House passes Iowa Rep. Ashley Hinson's stillbirth prevention bill. What will it do?

Federal lawmakers this week overwhelming passed a bipartisan bill sponsored by Iowa U.S. Rep. Ashley Hinson aimed at reducing the more than 20,000 pregnancies that end in stillbirth every year in the United States.

The Maternal and Child Health Stillbirth Prevention Act of 2023 passed the House by a vote of 408-3. A similar version previously passed the Senate, where Sen. Jeff Merkley, D-Ore., and Sen. Bill Cassidy, R-La., introduced companion legislation.

The bill would clarify that public health agencies can use existing federal grant dollars earmarked for mothers and children for stillbirth prevention and research, including initiatives that encourage expectant parents to be aware of and track their babies’ movements in the womb. Other prevention efforts include smoking cessation for pregnant women and reducing incidence of congenital syphilis.

Hinson, a Republican from Marion, said the clarification will enable the U.S. medical community to use federal resources to advance evidence-based stillbirth prevention efforts, saving the lives of mothers and babies.

“I was blessed to spend Mother’s Day with my two sons this last weekend, but of course my heart aches for the women who are mourning the loss of a child that they never got to meet,” Hinson told reporters Friday. “By passing this bill this week, we are making meaningful progress to reduce stillbirths, ensure expecting women receive the care they deserve and support growing families.”

Every year, over 20,000 pregnancies in the United States end in a stillbirth, the death of an expected child at 20 weeks or more of pregnancy. Nearly 1 in 4 stillbirths may be preventable, but the United States is trailing other countries in making progress.

The annual number of deaths far exceeds the top five leading causes of deaths among children ages up to 14 combined, including unintentional injuries, congenital anomalies, preterm birth, homicide, SIDS and heart disease, said Emily Price, an Iowa stillbirth prevention advocate and chief executive officer of Healthy Birth Day Inc.

“The deafening silence of a baby born still echoes through hospitals across our country 65 times every single day,” said Price, who joined Hinson on a call with reporters. “ … This legislation says we can end preventable stillbirths” and make it a “maternal health tragedy of the past.”

The legislation is an outgrowth of Count the Kicks, a public health program founded in 2008 by five Iowa mothers who experienced stillbirth or infant death in the early 2000s. The program is based on Norwegian research that found a 30 percent reduction in stillbirth by teaching pregnant women how to monitor fetal movement during the third trimester by doing kick counts daily. The program helps parents get to know their expectant baby's normal movement patterns and speak up if they notice a change.

Iowa's stillbirth rate decreased nearly 32 percent from 2008 to 2012, the first 10 years of the Count the Kicks stillbirth prevention campaign.

“This bill is a call to action from Congress that states can use their Title V funds that Congress has given them to invest in programs and research to move the needle like Iowa has,” Price said.

She said her organization is working to partner with the University of Iowa on stillbirth prevention research.

March of Dimes, a nonprofit focused on maternal and infant health, said in a statement it looks forward to seeing the legislation signed by Democratic President Joe Biden.

Iowa's maternal death rate and infant mortality rate have climbed as birthing units have closed in recent years. Iowa is one of four states in the nation to have significant increases in infant mortality rates from 2021 to 2022. The state’s infant death rate per 1,000 live births rose from 3.99 to 5.20 in 2022 — a 30 percent jump.

At least 34 maternity units have closed in the state since 2000, leaving rural Iowans less likely to access care. A 2023 report from the March of Dimes found a third of Iowa's counties are "maternity care deserts" — they have no hospital birthing centers or OB/GYN providers. Iowa has the fewest OB/GYNs per capita of any U.S. state, according to the American College of Obstetricians and Gynecologists.

Price said it’s commonplace for rural Iowa mothers to drive an hour or more to see an OB/GYN or visit a hospital maternity ward.

“In some cases that can be deadly, if you’re driving an hour and you have a real urgent need but there’s no one nearby equipped to assess or investigate your obstetric emergency,” she said.

As Iowa struggles with a provider shortage, Hinson has also pursued legislation to expand access to midwives to improve maternal health care. Hinson also secured $1.1 million to expand and modernize the maternity health care unit at the Gundersen Palmer Lutheran Hospital and Clinics in West Union, and has requested $1.25 million to support the expansion of the Grinnell Regional Medical Center labor and delivery unit, increasing its delivery capacity up to 250 births annually.

According to Hinson’s office, the current facility is unable to meet the demands of the rural six-county region that the hospital serves.

Comments: (319) 398-8499; tom.barton@thegazette.com