[Congressional Record (Bound Edition), Volume 154 (2008), Part 7]
[House]
[Pages 9675-9678]
[From the U.S. 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;
       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.

[[Page 9676]]

  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.
  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.

[[Page 9677]]

  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 stronger commitment to improving maternal 
health.
   Mr. SMITH of New Jersey. I yield back the balance of my time.

[[Page 9678]]


  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.

                          ____________________