Bill Text: IA HF476 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act creating the dignity in pregnancy and childbirth Act.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2021-02-10 - Introduced, referred to Human Resources. H.J. 339. [HF476 Detail]
Download: Iowa-2021-HF476-Introduced.html
House
File
476
-
Introduced
HOUSE
FILE
476
BY
MASCHER
and
WINCKLER
A
BILL
FOR
An
Act
creating
the
dignity
in
pregnancy
and
childbirth
Act.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
LEGISLATIVE
FINDINGS
AND
INTENT.
1
1.
The
general
assembly
finds
all
of
the
following:
2
a.
Every
person
should
be
entitled
to
dignity
and
respect
3
during
and
after
pregnancy
and
childbirth.
Patients
should
4
receive
the
best
care
possible
regardless
of
their
race,
5
gender,
age,
class,
sexual
orientation,
gender
identity,
6
disability,
language
proficiency,
nationality,
immigration
7
status,
gender
expression,
or
religion.
8
b.
The
United
States
has
the
highest
maternal
mortality
9
rate
in
the
developed
world.
Approximately
seven
hundred
10
women
die
each
year
from
complications
related
to
pregnancy
or
11
childbirth.
In
Iowa,
from
2016
to
2018,
the
rate
of
maternal
12
death
increased
by
sixteen
percent.
13
c.
For
women
of
color,
particularly
black
women,
the
14
maternal
mortality
rate
remains
three
to
four
times
higher
15
than
for
white
women.
Black
women
make
up
approximately
16
five
percent
of
the
pregnancy
cohort
in
Iowa,
but
represent
17
twenty-one
percent
of
the
pregnancy-related
deaths.
18
d.
In
the
United
States,
it
is
estimated
that
over
19
sixty-three
percent
of
pregnancy-related
deaths
were
20
preventable.
21
e.
Access
to
prenatal
care,
socioeconomic
status,
and
22
general
physical
health
do
not
fully
explain
the
disparity
23
seen
in
black
women’s
maternal
mortality
and
morbidity
rates.
24
There
is
a
growing
body
of
evidence
that
black
women
are
often
25
treated
unfairly
and
unequally
in
the
health
care
system.
26
f.
Implicit
bias
is
a
key
cause
that
drives
health
27
disparities
in
communities
of
color.
At
present,
health
care
28
providers
in
Iowa
are
not
required
to
undergo
any
implicit
bias
29
testing
or
training.
Nor
does
there
exist
any
system
to
track
30
the
number
of
incidents
where
implicit
prejudice
and
implicit
31
stereotypes
have
led
to
negative
birth
and
maternal
health
32
outcomes.
33
2.
It
is
the
intent
of
the
general
assembly
to
reduce
34
the
effects
of
implicit
bias
in
pregnancy,
childbirth,
and
35
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postnatal
care
so
that
all
people
are
treated
with
dignity
and
1
respect
by
their
health
care
providers.
2
Sec.
2.
NEW
SECTION
.
135Q.1
Title.
3
This
Act
shall
be
known,
and
may
be
cited
as
“The
Iowa
4
Dignity
in
Pregnancy
and
Childbirth
Act”
.
5
Sec.
3.
NEW
SECTION
.
135Q.2
Definitions.
6
For
the
purposes
of
this
chapter,
unless
the
context
7
otherwise
requires:
8
1.
“Birth
center”
means
the
same
as
defined
in
section
9
135.61.
10
2.
“Department”
means
the
department
of
public
health.
11
3.
“Health
care
professional”
means
a
health-related
12
professional
required
to
be
licensed
under
chapter
147
who
13
provides
perinatal
care.
14
4.
“Hospital”
means
the
same
as
defined
in
section
135B.1.
15
5.
“Implicit
bias”
means
a
bias
in
judgment
or
behavior
16
that
results
from
subtle
cognitive
processes
including
implicit
17
prejudice
and
implicit
stereotypes
that
often
operate
at
18
a
level
below
conscious
awareness
and
without
intentional
19
control.
20
6.
“Implicit
prejudice”
means
prejudicial
negative
feelings
21
or
beliefs
about
a
group
that
a
person
holds
without
being
22
aware
of
them.
23
7.
“Implicit
stereotypes”
means
the
unconscious
attributions
24
of
particular
qualities
to
a
member
of
a
certain
social
group
25
which
are
influenced
by
experience
and
are
based
on
learned
26
associations
between
various
qualities
and
social
categories,
27
including
race
or
gender.
28
8.
“Perinatal
care”
means
the
provision
of
care
during
29
pregnancy,
labor,
delivery,
and
the
postpartum
and
neonatal
30
periods.
31
9.
“Pregnancy-related
death”
means
the
death
of
a
person
32
while
pregnant
or
within
three
hundred
sixty-five
days
of
the
33
end
of
a
pregnancy,
irrespective
of
the
duration
or
site
of
34
the
pregnancy,
from
any
cause
related
to,
or
aggravated
by,
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the
pregnancy
or
its
management,
but
not
from
accidental
or
1
incidental
causes.
2
Sec.
4.
NEW
SECTION
.
135Q.3
Perinatal
care
——
health
care
3
professional
training.
4
1.
A
hospital
or
primary
care
clinic
that
provides
5
perinatal
care
and
a
birth
center
shall
implement
an
6
evidence-based
implicit
bias
training
program
for
all
health
7
care
professionals
involved
in
providing
perinatal
care
to
8
patients
within
the
facility.
9
2.
An
implicit
bias
program
implemented
pursuant
to
this
10
section
shall
include
all
of
the
following:
11
a.
Identification
of
previous
or
current
unconscious
biases
12
and
misinformation.
13
b.
Identification
of
personal,
interpersonal,
14
institutional,
structural,
and
cultural
barriers
to
inclusion.
15
c.
Corrective
measures
to
decrease
implicit
bias
at
the
16
interpersonal
and
institutional
levels,
including
ongoing
17
policies
and
practices
for
that
purpose.
18
d.
Information
on
the
effects
including
but
not
limited
19
to
ongoing
personal
effects
of
historical
and
contemporary
20
exclusion
and
oppression
of
minority
communities.
21
e.
Information
about
cultural
identity
across
racial
or
22
ethnic
groups.
23
f.
Information
about
communicating
more
effectively
across
24
identities,
including
racial,
ethnic,
religious,
and
gender
25
identities.
26
g.
Discussions
about
power
dynamics
and
organizational
27
decision
making.
28
h.
Discussions
about
health
inequities
within
the
perinatal
29
care
field,
including
information
on
how
implicit
bias
impacts
30
maternal
and
infant
health
outcomes.
31
i.
Perspectives
of
diverse,
local
constituency
groups
32
and
experts
on
particular
racial,
identity,
cultural,
and
33
provider-community
relations
issues
in
the
community.
34
j.
Information
on
reproductive
justice.
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3.
a.
A
health
care
professional,
whether
or
not
directly
1
employed
by
a
facility
specified
in
this
section,
providing
2
perinatal
care
in
such
facility,
shall
complete
initial
3
implicit
bias
training
as
implemented
in
accordance
with
the
4
components
described
in
this
section.
5
b.
Following
completion
of
the
initial
implicit
bias
6
training,
a
health
care
professional
providing
perinatal
7
care
in
a
facility
specified
in
this
section
shall
complete
8
a
refresher
course
every
two
years
thereafter,
or
on
a
more
9
frequent
basis
if
deemed
necessary
by
the
facility,
to
remain
10
informed
about
changing
racial,
identity,
and
cultural
trends
11
and
best
practices
in
an
effort
to
decrease
interpersonal
and
12
institutional
implicit
bias.
13
c.
A
hospital
or
primary
care
clinic
that
provides
perinatal
14
care
and
a
birth
center
shall
provide
a
certificate
of
training
15
completion
to
a
health
care
professional
or
to
another
such
16
facility
upon
request.
A
facility
may
accept
a
certificate
of
17
training
completion
from
another
facility
described
in
this
18
section
as
evidence
of
satisfactory
completion
of
the
training
19
requirement
by
a
health
care
professional
who
practices
in
more
20
than
one
facility.
21
Sec.
5.
NEW
SECTION
.
135Q.4
Maternal
morbidity
and
22
pregnancy-related
deaths
——
data
collection
and
reporting.
23
1.
Pursuant
to
section
135.40,
the
department
shall
collect
24
data
on
severe
maternal
morbidity
including
but
not
limited
to
25
morbidity
involving
any
of
the
following
health
conditions:
26
a.
Obstetric
hemorrhage.
27
b.
Hypertension.
28
c.
Preeclampsia
and
eclampsia.
29
d.
Venous
thromboembolism.
30
e.
Sepsis.
31
f.
Cerebrovascular
accident.
32
g.
Amniotic
fluid
embolism.
33
2.
The
department
shall
track
data
on
pregnancy-related
34
deaths,
including
but
not
limited
to
the
deaths
resulting
from
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any
of
the
conditions
specified
in
subsection
1,
indirect
1
obstetric
deaths,
and
other
maternal
disorders
predominately
2
related
to
pregnancy
and
complications
predominantly
related
3
to
puerperium.
4
3.
The
data
collected
pursuant
to
subsections
1
and
2
shall
5
be
published
at
least
once
every
three
years
after
all
of
the
6
following
have
occurred:
7
a.
The
data
has
been
aggregated
by
state
regions
or
other
8
geographic
areas
as
defined
by
the
department,
to
ensure
the
9
data
reflects
how
regionalized
care
systems
are
or
should
10
be
collaborating
to
improve
maternal
health
outcomes.
The
11
data
may
be
aggregated
on
an
alternative
sorting
basis
if
12
the
sorting
is
based
on
standard
statistical
methods
for
13
accurate
dissemination
of
public
health
data
without
risking
a
14
confidentiality
or
other
disclosure
breach.
15
b.
The
data
has
been
disaggregated
by
racial
and
ethnic
16
identity.
17
EXPLANATION
18
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
19
the
explanation’s
substance
by
the
members
of
the
general
assembly.
20
This
bill
creates
the
dignity
in
pregnancy
and
childbirth
21
Act.
The
bill
includes
legislative
findings
and
intent.
22
The
bill
creates
new
Code
chapter
135Q,
to
be
known
and
23
cited
as
“The
Iowa
Dignity
in
Pregnancy
and
Childbirth
Act”.
24
The
bill
includes
definitions
including
those
for
“implicit
25
bias”,
“implicit
prejudice”,
“implicit
stereotypes”,
and
26
“pregnancy-related
death”.
27
The
bill
requires
a
hospital
or
a
primary
care
clinic
that
28
provides
perinatal
care
and
a
birth
center
to
implement
an
29
evidence-based
implicit
bias
training
program
for
all
health
30
care
professionals
involved
in
providing
care
to
patients
31
within
the
facility.
The
bill
specifies
the
information
to
be
32
included
in
the
implicit
bias
training
program,
and
requires
a
33
health
care
professional,
whether
or
not
directly
employed
by
34
a
facility
specified
in
the
bill,
providing
perinatal
care
in
35
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476
such
facility,
to
complete
both
initial
implicit
bias
training
1
and
a
refresher
course
every
two
years
thereafter,
or
more
2
frequently
if
deemed
necessary
by
the
facility.
The
facility
3
shall
provide
a
certificate
of
training
completion
to
a
health
4
care
professional
or
to
another
such
facility
upon
request
and
5
a
facility
may
accept
a
certificate
of
completion
from
another
6
facility
as
evidence
of
satisfactory
completion
of
the
training
7
requirement
by
a
health
care
professional
who
practices
in
more
8
than
one
facility.
9
The
bill
requires
the
department
of
public
health
(DPH)
to
10
collect
data
on
severe
maternal
morbidity
including
morbidity
11
involving
certain
health
conditions
and
requires
DPH
to
track
12
data
on
pregnancy-related
deaths,
including
but
not
limited
to
13
the
deaths
resulting
from
the
specified
conditions,
indirect
14
obstetric
deaths,
and
other
maternal
disorders
predominately
15
related
to
pregnancy
and
complications
predominantly
related
16
to
puerperium.
The
data
collected
shall
be
published
at
least
17
once
every
three
years
after
the
data
has
been
aggregated
by
18
state
regions
or
other
areas
as
defined
by
the
DPH
to
ensure
19
the
data
reflects
how
regionalized
care
systems
are
or
should
20
be
collaborating
to
improve
maternal
health
outcomes
and
after
21
the
data
has
been
disaggregated
by
racial
and
ethnic
identity.
22
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