,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ijae  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #bb1 #bjbf,ms4   
,de,lauro introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,=eign       
,affairs  ,a ,,bill  ,to au?orize       
assi/ance to tra9 & reta9               
ob/etrician-gynecologi/s &              
sub-speciali/s 9 urogynecology & to help
 improve ! quality ( c>e to meet ! heal?
 c>e ne$s ( wom5 9 lea/ develop$        
c\ntries1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,physician ,education = ,fi/ula         
,treatm5t ,act4  #b4 ,f9d+s ,congress   
f9ds ! foll[+3  7#a7 ,ob/etric fi/ula1  
an abnormal op5+ betwe5 a woman's g5ital
 tract & h] ur9>y tract or rectum1 is a 
deva/at+ *ildbir? injury caus$ by       
prolong$1 ob/ruct$ labor 9 ! abs5ce (   
timely & quality m$ical c>e4  7#b7      
,worldwide1 an e/imat$ #ejj1jjj wom5 &  
girls live ) ob/etric fi/ula ) ?\s&s m  
occurr+ annually4 ,x occurs             
disproportionately among impov]i%$1     

vuln]able1 & m>g9aliz$ girls & wom54    
7#c7 ,wom5 :o exp]i5ce an ob/etric      
fi/ula suff] life-%att]+ consequ5ces    
includ+ *ronic incont95ce1 %ame1 social 
isolation1 pov]ty1 & physical1 m5tal1 & 
emotional heal? problems4  7#d7         
,ob/etric fi/ula is a violation ( human 
rights & an indicator ( ! failure (     
heal? sy/ems to deliv] univ]sally       
accessible1 timely1 & quality heal? c>e 
to wom5 & girls :o ne$ x4  7#e7         
,ob/etric fi/ula is prev5table4         
,univ]sal heal? cov]age & univ]sal      
access to quality c>e are ess5tial 9    
end+ prev5table mat]nal & newborn dea?s 
& disabilities1 includ+ fi/ula4 ,skill$ 
heal? p]sonnel at bir?1 em]g5cy ob/etric
 & newborn c>e1 & univ]sal access to    
mod]n contraception are ! mo/ effective 
int]v5tions to prev5t mat]nal mortality 
& fi/ula4  7#f7 ,safegu>d+ ! rights &   
dignity ( wom5 & girls & address+       
und]ly+ g5d] & socioeconomic            
inequalities & discrim9ation :i* drive  
ob/etric fi/ula are equally important to

 end ! condition4  7#g7 ,9 #bjah &      
#bjbj1 ! ,unit$ ,nations ,g5]al         
,assembly resolutions on fi/ula 7       
adopt$1 call+ = ,end+ fi/ula )9 a       
decade4 ,?is repres5ts a turn+ po9t 9 ! 
global fight to elim9ate fi/ula1 z x    
br+s ! global objective & timel9e = end+
 fi/ula into alignm5t ) a*iev+ !        
,su/a9able ,developm5t ,goals           
7,s,d,gs7_/,ag5da #bjcj4 ,! resolutions 
also call = an increas$ focus on social 
det]m9ants to tackle ! root causes (    
fi/ula4  7#h7 ,ob/etric fi/ula c be     
surgically treat$4 ,! impact ( an       
ob/etric fi/ula-repair surg]y is        
imm$iate & wom5 c be re9tegrat$ into    
society4 ,!re is h[ev] a high unmet ne$ 
= treatm5t & social re9tegration (      
fi/ula survivors4  7#i7 ,9 #ij p]c5t (  
cases :]e wom5 develop fi/ula & timely  
m$ical c>e is n available1 a /illborn   
baby is tragically deliv]$4  7#aj7 ,!   
,unit$ ,nations ,population ,fund       
7,,unfpa7-l$ global ,campaign to ,end   
,fi/ula1 is a key contributor to promot+

 ! rights1 dignity1 & well-be+ ( wom5 & 
girls4 ,! ,campaign focuses on          
prev5tion1 treatm5t1 social             
re9tegration1 & advocacy4 ,aim$ at leav+
 no "o beh9d & rea*+ ! fur!/ beh9d1 x   
contributes to a*iev+ ! ,s,d,gs & has   
also help$ re/ore ov]all heal?1 dignity1
 hope1 & a s5se ( self-wor? & ag5cy to  
"s ( ! poore/1 mo/ m>g9aliz$ wom5 &     
girls worldwide ?r\gh its holi/ic1      
g5d]-s5sitive1 & rights-bas$ approa* to 
policies & programs = ! elim9ation (    
ob/etric fi/ula & sev]al o!r mat]nal    
morbidities4  7#aa7 ,,unfpa has support$
 ov] #aej1jjj surgical repairs ov] ! la/
 two decades4 ,! ,campaign to ,end      
,fi/ula & its p>tn]s h made rem>kable   
progress1 b ! ne$s rema9 great4  7#ab7  
,) #d ye>s to rea* ! global goal ( end+ 
fi/ula by #bjcj1 significantly int5sifi$
 inve/m5t1 ef=ts1 & p>tn]%ips at !      
int]national & national levels are      
requir$4  7#ac7 ,! ,int]national ,day to
 ,end ,ob/etric ,fi/ula :i* takes place 
on ,may #bc1 #bjbd1 w be commemorat$ ?is

 ye> ) ! !me3 ,h] heal?1 h] "r3 ,%ap+ a 
future )\t fi/ula1 emphasiz+ t e girl & 
woman has ! fundam5tal "r to heal?1     
includ+ reproductive & sexual heal?1 & t
 ! cont9u$ exi/5ce ( ob/etric fi/ula is 
a cle> violation ( ?is "r4  #c4         
,int]national ob_/gyn & urogynecology   
promotion program  7a7 ,purpose ,!      
purpose ( assi/ance "u ?is section is to
 tra9 & reta9 ob/etrician-gynecologi/s  
7,,ob-,g,y,ns7 & sub-speciali/s 9       
urogynecology & to help improve !       
quality ( c>e to meet ! heal? c>e ne$s (
 wom5 9 lea/ develop$ c\ntries4  7b7    
,au?orization  7#a7 ,9 g5]al ,to c>ry   
out ! purpose ( subsection 7a71 !       
,presid5t1 act+ ?r\gh ! ,director ( !   
,john ,e4 ,fog>ty ,int]national ,c5t] = 
,advanc$ ,/udy 9 ! ,heal? ,sci5ces1 is  
au?oriz$ to provide assi/ance = lea/    
develop$ c\ntries to support !          
activities describ$ 9 subsection 7c74   
7#b7 ,ref]5ce ,assi/ance au?oriz$ "u ?is
 section may be ref]r$ to z !           
,int]national ,,ob_/,,gyn &             

,urogynecology ,promotion ,program4  7c7
 ,activities support$ ,activities t may 
be support$ by assi/ance "u subsection  
7b7 include ! foll[+3 7#a7 ,fell[%ip &  
resid5cy programs ,e/abli%m5t ( fell[%ip
 & resid5cy programs to be c>ri$ out 9  
coord9ation ) in/itutions ( high]       
education 7z su* t]m is def9$ 9 section 
#aja ( ! ,high] ,education ,act ( #aife 
7#bj ,u4,s4,c4 #ajja771 in/itutions (   
high] le>n+1 midwif]y programs1 & exi/+ 
cl9ical c5t]s 9 lea/ develop$ c\ntries--
  7,a7 to support exi/+ academic        
curricula = education tra9+ = midwif]y  
/ud5ts2  7,b7 to develop & help su/a9   
exi/+ specializ$ curriculum tra9+ =     
m$ical /ud5ts & resid5ts to become      
kn[l$geable & pr(ici5t 9 wom5's heal?   
c>e2 &  7,c7 to all[ m$ical /ud5ts1     
resid5ts1 & midwif]y /ud5ts to practice 
& develop exp]tise 9 geographical areas 
9 :i* *ildbir?-relat$ injuries are mo/  
preval5t4  7#b7 ,tra9+ c5t]s ,e/abli%m5t
 ( tra9+ c5t]s--  7,a7 to address !     
%ortage ( ,,ob-,g,y,ns & sub-speciali/s 

9 ! urogynecology pr(ession2 &  7,b7 to 
c>ry out specializ$ programs t are      
locat$ at heal? c>e in/itutions t       
provide exceptionally high conc5trations
 ( exp]tise & relat$ res\rces relat$ to 
^! m$ical pr(essions & are deliv]$ 9 a  
compreh5sive & int]discipl9>y fa%ion4   
#d4 ,compreh5sive #aj-ye> /rategy to    
address ! %ortage ( physicians 9 lea/   
develop$ c\ntries  7a7 ,9 g5]al ,!      
,presid5t1 act+ ?r\gh ! ,director ( !   
,john ,e4 ,fog>ty ,int]national ,c5t] = 
,advanc$ ,/udy 9 ! ,heal? ,sci5ces1 %all
 e/abli% a compreh5sive1 integrat$1     
#aj-ye> /rategy to address ! %ortage (  
physicians 9 lea/ develop$ c\ntries4    
7b7 ,elem5ts ,su* /rategy %all ma9ta9   
suffici5t flexibility & rema9 responsive
 to ! ne$s ( wom5 afflict$ )            
*ildbir?-relat$ injuries & %all include 
! foll[+3  7#a7 ,a plan = implem5tation 
& coord9ation ( programs & activities "u
 ?is ,act1 includ+ grants & contracts = 
prev5tion1 treatm5t1 & monitor+ (       
*ildbir?-relat$ injuries4  7#b7         

,specific objectives1 multi-sector      
approa*es1 & specific /rategies to treat
 wom5 :o suff] f *ildbir?-relat$        
injuries & to prev5t fur!r occurr5ces ( 
*ildbir?-relat$ injuries4  7#c7         
,assignm5t ( priorities = relevant      
executive bran* ag5cies4  7#d7 ,public  
heal? & heal? c>e deliv]y sy/em rese>*  
on ! prev5tion1 repair1 & rehabilitation
 ( *ildbir?-relat$ injuries4  7#e7      
,social sci5ce rese>* 9 fields su* z    
an?ropology1 sociology1 & relat$ fields 
to monitor & evaluate ! und]ly+ social &
 economic factors t contribute to       
*ildbir?-relat$ injuries4  7#f7         
,developm5t1 implem5tation1 & evaluation
 ( evid5ce-bas$ sy/ems ( c>e connect+   
mat]nity c>e facilities ) local c>e     
deliv]y & community education programs4 
,su* sy/ems ( c>e %\ld promote rapid &  
long-t]m prev5tion ( *ildbir?-relat$    
injuries1 includ+--  7,a7 culturally    
appropriate *ildbir? education1         
prep>ation1 & plann+2 &  7,b7 access to 
ob/etrician-gynecologi/s 7,,ob-,g,y,ns71

 urogynecology c>e1 or midwif]y c>e4    
7#g7 ,expansion ( tra9+ c5t]s &         
p>tn]%ips ) in/itutions ( high] le>n+ = 
m$ical /ud5ts & resid5ts4  7#h7         
,priorities = ! di/ribution ( res\rces  
bas$ on factors su* z ! size &          
demographics ( ! population suff]+ f    
*ildbir?-relat$ injuries1 ! ne$s ( t    
population1 & ! exi/+ infra/ructure or  
fund+ levels t may exi/ to treat &      
prev5t *ildbir?-relat$ injuries1 includ+
 ob/etric fi/ula4  7#i7 ,a plan =       
in/itutional capacity-build+ ( p>tn]%ips
 to /r5g!n univ]sities1 rese>* c5t]s1   
heal?-pr(ession tra9+ programs1 &       
gov]nm5t in/itutes to build ! 9-c\ntry  
capacity ne$$ to eradicate              
*ildbir?-relat$ injuries 9 lea/ develop$
 c\ntries4  7c7 ,report ,n lat] ?an #b  
ye>s aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,presid5t %all submit to        
,congress a report t conta9s ! /rategy  
requir$ "u ?is section4  #e4 ,report    
7a7 ,9 g5]al ,! ,presid5t1 act+ ?r\gh ! 
,director ( ! ,john ,e4 ,fog>ty         

,int]national ,c5t] = ,advanc$ ,/udy 9 !
 ,heal? ,sci5ces1 %all submit to        
,congress1 on an annual basis1 a report 
on ! implem5tation ( ?is ,act = ! prec$+
 ye>4  7b7 ,matt]s ,to be includ$ ,!    
report requir$ "u subsection 7a7 %all   
include an evaluation ( ! effectiv5ess &
 p]=mance ( ! ,int]national ,,ob_/,,gyn 
& ,urogynecology ,promotion ,program    
e/abli%$ "u section #c & all relat$     
community outrea* & m$ical programs4    
#f4 ,def9itions ,9 ?is ,act3 7#a7       
,*ildbir?-relat$ injuries ,! t]m        
*ildbir?-relat$ injuries means injuries 
associat$ ) ob/ruct$ labor1 includ+--   
7,a7 pelvic organ prolapse2  7,b7 a     
displacem5t ( pelvic organs su* z !     
ut]us1 bladd]1 or b[el2 &  7,c7 ob/etric
 fi/ula4  7#b7 ,l[-income c\ntry ,! t]m 
l[-income c\ntry means a c\ntry ) a p]  
capita gross national income ( #a1jce or
 less4  7#c7 ,lea/ develop$ c\ntry ,!   
t]m lea/ develop$ c\ntry means a c\ntry 
t-- 7,a7 is a l[-income c\ntry2 &  7,b7 
accord+ to ! ,unit$ ,nations ,economic  

,analysis & ,policy ,division1 is       
confront+ sev]e /ructural imp$im5ts to  
su/a9able developm5t4  7#d7 ,relevant   
executive bran* ag5cies ,! t]m relevant 
executive bran* ag5cies means !         
,dep>tm5t ( ,/ate1 ! ,unit$ ,/ates      
,ag5cy = ,int]national ,developm5t1 &   
any o!r dep>tm5t or ag5cy ( ! ,unit$    
,/ates t p>ticipates 9 int]national     
heal? & humanit>ian activities pursuant 
to ! au?orities ( su* dep>tm5t or ag5cy 
or ! ,=eign ,assi/ance ,act ( #aifa4