The NCSL Blog


By Erik Skinner

After just one year in the world, NCSL’s Maternal and Child Health (MCH) Database hit some important milestones.

mohter and babyWhile most 1-year-olds are busy learning to point, associate words with objects and momentarily stand without support, NCSL’s MCH Database has managed to create a 14-category, 50-state repository of legislation that addresses maternal and child health issues. Not bad for its first trip around the sun!

In order to cover the developments from the last year (and drop this metaphor), the rest of this blog summarizes the main areas of state legislative focus across five topics with the highest volume of enacted bills in 2019.

Maternal Mortality and Morbidity

In 2019, there were at least 51 enacted bills across 26 states that address maternal mortality and/or morbidity. Maternal morbidity is also described as severe maternal morbidity, which includes unexpected outcomes of labor and delivery resulting in significant short- or long-term consequences to a woman’s health.

Policies enacted included maternal mortality review commissions to study the problem and improve data collection. States also focused on hospital labor and delivery procedures or payment policies, sometimes called “safety bundles,” to reduce maternal mortality and morbidity rates. Additional initiatives included community-based approaches such as education for healthy behaviors and education on locating maternity or specialty services.

Maternal Mental Health

At least seven states enacted 17 bills that addressed access to care or provided programmatic supports and services for women from preconception to the postpartum period. Many states focused on both public and private insurance to ensure access to care for pregnant and postpartum women with a mental health condition. States mandated insurance companies cover certain mental health services for pregnant women, changed the insurance code to include pregnant women with mental health conditions in general definitions for mental health disorders and added mental health services for pregnant and postpartum women to public coverage programs.

Children’s Mental Health in Schools

In 2019, there were at least 54 enacted bills across 26 states that addressed a student’s mental health through increased access to mental health prevention services, screenings and/or treatment in schools. Many bills related to improving access to mental health services through expanded facilities or employing more professionals that can address children’s mental health in a school setting. These bills varied from access to mental health services in general, prevention of mental health issues in the context of public safety, and prevention of mental health issues in the context of improved student performance and overall wellbeing. Mitigating student trauma was also a theme in these bills.

Children’s Nutrition

At least 49 enacted bills were enacted across 19 states in 2019 that addressed the nutritional value of food provided to children in public schools and other settings. Trends included bills on “lunch shaming,” policies or programs related to children’s food in schools such as shared table, school meal programs, Women, Infants and Children’s programs (WIC) and others. Some states also coupled nutrition with other efforts such as farm-to-school initiatives to improve health and support the state agricultural economy.

Childhood Immunization Requirements

National attention has focused on debates in states that remove child immunization exemptions for public school attendance. In 2019, there were at least 23 enacted bills across 17 states that addressed access to vaccines, public school vaccine requirements for children and other related policies. While a few states passed such bills last session (Maine HB 586, New York SB 2994 and Washington HB 1638) some states made minor changes to how the department of health implements requirements around philosophical and religious exemptions, as well as vaccination policy more broadly, such as requiring education materials before an exemption is issued, changing vaccination reporting requirements to the state immunization registry and allowing pharmacists to administer vaccines for the influenza and HPV viruses and other diseases.

And with that, we conclude the NCSL MCH Database year in review. Feel free to explore the database on your own to learn more about the state laws described above. Additional topics tracked include breastfeeding, childhood obesity, children’s mental health services, children’s oral health, infant mortality, neonatal abstinence syndrome, newborn screening, oral health and pregnancy and postpartum LARC insertion.


NCSL also produces publications and research on these topics and many others. Here are a few resources related to the health topics covered in this blog:

Erik Skinner is a policy associate in NCSL's Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.