MOMS for the 21st Century Bill Filed in House of Representatives!

Childbirth Connection is pleased to inform eNews subscribers that Congresswoman Lucille Roybal-Allard of California has filed the Maximizing Optimal Maternity Services for the 21st Century bill (HR 5807). Also known as “MOMS for the 21st Century,” the bill was filed with 25 co-sponsors.

This sweeping legislation aims to “promote optimal maternity outcomes by making evidence-based maternity care a national priority.” Key provisions include:

• establishing a focal area on optimal maternity care in the Office
on Women’s Health, Department of Health and Human Services
• establishing a federal Interagency Coordinating Committee on the
Promotion of Optimal Maternity Outcomes
• developing and carrying out a national consumer education
campaign about optimal maternity care
• developing, making publicly available, and keeping up to date a
bibliographic database of systematic reviews for care of
childbearing women and newborns
• identifying maternity care health professional shortage areas
• establishing Centers for Excellence on Optimal Maternity Outcomes
• directing the Center for Medicare and Medicaid Innovation to test
innovative maternity care models
• developing common core curricula for maternity care providers
• establishing payment for certified nurse-midwife teachers of
students in health professions education programs
• establishing a loan repayment program for maternity care
professionals
• providing grants to increase the diversity of the maternity care workforce.

Moms for the 21st Century includes key provisions recommended in two Childbirth Connection reports: Evidence-Based Maternity Care: What It Is and What It Can Achieve (2008) and the “Blueprint for Action: Steps toward a High-Quality, High-Value Maternity Care System” (2010). Childbirth Connection issued Evidence-Based Maternity Care together with the Reforming States Group and the Milbank Memorial Fund. The Blueprint was developed through the Transforming Maternity Care project, a multi-disciplinary, multi-stakeholder collaboration that engaged leaders from across the health care system over two and one-half years in identifying priority actions for driving maternity care quality improvement. Childbirth Connection was honored to work closely with Ms. Roybal-Allard’s office on this important legislation.

ENews readers are encouraged to:
• read the MOMS for the 21st Century bill
• read Rep. Roybal-Allard’s press release (PDF)
• watch Rep.Roybal-Allard’s floor speech to introduce the bill, and
• call Rep. Roybal-Allard’s office to thank her for exceptional
commitment to childbearing women and newborns: 202 225-1766.

ACOG Issues New VBAC Guidelines
A recent National Institutes of Health panel asked the American College of Obstetricians and Gynecologists (ACOG) to issue new guidelines that might increase access to vaginal birth after cesarean (VBAC), in consideration of an updated VBAC evidence report. The professional society has just released its updated VBAC guideline, which is published in the July issue of Obstetrics & Gynecology.

The new guideline persists in recommending that women who desire VBAC should give birth in facilities that provide immediate access to emergency cesarean, even though this is based on the lowest, Level C evidence (primarily consensus and expert opinion). Thus, this version is unlikely to increase access to VBAC in the many hospitals without 24/7 on-site surgical teams. On the other hand, the guidelines newly identify many clinical situations that are candidates for VBAC, including many women with: two prior cesareans, a suspected large fetus, and fetal gestation beyond 40 weeks. These changes could lead to increased use of VBAC in facilities with continuously present surgical teams. Childbirth Connection offers eNews readers tables comparing the new and previous ACOG VBAC guidelines (PDF).

Best wishes,

Maureen Corry
Executive Director
Childbirth Connection

Transforming Maternity Care
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Blueprint for Action
Evidenced-Based Maternity Care
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Resources for VBAC or Repeat C-
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