[Congressional Record Volume 143, Number 86 (Thursday, June 19, 1997)]
[Senate]
[Pages S6000-S6002]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BOND (for himself and Mr. Bumpers):
  S. 938. A bill to amend the Public Health Service Act to provide 
surveillance, research, and services aimed at the prevention and 
cessation of prenatal and postnatal smoking, and for other purposes; to 
the Committee on Labor and Human Resources.


             THE MOTHERS AND INFANTS HEALTH PROTECTION ACT

  Mr. BOND. Mr. President, I rise today to introduce the Mothers and 
Infants Health Protection Act on behalf of myself and Senator Bumpers. 
First, I express my sincere thanks to my colleagues in the Senate last 
week for having passed the Birth Defects Prevention Act. That act was a 
tremendous step forward in protecting the health of our Nation's most 
vulnerable population and in saving families from the economic and 
emotional hardships associated with birth defects.

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  However, we must keep moving forward. After having had numerous 
discussions with the Centers for Disease Control and child advocacy 
organizations about the adverse birth outcomes and infant health 
problems connected with smoking during and after pregnancy, I decided 
we would introduce this legislation here today to carry the next step 
in our battle against birth defects.
  The main purpose of the measure introduced today is to provide 
surveillance, research, and services aimed at the prevention and 
cessation of smoking, both during and after pregnancy. The CDC, along 
with the Association of Maternal and Child Health Programs, is meeting 
today here in Washington to highlight that although the overall smoking 
rate for pregnant women is slowly declining, the smoking rate for 
pregnant teens is increasing. That is bad news. For black teenagers 
specifically, the rate rose 6 percent, the first increase since this 
information first became available in 1989. And even with this 
increase, smoking rates for white teenagers are still four to five 
times the rate for black teenagers. Furthermore, the smoking rate for 
those between the ages of 15 and 24 is 23 percent higher than the 
smoking rate among all pregnant women.
  In my home State of Missouri, this public health program is even more 
dramatic: 20 percent of all pregnant women in Missouri admit to 
smoking. This is 44 percent higher than the national average. This, 
unfortunately, may be connected to the fact that our incidence of birth 
defects and infant mortality is 50 percent higher than the national 
average.
  The consequences of smoking during and after pregnancy are downright 
horrifying. Recent studies show that this activity is a problem. 
Increases in maternal and fetal risk causes 20 to 30 percent of low 
birth rates and 10 percent of fetal and infant deaths in the United 
States.
  Smoking triples the risk of sudden infant death syndrome. Smoking 
elevates the risk of a child being born with a birth defect. Smoking 
increases the risk of spontaneous abortion, premature rupture of 
membranes, and the delivery of a stillborn infant. Smoking may impede 
the growth of a fetus and increase the likelihood of mental retardation 
by 50 percent, and smoking increases the risk of respiratory illness in 
infants and children.
  Adding to this devastating problem, the proportion of women who quit 
smoking during pregnancy but then relapse at 6 months postpartum is 
nearly 63 percent, thereby exposing their infants to passive smoke and 
increasing their risk for SIDS and other health-related problems.
  These are just a few of the problems related to smoking during and 
after pregnancy. But in addition to the risks for the fetus and infant, 
smoking is associated with a wide variety of hazards for pregnant 
women, such as infertility and ectopic pregnancy.
  There is no question that smoking during and after pregnancy is a 
compelling public health problem. These facts clearly underscore the 
necessity for smoking prevention and cessation programs aimed 
specifically for pregnant women. This legislation aims to reverse these 
devastating outcomes on several fronts.
  First, the CDC is directed to foster coordination between all 
governmental levels, other public entities, and private voluntary 
organizations that conduct or support prenatal and postnatal smoking 
research, prevention, and surveillance.
  Second, the bill provides grants to state and local health 
departments, community health centers, other public entities, and non-
profit organizations for the development of community-based public 
awareness campaigns aimed at the prevention and cessation of smoking 
during and after pregnancy.
  Third, monies would be made available to the groups just mentioned 
for the purpose of coordinating and conducting basic and applied 
research concerning prenatal and postnatal smoking and its effects on 
fetuses and newborns.
  Fourth, the bill calls for a procedure for the dissemination of 
effective prevention and cessation strategies and the diagnostic 
criteria for infants suffering the effects of exposure to intrauterine 
and passive tobacco smoke to health care professionals.
  Finally, this measure authorizes a modest appropriation of $10 
million to achieve these goals.
  Similar to the Birth Defects Prevention Act, this is another stride 
in improving the health of our children and in reducing infant 
mortality and morbidity.
  Fetuses, newborns, and children are too vulnerable and cannot protect 
themselves. We must therefore have a coordinated effort among 
government, nonprofit groups and local communities to get the message 
out on the devastating outcomes associated with pre and post natal 
smoking as well as information on effective prevention and cessation 
opportunities.
  Again, it is important to note that overall, fewer pregnant women are 
smoking now that they know the health risks for themselves and for 
their babies. The bad news is that not everyone has gotten the 
message--in particular those between the ages of 15 and 24. They are 
moving directly against the trend.
  This is the generation coming up; and these women are likely to go on 
having more children. If they are smoking more, that does not bode well 
for their future health, or for that of their children.
  Many people still do not understand that there is a link between 
adverse birth outcomes and prenatal and postnatal smoking. Part of the 
reason is that not all women have adequate access to prenatal care.
  Thus, it is my firm belief that this legislation will ensure that all 
mothers will receive information on the potential tragedies of smoking 
during and after pregnancy and the much needed assistance in quitting 
their habit.
  Mr. BUMPERS. Mr. President, let me first extend my sincere and 
profound gratitude to Senator Bond for creating and being the 
originator of this legislation. I am honored he has asked me to be his 
chief cosponsor.
  I just want to say for the Record and for those who may be watching, 
I remember when I was Governor of my State and my wife, Betty, was 
first lady. She had spent 2 years laying the groundwork for a statewide 
immunization program. It was a howling success. We immunized 300,000 
children one Saturday without a single reaction. That evening I said, 
``Betty, you ought to take great pride in what you just accomplished 
today.'' She said, ``I do. Of course, this is good for your political 
career and it is good for the babies who were immunized today, but it 
is certainly no final solution because we will lapse right back into 
the lethargy we have experienced and watched for years with low 
immunization rates among children who are yet to be born.'' She said 
until we institutionalize a program that can track each child's 
immunizations from birth through early childhood we will not have 
succeeded. Thanks to her efforts and many others, including Rosalynn 
Carter, and the program Every Child By Two, immunization levels in this 
country are now at an all-time high.
  The same principle applies in this case. Once we get this bill 
passed, and we will get it passed, it is imperative that we follow it 
up year after year after year so we do not lapse into the condition we 
are in right now where the rate of smoking among teenage women, 
pregnant teenage women, is going up. We got it down to 14 percent and 
now it is back up to 17 percent.
  If you ask that same teenage mother, what and whom do you love most, 
she loves mostly that fetus that lies inside her womb, and when that 
baby is born, she loves that baby above everything under the shining 
sun--above all else.
  So ask yourself, why would a woman, or why would parents smoke during 
pregnancy, and why would parents smoke after the baby is born? Every 
pediatrician in the country will tell you horror stories about sending 
children home after asthma attacks, only to see them come back with 
another asthma attack because people are smoking in the household.
  Senator Bond and I are asking for $10 million for this new 
initiative, an infinitesimal sum when compared to the savings it will 
produce. Hubert Humphrey stood at that desk right there. I never will 
forget the speech he made. ``We don't have national health insurance. 
What we have is national sick insurance. It isn't worth anything until 
you get sick.'' He told me about preventive programs that Ford Motor 
Company had instituted among all their employees and how much they

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were saving on health care costs through preventive medicine.
  Here we are now with a chance to save 10 to 100 times more than the 
paltry $10 million we will spend educating pregnant women in this 
country and telling them the consequences of asthma and low-birthweight 
babies. After the baby is born, one of the biggest single problems is 
sudden infant death syndrome. One of its causes is smoking around 
newborn babies.
  Mr. President, I am honored to join my distinguished colleague, 
Senator Bond, in pushing this. I hope we will be able to get hearings 
on this very shortly. Incidentally, I hope that the Centers for Disease 
Control will not just conduct outreach and education among pregnant 
women. I hope they will also work to educate the College of 
Obstetricians and Gynecologists and the American Academy of Pediatrics. 
Sometimes the very best professionals neglect and forget to tell 
pregnant women how to conduct themselves during pregnancy. I do not 
think that is a big problem, but I do think providers must be made 
acutely aware that they have this grave responsibility to at least tell 
pregnant women what they are up against and tell women what they must 
do when they go home from the hospital with a newborn.
  I yield the floor.
                                 ______