Table 1.

Chronology of the Evolution of MCH and Perinatal Care Policy and Guidelines

1912Children's Bureau established by Congress as first US public health “grant-in-aid” program
1921Sheppard-Towner Act passed; provided grants to states with enabling legislation to improve access to MCH services
1929Sheppard-Towner Act repealed
1935Social Security Act with Title V signed; plan and provision of an infrastructure for MCH services distinguishes that population. Title V requires state MCH programs to be located in state health agencies
1946Hospital Survey and Construction Act (Hill-Burton) Grants to states to build hospitals
1964Medicare and Medicaid programs enacted into law to increase access to care for elderly and poor
1976Toward Improving the Outcome of Pregnancy: Recommendations for the Regional Development of Maternal and Perinatal Health Services (TIOP I)
1981Title V funds combined with other programs as an MCH block grant as a result of OBRA
1983First edition Guidelines for Perinatal Carepublished by American Academy of Pediatrics and American College of Obstetricians and Gynecologists.
1984First Medicaid expansion to extend coverage beyond AFDC income levels, with a series of expansions continuing through 1990
1988Institute of Medicine report on The Future of Public Health
1989OBRA '89 (Omnibus Budget Reconciliation Act of 1989) provided amendments to Title V including reporting requirements
1991Federal MCH program unit changed (elevated) from Office to a Bureau.
1993Toward Improving the Outcome of Pregnancy: The 90s and Beyond (TIOP II)
1995GRPA, P.L. 103-62 (Government Performance and Results Act) created additional accountability requirements for Title V and other programs
1998Maternal and Child Health Bureau National Performance Guidelines Measures