Sens. Tom Carper, D-Delaware; Shelley Moore Capito, R-West Virginia; Bill Nelson, D-Florida; and Tim Scott, R-South Carolina, led a bipartisan group of senators in calling for an increased focus on reducing maternal mortality in the U.S. and improving health outcomes for all mothers and children.

In a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma, 14 Democratic and Republican senators requested that the Department and Agency prioritize developing strategies to reduce maternal mortality rates, including for pregnant women and mothers enrolled in Medicaid and the Children’s Health Insurance Program.

From 2000 to 2014, the rate of maternal mortality, defined as the death of a woman while pregnant or during the one-year period following the date of the end of pregnancy, increased by 26 percent in the U.S. The U.S. ranks 30 of 31 in maternal mortality among developed nations, according to the Organization for Economic Co-operation and Development. Research shows that about 60 percent of maternal deaths in the U.S. could have prevented with improved patient care and education, standardized protocols and timely intervention.

The senators highlighted the racial and ethnic disparities in maternal and infant health in the U.S. For instance, African-American women are three to four times more likely to die from pregnancy-related causes as compared to other women in the U.S. American Indian and Alaskan native women also fare worse than white women with about twice as many pregnancy-related deaths per 100,000 live births.

“Research indicates that numerous factors may contribute to these glaring health disparities, including barriers to accessing necessary prenatal and postnatal care, a growing prevalence of chronic conditions, maternal stress, inadequate training for health care providers, racial bias and social determinants of health. We therefore also ask that you review existing data and provide us with recommendations about what can be done at the federal, state and local levels to reduce mortality and improve health outcomes for all mothers and their children, regardless of their racial and ethnic background, income level or educational attainment,” the senators wrote.

The bipartisan lawmakers also called attention to effective policies that some hospitals have developed to better prepare for pregnancy-related complications that could serve as a model for hospitals nationwide.

“Although some states have taken significant steps to overcome training, education, and system barriers to reducing maternal mortality, not all hospitals and birth centers have implemented common protocols and comprehensive quality measures to help ensure safe labor and delivery, prenatal and postnatal care. Where protocols exist, they may not be integrated into health care delivery systems and hospitals; systems of accountability and support for patients and clinicians are often lacking,” the senators wrote.

Joining Carper, Capito, Nelson and Scott were Sens. Ron Wyden, D-Oregon; Lisa Murkowski, R-Alaska; Ben Cardin, D-Maryland; Marco Rubio, R-Florida; Cory Booker, D-New York; Dean Heller, R-Nevada; Debbie Stabenow, D-Michigan; Todd Young, R-Indiana; Robert Menendez, D-New Jersey; and Joe Donnelly, D-Indiana.

The text of the letter is available at