Request for Information (RFI): Inviting Comments and Suggestions for a Proposed Research Initiative to Decrease Maternal Mortality

Notice Number: NOT-OD-20-063

Key Dates
Release Date: January 31, 2020
Response Date: February 21, 2020

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Issued by

National Institutes of Health (NIH)


This Notice is a time-sensitive Request for Information (RFI) inviting comments and suggestions on a proposal for a trans-NIH research initiative to reduce maternal mortality.

NOTE: It is important to read this entire RFI notice to ensure an adequate response is prepared and to have a full understanding of how your response will be utilized.


The alarming rise of maternal mortality (MM) in the United States is a serious public health concern that has garnered wide-spread attention from U.S. government leadership (e.g., HHS, Congress), the NIH, and the public. The etiology of MM, particularly among women in disproportionately affected populations, is multifactorial. Addressing this compelling and urgent health risk will require a multipronged, trans-NIH effort to develop a bold, aggressive research approach to reverse the upward national trend in MM.

In strategic alignment with efforts undertaken across HHS and NIH’s already significant investments in MM research, NIH is considering the proposed two-pronged research initiative below in pursuit of cutting-edge, innovative, and collaborative approaches to reduce MM:

  • A multi-site community-based participatory research effort to evaluate and implement effective MM interventions and tools across state-tailored healthcare, behavioral health, government, and community systems focused on populations most affected by maternal health disparities (according to age, racial, ethnic groups, and social determinants of health) and that will incorporate:
    • Local communities and stakeholders (e.g., Veterans Affairs (VA), Historically Black Colleges and Universities (HBCUs), African American Sororities, and Federally Qualified Health Centers (FQHC), Faith-based organizations, Tribal Health/Indian Health Service, nurse midwife and doula services, addiction treatment centers, and various community merchants) and leverage advances in machine learning and artificial intelligence to explore underlying factors via hypothesis-driven investigations
    • Exploration of alternative models of care (e.g., doula, midwife) for areas that lack obstetric practitioners, as well as consider social determinants of health
    • Testing of evidence-based practices, interventions, and tools with demonstrable promise or success (e.g., safety bundles used in California) across health care, behavioral health, and other community-based settings
    • Research partnerships with communities that have successfully reduced MM or have the highest rates of MM
    • Studies on the effectiveness of coordinated systems of care (including telemedicine) to increase prenatal care and screening and improve postnatal follow-up care
    • Studies of the impact of community-based public awareness campaigns
  • Research opportunities to address risk factors and identify biomarkers of poor outcomes for women during pregnancy, delivery, and postpartum, particularly in populations disproportionately affected by maternal health disparities (i.e., African American women, American Indian/Alaska Native, rural populations). Additionally, this initiative would further investigate the underlying biological basis of risks of adverse outcomes in women with pre-existing chronic diseases during pregnancy, as well as provide insights into the pharmacoepidemiology of treatments for these chronic pre-existing conditions during pregnancy. In particular, the focus of the initiative would be on:
    • Cardiovascular disease including peripartum cardiomyopathy, preeclampsia, hemorrhage, blood clotting disorders and stroke, and risk factors for hypertension, diabetes, and obesity
    • Maternal infection, including peripartum and postpartum sepsis and influenza
    • Mental health pre-pregnancy, during pregnancy, and postpartum, and factors that predispose towards suicide, substance use, or substance use disorders (especially opioids and alcohol)

Both efforts would focus on addressing health disparities in maternal mortality, particularly in African American, American Indian/Alaska Native, and rural populations, and improving data collection, standardization, and availability (e.g., common data elements).

Information Requested/Request for Comments

This RFI seeks input from stakeholders throughout the scientific research, advocacy, and clinical practice communities, as well as the general public, regarding the above proposed research plan.

The NIH seeks comments on any or all of, but not limited to, the following topics:

  • Serious research gaps, barriers, or best practices to consider within the context of the proposed initiative
  • Resources required or lacking or existing leverageable resources (e.g., existing partnerships, collaborations, or infrastructure) that could advance the proposed initiatives
  • Emerging scientific advances or techniques in basic, clinical, implementation, or behavioral research that could advance the proposed initiative
  • Additional ideas for bold, innovative research initiatives that could yield knowledge readily translatable to reduce maternal mortality

NIH encourages organizations (e.g., patient advocacy groups, professional organizations) to submit a single response reflective of the views of the organization/membership as a whole when possible.

How to Submit a Response

All comments must be submitted electronically on the submission website .

Responses must be received by 11:59:59 pm (ET) on February 21, 2020. You will see an electronic confirmation acknowledging receipt of your response.

Responses to this RFI are voluntary and may be submitted anonymously. Please do not include any personally identifiable or other information that you do not wish to make public. Proprietary, classified, confidential, or sensitive information should not be included in responses. The Government will use the information submitted in response to this RFI at its discretion. The Government reserves the right to use any submitted information on public websites, in reports, in summaries of the state of the science, in any possible resultant solicitation(s), grant(s), or cooperative agreement(s), or in the development of future funding opportunity announcements. This RFI is for informational and planning purposes only and is not a solicitation for applications or an obligation on the part of the Government to provide support for any ideas identified in response to it. Please note that the Government will not pay for the preparation of any information submitted or for use of that information.

We look forward to your input and hope that you will share this RFI document with your colleagues.


Please direct all inquiries to: