Senate Advances Maternal Health Package

BOSTON (08/17/2020) – The Massachusetts Senate unanimously passed three bipartisan bills to increase birth options and safety for all pregnant and perinatal people in the Commonwealth of Massachusetts. One bill establishes a commission to study barriers to substance use treatment for women in the perinatal period, another establishes a commission to address racial inequities in maternal healthcare in Massachusetts, and a third increases options for safe, professional birthing care in the Commonwealth by licensing midwifery. 

“The COVID-19 pandemic has highlighted glaring inequities in our health care system, particularly in maternal health,” said Senator Cindy F. Friedman (D-Arlington), co-chair of the Joint Committee on Health Care Financing. “This package of bills seeks to address these inequities among vulnerable and marginalized populations to ensure that women have access to the care they need to live healthy lives. This legislation builds on the Senate’s ongoing commitment to breakinng down barriers to care and creating a health care system that works better for everyone.”

An Act relative to improving access to treatment for individuals with perinatal substance use disordercreates a special commission to study the barriers to substance use treatment for women in the perinatal period. This commission will bring together the Department of Mental Health (DMH), the Department of Public Health (DPH), the Department of Children and Families (DCF), MassHealth, the Bureau of Substance Abuse Services, and private partners with expertise in maternal mental health and substance use treatment to ensure pregnant and postpartum women with substance use disorder have meaningful access to the care they need. 

This commission will evaluate how different factors like insurance coverage, access to family-based treatment, screening for perinatal substance use disorder, and the integration of perinatal care and substance use treatment affect the availability of care. The commission will also recommendations to provide greater access to treatment for this vulnerable population.

An Act to reduce racial disparities in maternal healthestablishes a commission to address the continuing racial inequities in the Commonwealth’s maternal health outcomes, specifically in cases of maternal mortality and morbidity. Among the developed nations of the world, only the U.S. continues to allow people giving birth to die in increasing numbers, and the outcomes are staggeringly worse for people of color, who experienced a 238% increase in the risk of maternal death between 1978 and 2015.

The commission will bring together diverse perspectives on maternal health and racial health disparities and will include public health experts, physicians, midwives, a doula, and individuals with first-hand experience with health disparities, including a survivor of maternal morbidity. The bill requires that a majority of commission members represent Massachusetts communities most impacted by maternal health inequity, which statistically have been Black and brown communities. The commission must submit a report of its findings and recommendations, including any draft legislation necessary to achieve the recommendations of the commission, within one year of its creation.

An Act relative to out-of-hospital birth access and safetycreates licensure for certified professional midwives who provide home birth services, which are less expensive than hospital-based birth and associated with healthy birth outcomes, including lower rates of Caesarean section and fewer postpartum complications. This credentialing process will standardize midwifery training and qualifications, provide consumers with transparent information when seeking a home birth, and facilitate the hospital transfer process in the event of labor compilations. In addition to making home birth midwifery care more accessible for birthing people, the bill also reduces potential barriers to entry into the profession. Two members of the licensing board must come from populations historically underrepresented in the profession, and the legislation includes licensing fee waivers for aspiring low-income midwives.

The demand for home birth midwifery care has increased sharply during the coronavirus crisis. The licensure provided by this legislation secures healthcare worker status for professional midwives, yielding access to personal protective equipment and other supports necessary for Massachusetts midwives to safely deliver pre- and post-natal care.

The Senate’s maternal health packagenow moves to the Massachusetts House of Representatives for consideration.