 
on ,optimal ,mat]nity ,outcomes4  7b7   
,rese>* ,ea* ,c5t] = ,excell5ce on      
,optimal ,mat]nity ,outcomes %all--     
7#a7 conduct at lea/ "o focus$ program (
 rese>* to improve mat]nity outcomes1   
includ+ ! r$uction ( ces>ean bir? rates1
 elective inductions1 prematurity rates1
 & l[ bir? weight rates )9 an und]s]v$  
population t has a disproportionately   
l>ge burd5 ( suboptimal mat]nity        
outcomes1 includ+ mat]nal mortality &   
morbidity1 infant mortality1            
prematurity1 or l[ bir? weight2  7#b7 "w
 ) p>tn]s on special int]e/ projects1 z 
specifi$ by ! ,c5t]s = ,disease ,control
 & ,prev5tion & o!r relevant ag5cies )9 

! ,dep>tm5t ( ,heal? & ,human ,s]vices1 
& on projects fund$ by o!r s\rces2 &    
7#c7 involve a m9imum ( two di/9ct bir? 
sett+ models1 su* z a hospital labor &  
deliv]y model & free/&+ bir? c5t] model2
 or a hospital labor & deliv]y model &  
plann$ home bir? model4  7c7            
,int]discipl9>y provid]s ,ea* ,c5t] =   
,excell5ce on ,optimal ,mat]nity        
,outcomes %all include ! foll[+         
int]discipl9>y provid]s ( mat]nity c>e3 
7#a7 ,ob/etrician-gynecologi/s4  7#b7   
,c]tifi$ nurse midwives or c]tifi$      
midwives4  7#c7 ,at lea/ two ( ! foll[+ 
provid]s3  7,a7 ,family practice        
physicians4  7,b7 ,nurse practition]s4  
7,c7 ,physician assi/ants4  7,d7        
,c]tifi$ pr(essional midwives4  7d7     
,s]vices ,rese>* conduct$ by ea* ,c5t] =
 ,excell5ce on ,optimal ,mat]nity       
,outcomes %all include at lea/ #b 7&    
pref]ably m7 ( ! foll[+ supportive      
provid] s]vices3  7#a7 ,m5tal heal?4    
7#b7 ,d\la labor support4  7#c7         
,nutrition education4  7#d7 ,*ildbir?   

education4  7#e7 ,social "w4  7#f7      
,physical !rapy or occupation !rapy4    
7#g7 ,sub/ance abuse s]vices4  7#h7     
,home visit+4  7e7 ,coord9ation ,!      
programs ( rese>* at ea* ( ! two ,c5t]s 
( ,excell5ce on ,optimal ,mat]nity      
,outcomes %all complim5t & n replicate !
 "w ( ! o!r4  7f7 ,au?orization (       
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#b1jjj1jjj = ea* ( ! fiscal ye>s #bjad  
?r\gh #bjah4  #bjc4 ,exp&+ models to be 
te/$ by ,c5t] = ,m$ic>e & ,m$icaid      
,innovation to include mat]nity c>e     
models ,section #aaae;,a7b77#b77;,b7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acae;a7b77#b77;,b77 is am5d$ by add+ at
 ! end ! foll[+ new clause3  7xxi7      
,promot+ evid5ce-bas$ models ( pr5atal  
c>e t h be5 associat$ ) r$uctions 9     
mat]nal & infant heal? disp>ities2      
incorporat+ ! use ( d\la & promotoras   
support2 & advanc+ out-(-hospital bir?s1
 includ+ bir?s at home & 9 free/&+ bir? 
c5t]s4  4  ,,iii ,enhancem5t ( a        

,geographically1 ,racially1 & ,e?nically
 ,div]se ,int]pr(essional ,mat]nity     
,work=ce  #cja4 ,developm5t (           
int]pr(essional mat]nity c>e educational
 models & tools  7a7 ,9 g5]al ,n lat]   
?an #f mon?s aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y ( ,heal? & ,human 
,s]vices1 act+ 9 conjunction ) !        
,adm9i/rator ( ,heal? ,res\rces &       
,s]vices ,adm9i/ration1 %all conv5e1 = a
 #a-ye> p]iod1 an ,int]pr(essional      
,mat]nity ,provid] ,education           
,commission to discuss & make           
recomm5dations =--  7#a7 a cons5sus /&>d
 physiologic mat]nity c>e curriculum t  
takes into acc\nt ! core compet5cies =  
basic midwif]y practice su* z ^?        
develop$ by ! ,am]ican ,college ( ,nurse
 ,midwives & ! ,nor? ,am]ican ,regi/ry (
 ,midwives1 & ! educational objectives =
 physicians practic+ 9 ob/etrics &      
gynecology z det]m9$ by ! ,c\ncil on    
,resid5t ,education 9 ,ob/etrics &      
,gynecology2  7#b7 sugge/ions =         
multi-discipl9>y use ( ! cons5sus       

physiologic curriculum2  7#c7 /rategies 
to integrate & coord9ate education      
across mat]nity c>e discipl9es1 includ+ 
recomm5dations to increase m$ical &     
midwif]y /ud5t exposure to              
out-(-hospital bir?2 &  7#d7 pilot      
demon/rations ( int]pr(essional         
educational models4  7b7 ,p>ticipants ,!
 ,commission %all include mat]nity c>e  
educators1 curriculum develop]s1 s]vice 
lead]s1 c]tification lead]s1 &          
accr$itation lead]s f ! v>i\s pr(essions
 t provide mat]nity c>e 9 ?is c\ntry4   
,su* pr(essions %all include            
ob/etrician-gynecologi/s1 c]tifi$ nurse 
midwives or c]tifi$ midwives1 family    
practice physicians1 nurse practition]s1
 physician assi/ants1 c]tifi$           
pr(essional midwives1 & p]9atal nurses4 
,additionally1 ! ,commission %all       
include repres5tation f mat]nity c>e    
consum] advocates4  7c7 ,curriculum ,!  
cons5sus /&>d physiologic mat]nity c>e  
curriculum describ$ 9 subsection 7a77#a7
 %all--  7#a7 h a public heal? focus ) a

 f\ndation 9 heal? promotion & disease  
prev5tion2  7#b7 fo/] physiologic       
*ildbe>+ & woman & family c5t]$ c>e2    
7#c7 integrate /rategies to r$uce       
mat]nal & infant morbidity & mortality2 
7#d7 incorporate recomm5dations to      
ensure respectful1 safe1 & seamless     
consultation1 ref]ral1 transport1 &     
transf] ( c>e :5 necess>y2 &  7#e7      
include cultural s5sitivity & /rategies 
to decrease disp>ities 9 mat]nity       
outcomes4  7d7 ,report ,n lat] ?an #f   
mon?s aft] ! f9al day ( ! summit1 !     
,secret>y ( ,heal? & ,human ,s]vices    
%all--  7#a7 submit to ,congress a      
report conta9+ ! recomm5dations made by 
! summit "u ?is section2 &  7#b7 make   
su* report publicly available4  7e7     
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #a1jjj1jjj = ea* ( ! fiscal 
ye>s #bjad & #bjae1 & su* sums z are    
necess>y = ea* ( ! fiscal ye>s #bjaf    
?r\gh #bjah4  #cjb4 ,int]pr(essional    
tra9+ ( m$ical /ud5ts1 resid5ts1 & /ud5t

 midwives 9 academic heal? c5t]s &      
free/&+ bir? c5t]s  7a7 ,includ+ )9     
inpati5t hospital s]vices "u ,m$ic>e    
s]vices furni%$ by c]ta9 /ud5ts1 int]ns1
 & resid5ts sup]vis$ by c]tifi$ nurse   
midwives ,section #ahfa7;b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciex7b77
 is am5d$--  7#a7 9 p>agraph 7#f71 by   
/rik+ 2 or & ins]t+ 1 or 9 ! case (     
s]vices 9 a hospital or o/eopa?ic       
hospital by a /ud5t midwife or an int]n 
or resid5t-9-tra9+ "u a tea*+ program   
previ\sly describ$ 9 ?is p>agraph :o is 
9 ! field ( ob/etrics & gynecology1 if  
su* /ud5t midwife1 int]n1 or            
resid5t-9-tra9+ is sup]vis$ by a c]tifi$
 nurse-midwife to ! ext5t p]mitt$ "u    
applicable ,/ate law & z may be au?oriz$
 by ! hospital22  7#b7 9 p>agraph 7#g71 
by /rik+ ! p]iod at ! end & ins]t+ 2 or2
 &  7#c7 by add+ at ! end ! foll[+ new  
p>agraph3  7#h7 a c]tifi$ nurse-midwife 
:]e ! hospital has a tea*+ program      
approv$ z specifi$ 9 p>agraph 7#f71 if  
7,a7 ! hospital elects to receive any   

paym5t due "u ?is title = reasonable    
co/s ( su* s]vices1 & 7,b7 all c]tifi$  
nurse-midwives 9 su* hospital agree n to
 bill *>ges = pr(essional s]vices r5d]$ 
9 su* hospital to individuals cov]$ "u !
 insurance program e/abli%$ by ?is      
title4  4  7b7 ,effective date ,!       
am5dm5ts made by subsection 7a7 %all    
apply to s]vices furni%$ on or aft] !   
date ( ! enactm5t ( ?is ,act4  #cjc4    
,grants to pr(essional organizations to 
increase div]sity 9 mat]nity c>e        
pr(essionals  7a7 ,9 g5]al ,! ,secret>y 
( ,heal? & ,human ,s]vices1 ?r\gh !     
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 %all c>ry out a 
grant program "u :i* ! ,secret>y may    
make to eligible heal? pr(essional      
organizations--  7#a7 = fiscal ye>      
#bjad1 plann+ grants describ$ 9         
subsection 7b72 &  7#b7 = ! subsequ5t   
#d-ye> p]iod1 implem5tation grants      
describ$ 9 subsection 7c74  7b7 ,plann+ 
grants  7#a7 ,9 g5]al ,plann+ grants    
describ$ 9 ?is subsection are grants = !

 foll[+ purposes3  7,a7 ,to collect data
 & id5tify any work=ce disp>ities1 )    
respect to a heal? pr(ession1 at ea* ( !
 foll[+ areas along ! heal? pr(essional 
cont9uum3  7i7 ,pipel9e availability )  
respect to /ud5ts at ! high s*ool &     
college or univ]sity levels consid]+ &  
work+ t[>d entrance 9 ! pr(ession4  7ii7
 ,entrance into ! tra9+ program = !     
pr(ession4  7iii7 ,graduation f su*     
tra9+ program4  7iv7 ,entrance into     
practice4  7v7 ,ret5tion 9 practice = m 
?an a #e-ye> p]iod4  7,b7 ,to develop "o
 or m /rategies to address ! work=ce    
disp>ities )9 ! heal? pr(ession1 z      
id5tifi$ "u 7& 9 response to ! f9d+s    
pursuant to7 subp>agraph 7,a74  7#b7    
,application ,to be eligible to receive 
a grant "u ?is subsection1 an eligible  
heal? pr(essional organization %all     
submit to ! ,secret>y ( ,heal? & ,human 
,s]vices an application 9 su* =m & mann]
 & conta9+ su* in=mation z specifi$ by !
 ,secret>y4  7#c7 ,am\nt ,ea* grant     
aw>d$ "u ?is subsection %all be = an    

am\nt n to exce$ #cjj1jjj4  7#d7 ,report
 ,ea* recipi5t ( a grant "u ?is         
subsection %all submit to ! ,secret>y ( 
,heal? & ,human ,s]vices a report       
conta9+--  7,a7 in=mation on ! ext5t &  
di/ribution ( work=ce disp>ities        
id5tifi$ ?r\gh ! grant2 &  7,b7         
reasonable objectives & /rategies       
develop$ to address su* disp>ities )9 a 
#e-1 #aj-1 & #be-ye> p]iod4  7c7        
,implem5tation grants  7#a7 ,9 g5]al    
,implem5tation grants describ$ 9 ?is    
subsection are grants to implem5t "o or 
m ( ! /rategies develop$ pursuant to a  
plann+ grant aw>d$ "u subsection 7b74   
7#b7 ,application ,to be eligible to    
receive a grant "u ?is subsection1 an   
eligible heal? pr(essional organization 
%all submit to ! ,secret>y ( ,heal? &   
,human ,s]vices an application 9 su* =m 
& mann] z specifi$ by ! ,secret>y4 ,ea* 
su* application %all conta9 in=mation on
 ! capability ( ! organization to c>ry  
out a /rategy describ$ 9 p>agraph 7#a71 
involvem5t ( p>tn]s or coalitions1 plans

 = develop+ su/a9ability ( ! ef=ts aft] 
! culm9ation ( ! grant cycle1 & any o!r 
in=mation specifi$ by ! ,secret>y4  7#c7
 ,am\nt ,ea* grant aw>d$ "u ?is         
subsection %all be = an am\nt n to exce$
 #ejj1jjj ea* ye> dur+ ! #d-ye> p]iod ( 
! grant4  7#d7 ,reports ,= ea* ( ! fir/ 
#c ye>s = :i* an eligible heal?         
pr(essional organization is aw>d$ a     
grant "u ?is subsection1 ! organization 
%all submit to ! ,secret>y ( ,heal? &   
,human ,s]vices a report on ! activities
 c>ri$ out by su* organization ?r\gh !  
grant dur+ su* ye> & objectives = !     
subsequ5t ye>4 ,= ! f\r? ye> = :i* an   
eligible heal? pr(essional organization 
is aw>d$ a grant "u ?is subsection1 !   
organization %all submit to ! ,secret>y 
a report t includes an analysis ( all ! 
activities c>ri$ out by ! organization  
?r\gh ! grant & a detail$ plan =        
cont9uation ( outrea* ef=ts4  7d7       
,eligible heal? pr(essional organization
 def9$ ,= purposes ( ?is section1 ! t]m 
eligible heal? pr(essional organization 

means a pr(essional organization        
repres5t+ ob/etrician-gynecologi/s1     
c]tifi$ nurse midwives1 c]tifi$         
midwives1 family practice physicians1   
nurse practition]s ^: scope ( practice  
includes mat]nity c>e1 physician        
assi/ants ^: scope ( practice includes  
ob/etrical c>e1 or c]tifi$ pr(essional  
midwives4  7e7 ,au?orization (          
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#b1jjj1jjj = fiscal ye> #bjad &         
#c1jjj1jjj = ea* ( ! fiscal ye>s #bjae  
?r\gh #bjah4