As covid-19 began to ravage communities across the United States, Black and Native American birthing people were already facing a crisis: maternal mortality.

That’s why, nearly a year ago, Democratic lawmakers introduced the Black Maternal Health Momnibus Act, which was composed of nine bills aimed at addressing everything from maternity care for veterans and incarcerated people to diversifying the perinatal health workforce. But despite endorsements from almost 200 organizations, the Momnibus never made it to the floor for a vote.

On Monday, Reps. Alma Adams (D-N.C.) and Lauren Underwood (D-Ill.) — the co-founders of the Black Maternal Health Caucus — along with Sen. Cory Booker (D-N.J.), reintroduced the legislation. This time, the package includes three additional bills, one of which highlights the nation’s evolving battle with covid-19.

“While we are seeing these crisis-levels of deaths among African American and Native American pregnant people, as we make these improvements, it helps everybody,” Underwood said.

It’s well-documented that Black women are three to four times more likely to die of complications related to pregnancy than their White counterparts. Data suggest that Black and Hispanic pregnant women are also disproportionately affected by covid-19 compared with other racial/ethnic groups. More than 70 pregnant women have died after contracting the disease, according to the Centers for Disease Control and Prevention. But because many states do not report pregnancy status for patients with covid-19, experts say this is a conservative estimate.

One of the three additional pieces of legislation in the Momnibus aims to address that: the Maternal Health Pandemic Response Act, sponsored by Underwood in the House and Massachusetts Democrat Elizabeth Warren in the Senate. When the two introduced the legislation in August, it failed to pass. Still, Underwood is hopeful that the ideas outlined in their act will eventually come to fruition, and she is advocating for the bill to be included in the next covid relief package.

“If covid is contributing to increases in maternal mortality in this country, we need to know so we can save lives and have solutions,” Underwood said. “Our partners are laser-focused on this.”

Without data, it’s also difficult to determine whether certain treatments are working for pregnant people, Underwood said. Her bill would also direct the National Institutes of Health to ensure that at least one coronavirus vaccine is safe and effective for pregnant and breastfeeding people, who were excluded from clinical trials.

The two newest pieces of legislation included in the Momnibus focus broadly on vaccine awareness and the negative impact of climate change on mothers and infants, especially when they are Black.

This latter bill, the Protecting Moms and Babies Against Climate Change Act, would provide housing and transportation assistance to patients who live in areas affected by extreme weather events. Funding would also go toward educating current and future health-care workers to be cognizant of health risks associated with environmental factors.

“If you have some kind of pulmonary issue because you’re living outside of a manufacturing plant that has terrible air quality, someone might prescribe you something for your lungs and not even know that there is a related pollutant,” Underwood said. If doctors ask patients the right questions, they might be able to identify issues that plague entire communities.

Doulas and community health workers, who typically live in the same areas as their clients, can also “help flag some of these risk factors,” Underwood said.

Although covid-19 isn’t the primary focus of the Momnibus, Underwood says the legislative package touches on issues that have been “dominating the covid conversation.” Mental health, telehealth, data collection and the social determinants of health are all addressed in the package.

Underwood pointed to the rise in food insecurity, which is even more prevalent in households with children. Sponsored by Rep. Lucy McBath (D-Ga.), the Social Determinants for Moms Act extends the amount of time postpartum and breastfeeding women are eligible for food benefits through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

Under McBath’s proposal, WIC benefits for the mother would end after two years. Currently, the benefits cut off six months after the person gives birth or after one year if the mother is breastfeeding.

“No one should be going hungry, period,” Underwood said.

The pandemic has also further exposed how racism and bias in the medical system can have deadly consequences for communities of color. Two Momnibus bills would address this issue by funding bias and racism training programs for maternity-care providers and investing in research.

As Underwood put it, the Momnibus is “about making sure there’s justice and equity within our health-care system and that we have a health-care system that’s free of bias, discrimination and racism.”

As the Black Maternal Health Caucus moves forward with the Momnibus, it will try to increase the number of Republican supporters to get bills passed and signed into law — something it fell short on last year. The caucus has three Republican members: Reps. Jaime Herrera Beutler of Washington, Michael C. Burgess of Texas and Billy Long of Missouri.

Although they are not caucus members, Reps. John Katko (R-N.Y.) and Gus Bilirakis (R-Fla.) are co-sponsors of the Moms Matter Act and the Protecting Moms Who Served Act, respectively. Rep. Brian Fitzpatrick (R-Pa.) supports both bills.

Underwood said the maternal health issues that inspired the Momnibus are not “controversial”: People are dying and experiencing life-threatening complications during pregnancy, delivery and in the postpartum period, she said.

“This is something that has broad appeal across ideology,” she said. “In the United States of America in 2021, we should all be committed to doing everything that we can.”

And while Underwood said she hasn’t spoken to Vice President Harris — who sponsored the 2020 Momnibus as a senator — since the inauguration, the sophomore congresswoman is confident that the White House is committed to “taking action to save moms’ lives.” As a presidential candidate in 2020, President Biden said he was committed to reducing maternal mortality.

“We want things to be ready so that when they’re ready, it can just happen,” Underwood said.

“There’s a sense of urgency with this work. While maternal mortality rates are falling around the world, in the United States, they are rising. We cannot sit back and assume they’ll get to it. This is something that is a high priority.”

Sarah Lipo contributed to this report. She is a student at Marquette University and an intern for the O’Brien Fellowship in Public Service Journalism.

This story was funded by the O’Brien Fellowship in Public Service Journalism at Marquette University. Marquette University and administrators of the program played no role in the reporting, editing or presentation of this story.

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