[Congressional Record Volume 154, Number 82 (Monday, May 19, 2008)]
[House]
[Pages H4124-H4127]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
REDUCING MATERNAL MORTALITY BOTH AT HOME AND ABROAD
Ms. SCHAKOWSKY. Mr. Speaker, I move to suspend the rules and agree to
the resolution (H. Res. 1022) reducing maternal mortality both at home
and abroad, as amended.
The Clerk read the title of the resolution.
The text of the resolution is as follows:
H. Res. 1022
Whereas an estimated 536,000 women die during pregnancy and
childbirth every year which is equivalent to one death every
minute;
Whereas an estimated 15 percent of pregnancies and
childbirths involve unpredictable and often life-threatening
complications that require emergency care;
Whereas girls under 15 are estimated to be 5 times more
likely to die during childbirth than women in their 20s;
Whereas nearly all these deaths are preventable;
Whereas survival rates greatly depend upon the distance and
time a woman must travel to get skilled emergency medical
care;
Whereas care by skilled birth attendants, nurses, midwives,
or doctors during pregnancy and childbirth, including
emergency services, and care for mothers and newborns is
essential;
Whereas the poorer the household, the greater the risk of
maternal death, and 99 percent of maternal deaths occur in
developing countries;
Whereas newborns whose mothers die of any cause are 3 to 10
times more likely to die within 2 years than those whose
mothers survive;
Whereas more than 1,000,000 children are left motherless
and vulnerable every year;
Whereas young girls are often pulled from school and
required to fill their lost mother's roles;
Whereas a mother's death lowers family income and
productivity which affects the entire community;
Whereas in countries with similar levels of economic
development, maternal mortality is highest where women's
status is lowest;
Whereas the United States ranks 41st among 171 countries in
the latest UN list ranking maternal mortality;
Whereas the overall United States maternal mortality ratio
is now 11 deaths per 100,000 live births, one of the highest
rates among industrialized nations;
Whereas United States maternal deaths have remained roughly
stable since 1982 and have not declined significantly since
then;
[[Page H4125]]
Whereas the Centers for Disease Control estimates that the
true level of United States maternal deaths may be 1.3 to 3
times higher than the reported rate; and
Whereas ethnic and racial disparities in maternal mortality
rates persist and in the United States maternal mortality
among black women is almost four times the rate among non-
Hispanic white women: Now, therefore, be it
Resolved, That the House of Representatives--
(1) affirms its commitment to promoting maternal health and
child survival both at home and abroad through greater
international investment and participation; and
(2) recognizes maternal health and child survival as
fundamental to the well-being of families and societies, and
to global development and prosperity.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
Illinois (Ms. Schakowsky) and the gentleman from New Jersey (Mr. Smith)
each will control 20 minutes.
The Chair recognizes the gentlewoman from Illinois.
General Leave
Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days to revise and extend their remarks and
include extraneous material on the resolution under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Illinois?
There was no objection.
Ms. SCHAKOWSKY. Mr. Speaker, I yield myself as much time as I may
consume.
Mr. Speaker, I rise today in strong support of House Resolution 1022,
which is aimed at reducing maternal mortality, both at home and abroad.
As an original cosponsor of this resolution and a member of the Women's
Caucus, I am proud to speak out in support of its passage.
This week begins an entire week of maternal mortality awareness
events. During this week, women from abroad will provide firsthand
accounts of horrific maternal health challenges they've faced.
Globally, it is estimated that 15 percent of pregnancies and child
births involve unpredictable and often life-threatening complications
that require emergency care. What makes this statistic so staggering is
that nearly all of these situations are preventable.
Even more astounding is the fact that the United States ranks a
staggering 41st among 171 countries in a United Nations list ranking
infant mortality. We can and we must do a better job.
The resolution before us affirms our commitment to promoting maternal
mortality and child survival, both at home and abroad. It also
recognizes that maternal health is fundamental to the well-being of
families and societies.
I want to thank my colleagues, Congresswoman Lois Capps, Speaker
Nancy Pelosi, and the rest of the Congressional Women's Caucus for
their leadership on this issue, and I urge my colleagues to join me in
support of its adoption.
I reserve the balance of my time.
Mr. SMITH of New Jersey. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I rise in support of H. Res. 1022, as amended and
presented to the House today. Mr. Speaker, reducing maternal and child
mortality and providing quality health care and nutrition to ensure the
well-being of both mother and baby here and abroad, has been a top
legislative priority for me throughout my 28 years as a Member of
Congress.
All loss of life is tragic, especially when it is preventable. When a
mother dies, the loss, the heartache is compounded by the deleterious
impact on her children, on families and on the community.
As H. Res. 1022 points out, each year, more than a million children
are left motherless and, as a consequence, are vulnerable. In many
places, young girls are pulled from school and required to fill their
lost mother's role in the home, cutting short their abilities to pursue
an education.
And the evidence suggests that newborns whose mothers die of any
cause are 3 times to 10 times more likely to die within the first 2
years than those whose mothers survive.
What is most unfortunate and thereby, should be unacceptable, is the
fact that most maternal deaths are avoidable. With proper prenatal care
and maternal health care, sanitary conditions for delivery, and
available lifesaving emergency interventions, essential obstetrical
services, these lives need not be lost. Even in our own country
maternal mortality, although rarer than in the developing world,
occurs. No loss of life is acceptable.
Mr. Speaker, hemorrhaging and blood loss are the top cause of
maternal mortality and are of grave concern. During an African
subcommittee hearing that I chaired during the previous Congress which
concerned itself with safe blood, we heard from Dr. Neelam Dhingra, of
the World Health Organization. Dr. Dhingra informed us that the most
common cause of maternal death in sub-Saharan Africa is severe
bleeding, which can take the life of even a healthy woman within 2
hours, if not properly and immediately treated. She gave us the
astounding statistic that in Africa, severe bleeding during delivery,
or after childbirth, contributes to up to 44 percent of maternal
deaths, many of which could be prevented simply through access to safe
blood.
Sufficient quantity and quality of immediately available and usable
blood must become the norm and not the exception.
And I want to applaud the efforts of Chaka Fattah who has pushed very
hard over the years to try to grow the amount, the quality and the
quantity of blood in Africa. And USAID is addressing this in a number
of programs, including the PEPFAR program.
Women should not die from blood loss, simply due to lack of access to
basic interventions like safe blood. Support of this resolution today
puts us on record as focusing on these kinds of interventions.
Mr. Speaker, one severe disfiguring disability that occurs in
childbirth is obstetric fistula. Fistula can be treated and repaired
through a relatively minor surgical procedure that costs, on average,
$150 per surgery.
I saw that firsthand, Mr. Speaker, on a trip several years back to
Addis Ababa, where there is this famous hospital which has now grown
and has satellites, and obviously has inspired other similar hospitals
that treat the women who make it to them, and they're the lucky ones. I
saw many of the women who were waiting in lines, who were incontinent,
who were very sorrowful about their conditions but very hope-filled,
knowing it was a matter of when and not if they would get this great
surgery.
Still, large numbers of women, an estimated 2 million, endure the
tremendous pain and numbing isolation that comes from being the walking
wounded, incontinent and ostracized, and not able to get to hospitals
like that which is in Addis. With just a small investment of health
care dollars, the lives of these women could be dramatically changed.
In 2005, I would just point out, I sponsored an amendment that passed
on this floor to allocate $12.5 million dollars to establish 12 centers
to provide treatment and surgery that would have allowed thousands of
women to be physically cured and emotionally healed from fistula,
preventing disease, death, and allowing them to return to normal life.
The amendment authorized funding for preventive measures as well,
such as providing skilled birth attendants who can identify an
obstructed delivery early and prevent an obstetric fistula from
occurring in the fist place. Unfortunately, the underlying legislation
made it over to the Senate, but died.
However, I did ask the Bush administration, namely Dr. Kent Hill,
USAID Assistant Administrator for Global Health, to initiate
administratively a robust fistula program, which I'm happy to say he
did wholeheartedly with a great deal of skill and compassion. I am
happy to report that from 2004 to 2007, USAID has allocated more than
$20 million for fistula prevention and treatment. In 2008 that amount
will jump to $30 million, a great start but still not enough.
Nevertheless, more than 3,500 women have had life-changing fistula
repair through this program, not to mention the cases prevented through
proper obstetric care.
Helping mothers and helping their babies, Mr. Speaker, goes hand in
hand. There is no dichotomy. When women receive proper prenatal care
they are less likely to die in childbirth, and when unborn babies are
healthy in the womb they emerge as healthier, stronger newborns.
[[Page H4126]]
I am pleased that the resolution before us today does not endorse in
any way whatsoever the cruel ideology that pits women against their
babies by suggesting abortion as a means of combating maternal
mortality. Women and their babies deserve better than abortion, and
their health and well-being is intrinsically linked.
Unfortunately, some abortion activists in recent years have attempted
to exploit the tragedy of maternal mortality as a vehicle for their
promotion of abortion.
On one trip to Uganda, Mr. Speaker, I met with the head of the
Minister of Gender, and we talked about this problem of maternal
mortality. And she said, what African women want is essential
obstetrical services, not the demise of their unborn babies.
And so I am pleased that the resolution before us does not embrace
abortion and, instead, properly links maternal health care and child
survival to survival of all children, including the fragile and the
vulnerable unborn baby.
Birth is not the beginning of life, Mr. Speaker. It is merely an
event in the baby's life that began at the precise moment of
fertilization. Life is a continuum with many, many stages. Human rights
should be respected from womb to tomb. We need to recognize this
biological fact in policy, funding and programming, and treat both
mother and baby, unborn baby as well, as two patients in need of
respect, love and tangible assistance. We need to affirm them both.
Mr. Speaker, in 1985, I sponsored the Child Survival Fund Amendment
that doubled funding to $50 million, and it was adopted into law. The
legislation financed global vaccinations, oral rehydration therapy. I
think many Members will be a little bit shocked to learn that a leading
cause of child death is from diarrheal dehydration and the problems
that result from that, while oral rehydration therapy can prevent it
simply by getting fluids into that young child. It also focuses on
growth monitoring and breast feeding. So I'm happy to say that the
resolution also speaks to that issue very, very soundly.
UNICEF recognizes that unborn children and newborn children require
care and nurturing, stating, and I quote, ``significant improvement in
early neonatal period will depend on essential interventions for the
mother and babies before, during and immediately after birth.
{time} 1730
According to the latest estimates for 2000 to 2006, at present in the
developing world, one-quarter of pregnant women do not receive even a
single visit from a skilled health professional, doctor, nurse, or
midwife, and only 59 percent of births take place with the assistance
of a skilled attendant, and just over half take place in a health
facility. That has to be addressed.
And yet the care for the mother and unborn child cannot be restricted
to medical conditions and consultations, I should say, as important as
they are. For example, in its child survival series, the Lancet
identified fetal malnutrition and lower maternal body mass index as
likely factors in neo-natal mortality rates and fetal-growth
retardation. Just as undernutrition is the underlying cause of a
substantial percentage of all child deaths, the mother's nutritional
status has a direct bearing on the unborn child's development and the
ability to survive, and of course, on her life as well.
While visiting refugee camps in Sudan in the Darfur region, Mr.
Speaker, I asked a group of women what is it that they required most,
and I asked this at each and every camp, from the Muchar-Kama camp, all
of the camps that I visited, they were unanimous. They wanted access to
nutritious food so that these nursing mothers could continue to meet
the needs of their infants. It was all about the two working together.
If we are to address child and maternal deaths and go even further to
ensure the healthy development of the baby through adolescence and the
long-term health of the mother, the baby and the mother must be
provided adequate nutrition and health care from the earliest stages of
life prior to birth.
In sum, the lack of prenatal care, the lack of adequate nutrition
during pregnancy, the lack of sterile birthing environments, the lack
of clean blood, and the lack of access to essential obstetrical
services all contribute to the deaths of women and children. We must do
more to save the lives of both, and the Child Survival and Maternal
Mortality Initiatives must recognize, embrace, protect, and assist both
women and their children, both born and unborn, from all threats
including disease, hunger, trauma, and violence.
Mr. DINGELL. Mr. Speaker, I submit the following exchange of letters
for the Record:
Congress of the United States,
Committee on Foreign Affairs,
Washington, DC, May 19, 2008.
Hon. John D. Dingell,
Chairman, Committee on Energy and Commerce, Washington, DC.
Dear Mr. Chairman: I am writing to you regarding H. Res.
1022, a resolution introduced by Representative Lois Capps
(D-CA) for the purpose of reducing maternal mortality both at
home and abroad. This legislation was initially referred to
the Committee on Energy and Commerce and, in addition, to the
Committee on Foreign Affairs.
Representative Capps has requested that the Committee on
Foreign Affairs waive consideration of this resolution. Based
on the discussions that the staff of our two committees has
had regarding this resolution and in the interest of
permitting your Committee to proceed expeditiously to floor
consideration of this important resolution, I am willing to
waive further consideration of H. Res. 1022. I do so with the
understanding that by waiving consideration of the bill, the
Committee on Foreign Affairs does not waive any future
jurisdictional claim over the subject matters contained in
the resolution which fall within its Rule X jurisdiction.
Please place this letter in the Congressional Record during
consideration of the measure on the House floor. I look
forward to working with you as we move this important measure
through the legislative process.
Sincerely,
Howard L. Berman,
Chairman.
____
U.S. House of Representatives,
Committee on Energy and Commerce,
Washington, DC, May 19, 2008.
Hon. Howard L. Berman,
Chairman, Committee on Foreign Affairs,
Washington, DC.
Dear Mr. Chairman: I write with regard to H. Res. 1022, a
resolution on reducing maternal mortality both at home and
abroad, which was introduced by Representative Lois Capps.
The resolution was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Foreign
Affairs.
It is my understanding that Rep. Capps has requested the
Committee on Foreign Affairs to waive consideration of the
resolution. I appreciate that you have agreed to do so in
order to permit the Committee on Energy and Commerce to
proceed expeditiously to floor consideration of the
resolution. I agree that your willingness to forgo further
consideration of this resolution does not waive any future
jurisdictional claim over the subject matters contained in
the resolution that fall within the jurisdiction of the
Committee on Foreign Affairs under rule X of the Rules of the
House.
Thank you for your assistance in moving this important
measure through the legislative process.
Sincerely,
John D. Dingell,
Chairman.
Mrs. CAPPS. Mr. Speaker, I rise in strong support of H. Res. 1022.
I was proud introduce this resolution with my colleague and Co-Chair
of the Congressional Caucus for Women's Issues, Cathy McMorris Rodgers.
And I am equally proud that 122 Members of the House joined in
cosponsoring H. Res. 1022, including almost every single woman Member
of the House and our esteemed Speaker Nancy Pelosi.
Last fall, I was fortunate to lead a delegation of women Members to a
conference entitled ``Women Deliver.''
This conference brought together nearly 2000 participants from around
the world, including parliamentarians, diplomats, health professionals,
patients and activists.
We joined there and resolved to make a greater investment in women in
order to improve maternal health.
No woman should have to die giving life and I was proud to see
individuals from every background--ethnically, culturally, religiously,
and from all income levels--agree that we must deliver for women by
ensuring that they can safely deliver.
The 500,000 maternal deaths that occur annually are largely
preventable.
We know that through family planning, making emergency care more
widely available, and increasing the number of skilled health
professionals who can attend to births we can combat the epidemic of
maternal death both at home and abroad.
After all, the United States is not immune to maternal death and we
experience the highest rate of maternal mortality than all other
industrialized nations.
As we close out the month of May, when we celebrated Mother's Day,
let's join in making a
[[Page H4127]]
stronger commitment to improving maternal health.
Mr. SMITH of New Jersey. I yield back the balance of my time.
Ms. SCHAKOWSKY. Mr. Speaker, I have no further requests for time, and
I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from Illinois (Ms. Schakowsky) that the House suspend the
rules and agree to the resolution, H. Res. 1022, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. SMITH of New Jersey. Mr. Speaker, I object to the vote on the
ground that a quorum is not present and make the point of order that a
quorum is not present.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
The point of no quorum is considered withdrawn.
____________________