,,ii #aagth ,,congress #b;d ,session ,s4 #ebhd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ae1 #bjbb,ms4 ,warren 7for herself1 ,mr4 ,booker1 ,mrs4 ,gillibrand1 and ,ms4 ,smith7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve the public health response to addressing maternal mortality and morbidity during the ,,covid-#ai public health emergency4 #a4 ,short title ,this ,act may be cited as the ,maternal ,health ,pandemic ,response ,act of #bjbb4 #b4 ,findings ,congress finds as follows3 7#a7 ,the ,world ,health ,organization declared ,,covid-#ai a ,public ,health ,emergency of ,international ,concern on ,january #cj1 #bjbj4 ,as of ,december #ab1 #bjbb1 there have been over #fdc1hge1jjj confirmed cases of1 and over #f1fcj1jjj deaths associated with1 ,,covid-#ai worldwide4 7#b7 ,in the ,united ,states1 the number of cases of ,,covid-#ai has quickly surpassed the number of such cases in every other nation1 and as of ,december #ab1 #bjbb1 over #ii1jjj1jjj cases and #a1jhj1jjj deaths have been reported by the ,united ,states alone4 7#c7 ,longstanding systemic health and social inequities have put communities of color at increased risk of contracting ,,covid-#ai or experiencing severe illness2 age-adjusted hospitalization rates from ,,covid-#ai are highest for ,american ,indian and ,alaska ,native1 ,black1 and ,latinx people4 7#d7 ,prior to the start of the ,,covid-#ai pandemic1 the ,united ,states was facing a maternal mortality and morbidity crisis1 in which the ,united ,states has the highest maternal mortality rate in the developed world1 and the crisis is worsening4 7#e7 ,more than #ej1jjj women in the ,united ,states annually experience severe maternal morbidity1 and much larger numbers experience more common harmful challenges1 such as prenatal and postpartum mood disorders1 including depression1 anxiety disorder1 and ,,ptsd2 limited access to prenatal and postpartum care1 diagnosis1 and treatment of complications2 intimate partner violence2 and lack of support for meeting breastfeeding goals4 ,many perinatal complications are preventable or treatable1 and most injuries1 long-term adverse effects1 and deaths are preventable4 7#f7 ,compared to ,white women1 ,black and ,american ,indian and ,alaska ,native women in the ,united ,states are #b to #d times more likely to die from pregnancy-related complications1 and ,black and ,american ,indian and ,alaska ,native women suffer disproportionately high rates of maternal morbidity4 ,the maternal mortality rate for ,hispanic women1 which historically has been lower than such rate for ,white women1 is increasing and is now nearly the same as that of ,white women4 7#g7 ,the causes of maternal mortality and morbidity are complex and include racial1 ethnic1 socioeconomic1 and geographic inequities2 racism1 bias1 and discrimination2 comorbidities2 and inadequate access to the health care system1 including behavioral health care1 which are factors that have similarly contributed to the racial disparities seen in ,,covid-#ai outcomes4 7#h7 ,the burden of morbidity and mortality in the ,united ,states for both ,,covid-#ai and maternal health outcomes has also fallen disproportionately on ,black1 ,latinx1 and ,american ,indian and ,alaska ,native communities1 who suffer the most from great public health needs and are the most medically underserved4 ,underserved women also include those living in maternity care deserts1 which lack obstetric providers and hospitals or birth centers offering obstetric care4 7#i7 ,according to the ,centers for ,disease ,control and ,prevention1 pregnant and recently pregnant people with ,,covid-#ai are at increased risk for severe illness when compared with non-pregnant people04 ,additionally1 8pregnant people with ,,covid-#ai are also at increased risk for preterm birth and some data suggest an increased risk for other adverse pregnancy complications and outcomes1 such as preeclampsia1 coagulopathy1 and stillbirth1 compared with pregnant people without ,,covid-#ai4 ,research has also shown that ,,covid-#ai infection during pregnancy may increase the risk of preeclampsia2 having preeclampsia and other pregnancy complications also increases the risks of serious ,,covid-#ai infection4 7#aj7 ,as of ,december #bjbb1 the latest information from the ,centers for ,disease ,control and ,prevention indicates that pregnant women are more likely to be hospitalized and are at higher risk for intensive care unit admissions than nonpregnant women due to ,,covid-#ai1 and ,latinx and ,black pregnant people have been disproportionately infected by ,,covid-#ai1 as well as more likely to experience severe disease4 7#aa7 ,our understanding of the specific impact of ,,covid-#ai on pregnant people has grown significantly4 ,pregnant and newly delivered women are more susceptible to serious infection from ,,covid-#ai1 a direct impact4 ,in addition1 the ,,covid-#ai pandemic has further strained the health care system and decreased access to preconception1 prenatal1 and postpartum care4 ,the lack of access to care1 including mental health care1 increases the risks of maternal mortality and morbidity1 pregnancy loss1 and infant mortality4 ,it has also added another layer of fear and vulnerability for pregnant people1 with disproportionate effects on people of color4 7#ab7 ,as of ,march #g1 #bjbb1 over #ahj1jjj pregnant people in the ,united ,states have tested positive for ,,covid-#ai and #bic pregnant people have died as a result of ,,covid-#ai4 7#ac7 ,the ,world ,health ,organization states that everyone has the right to safe and positive childbirth experience1 whether or not they have a confirmed ,,covid-#ai infection1 this includes the right to respect and dignity1 a companion of choice1 clear communication by maternity staff1 pain relief strategies1 and mobility in labor when possible and the position of choice4 7#ad7 ,a ,,covid-#ai public health response without concerted ,federal action and focus on maternal health care access and quality1 research1 data collection1 mitigation of negative socioeconomic consequences of the pandemic1 and protection of the right to safe and positive childbirth experience has exacerbated the maternal mortality and morbidity crisis4 ,risk has also increased for pregnant women who have not been provided with a continuum of respectful1 responsive1 and empowering care from preconception through postpartum1 during the pandemic and beyond4 #c4 ,definitions ,in this ,act3 7#a7 ,,covid-#ai public health emergency ,the term ,,covid-#ai public health emergency means the period beginning on the date that the public health emergency declared by the ,secretary of ,health and ,human ,services under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d7 on ,january #ca1 #bjbj1 with respect to ,,covid-#ai took effect1 and ending on the later of the end of such public health emergency or ,january #a1 #bjbc4 7#b7 ,culturally congruent ,the term culturally congruent1 with respect to care or maternity care1 means care that is anti-racist and is in agreement with the preferred cultural values1 beliefs1 worldview1 and practices of the health care consumer and other stakeholders4 7#c7 ,indian ,tribe1 ,tribal organization1 and urban ,indian organization ,the terms ,indian ,tribe and ,tribal organization have the meanings given the terms ,indian tribe and tribal organization1 respectively1 in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd71 and the term urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 7#d7 ,maternal mortality ,the term maternal mortality means a death occurring during pregnancy or within one year of the end of pregnancy1 from a pregnancy complication1 a chain of events initiated by pregnancy1 or the aggravation of an unrelated condition by the physiologic effects of pregnancy4 7#e7 ,postpartum ,the term postpartum means the #a-year period beginning on the last day of a person's pregnancy4 7#f7 ,respectful maternity care ,the term respectful maternity care means care organized for1 and provided to1 all pregnant and postpartum people in a manner that-- 7,a7 is culturally congruent and linguistically appropriate2 7,b7 maintains a person's dignity1 privacy1 and confidentiality2 7,c7 ensures freedom from harm and mistreatment2 and 7,d7 enables informed choice and continuous support during labor1 childbirth1 and postpartum4 7#g7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#h7 ,severe maternal morbidity ,the term severe maternal morbidity means an unexpected outcome caused by labor and delivery that results in significant short-term or long-term consequences to the health of the pregnant person4 #d4 ,emergency funding for ,federal data collection1 surveillance1 and research on maternal health outcomes during the ,,covid-#ai public health emergency or a future public health emergency ,to conduct or support data collection1 surveillance1 and research on maternal health as a result of the ,,covid-#ai public health emergency or a future public health emergency1 including support to assist in the capacity building for ,state1 ,tribal1 territorial1 and local public health departments to collect and transmit racial1 ethnic1 and other demographic data related to maternal health1 there are authorized to be appropriated-- 7#a7 #ajj1jjj1jjj for the ,surveillance for ,emerging ,threats to ,mothers and ,babies program of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 work with public health1 clinical1 and community-based organizations to provide timely1 continually updated guidance to families and health care providers on ways to reduce health risks to mothers and babies and tailor interventions to improve their long-term health2 7,b7 partner with more ,state1 ,tribal1 territorial1 and local public health programs in the collection and analysis of clinical data on the impact of ,,covid-#ai and future public health emergencies on pregnant and postpartum patients and their newborns1 including among pregnant people of color2 and 7,c7 establish regionally based centers of excellence to offer medical1 public health1 and other knowledge to ensure communities1 especially communities of color1 rural communities1 and other underserved communities can help pregnant and postpartum patients and infants get the care they need2 7#b7 #cj1jjj1jjj for the ,enhancing ,reviews and ,surveillance to ,eliminate ,maternal ,mortality program 7commonly known as the ,,erase ,,mm program7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in expanding its partnerships with ,states and ,indian ,tribes and provide technical assistance to existing ,maternal ,mortality ,review ,committees2 7#c7 #de1jjj1jjj for the ,pregnancy ,risk ,assessment ,monitoring ,system 7commonly known as the ,,prams7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 create a ,,covid-#ai supplement to its ,,prams questionnaire2 7,b7 add questions around experiences of respectful1 responsive1 and empowering maternity care in prenatal1 intrapartum1 and postpartum care2 7,c7 conduct a rapid assessment of ,,covid-#ai awareness1 impact on care and experiences1 and use of preventive measures among pregnant1 laboring and birthing1 and postpartum people during the ,,covid-#ai public health emergency2 and 7,d7 work to transition the survey to an electronic platform and expand the survey to a larger population1 with a special focus on reaching underrepresented communities and underserved communities1 and with sensitivity to individuals who lack access to such a platform2 and 7#d7 #ae1jjj1jjj for the ,national ,institute of ,child ,health and ,human ,development1 to conduct or support research for interventions to mitigate the effects of the ,,covid-#ai public health emergency on pregnant and postpartum people1 including ,black1 ,latinx1 ,asian-,american and ,pacific ,islander1 and ,american ,indian and ,alaska ,native people1 as well as people living in areas with limited maternity care4 #e4 ,,covid-#ai maternal health data collection and disclosure 7a7 ,data collection ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall make publicly available1 on the website of the ,centers for ,disease ,control and ,prevention1 pregnancy and postpartum data collected across all surveillance systems relating to ,,covid-#ai1 disaggregated by race1 ethnicity1 primary language1 disability status1 gender identity1 sexual orientation1 immigration status1 insurance status1 and ,state and ,tribal location1 including the following3 7#a7 ,data related to all ,,covid-#ai diagnostic testing1 including the number of pregnant people and postpartum people tested and the number of positive cases4 7#b7 ,data related to all suspected cases of ,,covid-#ai in pregnant1 birthing1 and postpartum people who did not undergo testing4 7#c7 ,data related to all ,,covid-#ai serologic testing1 including the number of pregnant and postpartum people tested and the number of such serologic tests that were positive4 7#d7 ,data related to treatment for ,,covid-#ai1 including hospitalizations1 emergency room1 and intensive care unit admissions of pregnant1 birthing1 and postpartum people related to ,,covid-#ai4 7#e7 ,data related to ,,covid-#ai outcomes1 including total fatalities and case fatality 7expressed as the proportion of people who were infected with ,,covid-#ai and died from the virus7 of pregnant and postpartum people4 7#f7 ,data related to pregnancy and infant health outcomes for pregnant people with confirmed or suspected ,,covid-#ai1 which may include stillbirths1 maternal mortality and morbidity1 infant mortality1 preterm births1 low-birth weight infants1 and cesarean section births4 7#g7 ,data related to all long-term effects of ,,covid-#ai related to cases contracted during the pregnancy or postpartum period4 7b7 ,timeline ,the ,secretary shall update the data made available under this section not less frequently than monthly1 during the ,,covid-#ai public health emergency and for at least one month after the end of the ,,covid-#ai public health emergency4 7c7 ,privacy ,in publishing data under this section1 the ,secretary shall take all necessary steps to protect the privacy of people whose information is included in such data1 including by complying with-- 7#a7 privacy protections under the regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif 7#db ,u4,s4,c4 #acbj;d-#b note72 and 7#b7 protections from all inappropriate internal use by an entity that collects1 stores1 or receives the data1 including use of such data in determinations of eligibility 7or continued eligibility7 in health plans1 and from inappropriate uses4 7d7 ,indian ,health ,service ,the ,director of the ,indian ,health ,service and ,director of the ,centers for ,disease ,control and ,prevention shall consult with ,indian ,tribes and confer with urban ,indian organizations on data collection and reporting for purposes of this section4 7e7 ,data collection guidance ,the ,secretary shall issue guidance to ,states and local public health departments to ensure that all relevant demographic data1 including pregnancy and postpartum status1 are collected and included when sending ,,covid-#ai testing specimen to laboratories1 and ,state and local health departments and ,indian ,tribes are disaggregating data on ,,covid-#ai status in data on maternal and infant morbidity and mortality4 ,the ,secretary shall ensure that the guidance is developed in consultation with ,indian ,tribes to ensure that it includes ,tribally developed best practices on reducing misclassification of ,american ,indian and ,alaska ,native people in ,federal1 ,state1 and local public health surveillance systems4 #f4 ,public health communication regarding maternal care during ,,covid-#ai 7a7 ,public health campaign ,the ,director of the ,centers for ,disease ,control and ,prevention shall undertake a robust public health education effort to enhance access by pregnant people1 their employers1 and their providers to accurate1 evidence-based health information about ,,covid-#ai and pregnancy1 safety1 and risk1 with a particular focus on reaching pregnant and postpartum people in underserved communities4 7b7 ,emergency temporary standard 7#a7 ,in general ,in consideration of the grave risk presented by ,,covid-#ai and the need to strengthen protections for employees1 pursuant to section #f7;c77#a7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;c77#a77 and notwithstanding the provisions of law and the executive order described in paragraph 7#c71 not later than #g days after the date of enactment of this ,act1 the ,secretary of ,labor shall promulgate an emergency temporary standard to protect all employees at occupational risk from occupational exposure to ,,sars-,co,v-#b4 7#b7 ,pregnant and postpartum employees ,the emergency temporary standard promulgated under this subsection shall include consideration of the risks and needs specific to pregnant and postpartum employees4 7#c7 ,inapplicable provisions of law and executive order ,the requirements of chapter #f of title #e1 ,united ,states ,code 7commonly referred to as the ,regulatory ,flexibility ,act71 subchapter ,i of chapter #ce of title #dd1 ,united ,states ,code 7commonly referred to as the ,paperwork ,reduction ,act71 the ,unfunded ,mandates ,reform ,act of #aiie 7#b ,u4,s4,c4 #aeja et seq471 and ,executive ,order #abhff 7#eh ,fed4 ,reg4 #aij2 relating to regulatory planning and review7 shall not apply to the standard promulgated under this subsection4 7c7 ,task force on birthing experience and safe1 respectful1 responsive1 and empowering maternity care during pandemics and other public health emergencies 7#a7 ,establishment ,the ,secretary1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,health ,resources and ,services ,administration1 shall convene a task force to develop ,federal recommendations regarding respectful1 responsive1 and empowering maternity care1 including safe birth care and postpartum care1 during public health emergencies4 7#b7 ,duties ,the task force established under paragraph 7#a7 shall develop1 publicly post1 and update ,federal recommendations in multiple languages to ensure quality1 provide nondiscriminatory maternity care1 promote positive birthing experiences1 and improve maternal health outcomes during the ,,covid-#ai public health emergency and future public health emergencies1 with a particular focus on outcomes for communities of color and rural populations4 ,such guidelines and recommendations shall-- 7,a7 address1 with particular attention to ensuring equitable treatment on the basis of race and ethnicity-- 7i7 measures to facilitate respectful1 responsive1 and empowering maternity care2 7ii7 measures to facilitate telehealth maternity care for pregnant people who cannot regularly access in-person care2 7iii7 strategies to increase access to specialized care for those with high-risk pregnancies or pregnant individuals with elevated risk factors2 7iv7 diagnostic testing for pregnant and laboring patients2 7v7 birthing without one's chosen companions1 with one's chosen companions1 and with smartphone or other telehealth connection to one's chosen companions2 7vi7 newborn separation after birth in relation to maternal infection status2 7vii7 breast milk feeding in relation to maternal infection status2 7viii7 licensure1 training1 scope of practice1 and ,medicaid and other insurance reimbursement for certified midwives1 certified nurse-midwives1 certified professional midwives1 in a manner that facilitates inclusion of midwives of color and midwives from underserved communities2 7ix7 financial support and training for perinatal health workers who provide non-clinical support to people from pregnancy through the postpartum period1 such as a doula1 community health worker1 peer supporter1 lactation consultant1 nutritionist or dietitian1 social worker1 home visitor1 or a patient navigator in a manner that facilitates inclusion from underserved communities2 7x7 strategies to ensure and expand doula coverage under ,state ,medicaid programs2 7xi7 how to identify1 address1 and treat prenatal and postpartum mental and behavioral health conditions1 such as anxiety1 substance use disorder1 and depression1 which may have arisen or increased during the ,,covid-#ai public health emergency1 and how to mitigate the impact of future public health emergencies on maternal mental health2 7xii7 how to identify and address instances of intimate partner violence during pregnancy which may arise or intensify during public health emergencies1 and how to mitigate the impact of future public health emergencies on maternal mental health2 7xiii7 strategies to address hospital capacity concerns in communities with a surge in infectious disease cases and to provide childbearing people with options that reduce potential for cross-contamination and increase the ability to implement their care preferences while maintaining safety and quality1 such as the use of auxiliary maternity units and freestanding birth centers2 7xiv7 provision of child care services during prenatal appointments for mothers whose children are unable to attend as a result of restrictions relating to the public health emergencies2 7xv7 how to identify and address racism1 bias1 and discrimination in the delivery treatment and support to pregnant and postpartum people1 including evaluating the value of training for hospital staff on implicit bias and racism1 respectful1 responsive1 and empowering maternity care1 and demographic data collection2 7xvi7 how to address the needs of undocumented pregnant women and new mothers who may be afraid or unable to seek needed care during the ,,covid-#ai public health emergency2 7xvii7 how to address the needs of uninsured pregnant women who have historically relied on emergency departments for care2 7xviii7 how to identify women at risk for depression1 anxiety disorder1 psychosis1 obsessive-compulsive disorder1 and other maternal mood disorders before1 during1 and after pregnancy1 and how to treat those diagnosed with a postpartum mood disorder2 7xix7 how to effectively and compassionately screen for substance abuse during pregnancy and postpartum and help moms find support and effective treatment2 and 7xx7 such other matters as the task force determines appropriate2 7,b7 identify barriers to the implementation of the guidelines and recommendations2 7,c7 take into consideration existing ,state and other programs that have demonstrated effectiveness in addressing pregnancy1 birth1 and postpartum care during the ,,covid-#ai public health emergency2 and 7,d7 identify policies specific to ,,covid-#ai that should be discontinued when safely possible and those that should be continued as the public health emergency abates4 7#c7 ,membership ,the task force established under paragraph 7#a7 shall be comprised of-- 7,a7 representatives of the ,department of ,health and ,human ,services1 including representatives of-- 7i7 the ,secretary2 7ii7 the ,director of the ,centers for ,disease ,control and ,prevention2 7iii7 the ,administrator of the ,health ,resources and ,services ,administration2 7iv7 the ,administrator of the ,centers for ,medicare ,medicaid ,services2 7v7 the ,director of the ,agency for ,healthcare ,research and ,quality2 and 7vi7 the ,director of the ,indian ,health ,service2 7,b7 at least #c ,state1 local1 or territorial public health officials representing departments of public health1 who shall represent jurisdictions from different regions of the ,united ,states with relatively high concentrations of historically marginalized populations1 to be appointed by the ,secretary2 7,c7 at least #a ,tribal public health official representing departments of public health2 7,d7 #a or more representatives of a community-based organization that addresses adverse maternal health outcomes with a specific focus on racial and ethnic inequities in maternal health outcomes1 appointed by the ,secretary1 with special consideration given to organizations led by a person of color or from communities with significant minority populations2 7,e7 #a or more obstetrician-gynecologist or other physician who provides obstetric care1 with special consideration for physicians who are from1 or work in1 communities experiencing1 or that have experienced1 the highest rates of ,,covid-#ai mortality and morbidity2 7,f7 #a or more nurse1 such as a certified nurse-midwife1 women's health nurse practitioner1 or other nurse who provides obstetric care1 with special consideration for nurses who are from1 or work in1 communities experiencing1 or that have experienced1 the highest rates of ,,covid-#ai mortality and morbidity2 7,g7 #a or more perinatal health workers who provide non-clinical support to people from pregnancy through postpartum period1 such as a doula1 community health worker1 peer supporter1 lactation consultant1 nutritionist or dietitian1 social worker1 home visitor1 or patient navigator2 7,h7 #a or more patients who were pregnant or gave birth during the ,,covid-#ai public health emergency2 7,i7 #a or more patients who contracted ,,covid-#ai and later gave birth2 7,j7 #a or more patients who have received support from a perinatal health worker who provides prenatal and postpartum support1 such as a doula1 community health worker1 peer supporter1 lactation consultant1 nutritionist or dietitian1 social worker1 home visitor1 or a patient navigator1 or a spouse or family member of such patient2 and 7,k7 racially and ethnically diverse representation from at least #c independent experts with knowledge or field experience with racial and ethnic disparities in public health1 women's health1 or maternal mortality and severe maternal morbidity4 #g4 ,,gao report on maternal health and public health emergency preparedness ,not later than #a year after the end of the public health emergency declared by the ,secretary of ,health and ,human ,services under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d7 on ,january #ca1 #bjbj1 with respect to ,,covid-#ai1 the ,comptroller ,general of the ,united ,states shall submit to the appropriate committees of ,congress a report on maternal health and public health emergency preparedness1 including prenatal1 labor and delivery1 and postpartum care during the ,,covid-#ai public health emergency1 including the following3 7#a7 ,a review of the prenatal1 labor and delivery1 and postpartum experiences of people during the ,,covid-#ai public health emergency1 which shall-- 7,a7 identify barriers to accessing preconception1 pregnancy1 birth1 and postpartum care during a pandemic1 including maternal behavioral health care2 7,b7 assess the extent to which public and private insurers were providing coverage for maternal health care during the public health emergency1 including for telehealth services and out-of-hospital births2 7,c7 review the impact of the continuous enrollment condition included in the ,families ,first ,coronavirus ,response ,act 7,public ,law #aaf-abg7 had on enrollment of postpartum people in ,state ,medicaid programs and analyze health care services utilized by this population in the postpartum period2 7,d7 to the extent practicable1 analyze maternal and infant health outcomes by race and ethnicity 7including quality of care1 mortality1 morbidity1 cesarean section rates1 preterm birth1 prevalence of prenatal and postpartum anxiety and depression1 and other mood disorders7 during the ,,covid-#ai public health emergency and the impact of ,federal and ,state policy changes made in response to the ,,covid-#ai pandemic on such outcomes2 7,e7 identify contributors to population-based disparities seen in ,,covid-#ai outcomes1 such as racial profiling of1 and bias and discrimination against1 ,black1 ,american ,indian and ,alaska ,native1 ,latinx1 and ,asian-,american and ,pacific ,islander people2 7,f7 review the impact of increased unemployment1 paid family leave1 changes in health care coverage1 and other social determinants of health for pregnant and postpartum people during the public health emergency1 including intimate partner violence2 and 7,g7 assess the impact of the lack of inclusion of pregnant and lactating people in clinical trials for ,,covid-#ai therapeutics and vaccines4 7#b7 ,consultation with maternity care providers1 maternal behavioral health care specialists1 researchers who specialize in women's health or maternal mortality and severe maternal morbidity1 people who experienced pregnancy or childbirth during the ,,covid-#ai public health emergency1 representatives from community-based organizations that address maternal health1 and perinatal health workers who provide nonclinical support to pregnant and postpartum people 7such as a doula1 community health worker1 peer support1 certified lactation consultant1 nutritionist or dietician1 social worker1 home visitor1 or navigator74 7#c7 ,recommendations to improve the public health emergency response and preparedness efforts of the ,federal ,government specific to maternal health1 with a particular focus on outcomes for minority women1 including-- 7,a7 ways to improve research1 surveillance1 and data collection of the ,federal ,government related to maternal health2 7,b7 ways for the ,federal ,government to factor maternal health outcomes and disparities into decisions regarding distribution of resources1 including ,,covid-#ai tests1 personal protective equipment1 and emergency funding2 7,c7 the extent to which guidelines and recommendations of the ,federal ,government related to maternal health care during the ,,covid-#ai public health emergency were culturally congruent and linguistically competent for minority women2 7,d7 ways to improve the distribution of public health funds1 data1 and information to ,indian ,tribes and ,tribal organizations with regard to maternal health during public health emergencies2 and 7,e7 opportunities to incentivize or require sponsors to include safety data on pregnant and lactating people for therapeutics and vaccines in emergency use authorization submissions4