On the fifth attempt, the Senate Health, Education, Labor, and Pensions Committee approved a bill (S. 2328) designed to ensure safe motherhood. Sponsored by Sen. Tom Harkin (D-IA), the Safe Motherhood Act for Research and Treatment (SMART Mom Act) was approved, by voice vote, on September 5. In addition to addressing safe motherhood, the legislation approved by the committee includes several other bills that would authorize offices of women’s health at the Department of Health and Human Services (HHS), increase preventive health services for women, increase the awareness of the link between periodontal disease in pregnant women and pre-term, low birthweight babies, and establish a grant program regarding eating disorders.
Action on the legislation went forward after Senators agreed not to offer several contentious amendments. Prior to the August recess, controversy had erupted when Sen. Barbara Mikulski (D-MD) expressed her intent to offer an amendment that would have required insurance plans to cover prescription contraceptives if they cover other prescription drugs. The amendment was based on a bill (S. 104) sponsored by Sens. Olympia Snowe (R-ME) and Harry Reid (D-NV). In response, Sen. Tim Hutchinson (R-AK) had planned to offer an amendment that would have required HHS to study the safety of RU-486 and report back to the committee within 60 days.
The bill would establish an Interagency Coordinating Committee on Safe Motherhood. The coordinating committee would assess and evaluate health promotion campaigns administered by the federal government and their effect on health during pregnancy. The committee also would be charged with developing a federal research and strategic action plan for safe motherhood, reporting to Congress on key indicators of maternal health, and establishing and implementing a national public education and health promotion campaign on safe motherhood.
The SMART Mom Act also would expand and intensify research and data collection on pregnancy, pregnancy-related illnesses, injuries, or deaths, and postpartum health conditions at the National Institutes of Health (NIH). The bill would establish a Maternal Fetal Medicine Units Network at the NIH.
Under the bill, the Centers for Disease Control and Prevention (CDC) would be charged with awarding grants for community-based demonstration projects to reduce racial and ethnic disparities in pregnancy outcomes. Grants also would be awarded to prevention research centers to conduct research on improving maternal outcomes and improving racial and ethnic disparities in maternal mortality and morbidity. The CDC also would be required to expand and intensify its data collection and surveillance activities with respect to maternal mortality and morbidity, as well as the incidence and prevalence of symptoms and risk factors for pre-term births.
The Agency for Healthcare Research and Quality (AHRQ) also would be charged with conducting research on the quality of maternal health care.
Additionally, the NIH, the CDC, and the Food and Drug Administration (FDA) would be required to conduct a prospective study to determine the effects of pregnancy on the health of women.
The legislation would require the FDA to study marketed drugs, biological products, and devices to establish appropriate dosing for pregnant and lactating women and to determine whether they are safe for pregnant women and their fetuses. The bill also would require postmarketing studies by drug manufacturers to investigate the safe use of these drugs by pregnant and lactating women.
In addition to the SMART Mom Act, the bill includes several other women’s health bills—S. 946, S. 208, S. 2202, and S. 2249. The first measure (S. 946) would provide statutory authority through FY2006 for offices of women’s health at the Public Health Service, the CDC, the AHRQ, the Health Resources and Services Administration, and the FDA. S. 946 is sponsored by Sens. Snowe and Mikulski. A similar bill (H.R. 1784) was approved by the House Energy and Commerce Committee on June 13 (see The Source, 6/14/02).
S. 208, sponsored by Sens. Bill Frist (R-TN) and Harkin, would authorize $20 million in FY2003 and $25 million in FY2004 for the CDC to expand its WISEWOMAN program. Operated through the National Breast and Cervical Cancer Detection Program, WISEWOMAN provides cholesterol and high blood pressure screening for low-income, uninsured, and underinsured women. The program aims to provide preventive health services for cardiovascular diseases, osteoporosis, and obesity.
The third bill (S. 2202), sponsored by Sen. John Edwards (D-NC), would authorize $10 million in each of FY2003 through FY2005 for the Maternal and Child Health Bureau to award grants to organizations and research institutions to conduct research and demonstration projects that apply new scientific evidence about maternal and child oral health linkages related to adverse pregnancy outcomes and maternal transmission of dental caries.
S. 2249, sponsored by Sen. Hillary Rodham Clinton (D-NY), addresses the issue of eating disorders among American youth. The measure would authorize $5 million in FY2003, $5.5 million in FY2004, $6 million in FY2005, $6.5 million in FY2006, and $1 million in FY2007 to the CDC for grants to accredited universities, colleges, or nonprofit organizations to conduct research to comprehensively promote healthy eating behaviors in youth.
