Bay State Birth Coalition Statements After MA Legislature Passes Comprehensive Maternal Health Care Package

Legislation that will expand access to midwifery care and out-of-hospital birthing options now heads to Governor Healey’s desk

BOSTON (August 15, 2024) – Members of the Bay State Birth Coalition released the following statements after a comprehensive legislative package to address the worsening maternal health crisis passed out of the Massachusetts legislature in an informal session. The bill now heads to Governor Maura Healey’s desk. 

The legislation includes provisions to create a pathway to licensure for Certified Professional Midwives, to instruct the Department of Public Health (DPH) to update and revise the regulations that govern freestanding birth centers in the state, and to guarantee equitable Medicaid reimbursement for Certified Nurse Midwives. The comprehensive maternal health omnibus bill also contains measures to increase access to doulas, lactation support, and mental health screenings and services.

Emily Anesta, President of Bay State Birth Coalition: “The Maternal Health Omnibus Bill passed by the Massachusetts legislature will significantly improve access to high-quality, personalized maternity care for countless families across our state. This omnibus package is a powerful, multi-faceted approach to addressing our urgent maternal health crisis and racial inequities. People in Massachusetts want and deserve access to midwifery care and birth centers — and this is a huge step forward to ensure people can obtain this essential care.”

Rebecca Hart Holder, President of Reproductive Equity Now: “Today marks an historic day in our Commonwealth’s fight to ensure reproductive equity for every person. By unlocking the power of midwives and removing barriers to the creation of freestanding birth centers, this package will help address the worsening maternal health crisis, improve birthing outcomes, support new mothers, lower health care costs, and ensure that people can make the reproductive health care decisions that are right for them with autonomy and dignity. We are grateful to the Special Commission on Racial Inequities in Maternal Health, the Bay State Birth Coalition, and the team of advocates who fought long and hard to bring this issue to the forefront. Thank you to the Massachusetts legislature for realizing the urgency of this crisis and taking meaningful action to save lives.”

Traci Griffith, Racial Justice Program Director at the ACLU of Massachusetts: “We know that reproductive freedom – including the freedom to choose when and where to give birth – is a racial justice issue. Black families in Massachusetts are twice as likely to experience maternal deaths and severe complications. Expanding maternity care and birthing options will address persistent racial disparities in maternal and newborn health and strengthen care for all pregnant people and their families. We're grateful to the legislature for making this bill a priority.”

Dr. Ndidiamaka Amutah-Onukagha, Director and Founder, Center for Black Maternal Health and Reproductive Justice: “This landmark legislation, more than two years in the making, designates Massachusetts as the blueprint for other states to model. It puts quality, equitable, and respectful care in childbirth at the forefront, and opens the door for more choice and access for families. From studying the issue of maternal mortality as a member of the Special Commission on Racial Inequities in Maternal Health, to seeing many of our recommended priorities advance to become law, today marks an essential step in our work to expand access to this critical care and will help us avert maternal deaths in a meaningful way, for the first time in decades.”

Nashira Baril, Executive Director of the Neighborhood Birth Center: “With only one other birth center in the state of Massachusetts, there is an enormous need for community birth infrastructure. Every person should have equitable access to community midwifery. This legislative package will update the regulations governing licensed birth centers in Massachusetts and reduce financial and administrative barriers to the creation of free-standing birth centers, like Neighborhood Birth Center. Additionally, now Certified Professional Midwives will be licensed and able to bring the full range of their skills and leadership to community birth centers! With today’s passage, together we will continue to build power to redesign healthcare in ways that advance equity and justice.”

Katherine Rushfirth, CNM, FACNM, MA Affiliate of American College of Nurse MIdwives: “Expanding access to midwives is critical to addressing the maternal health crisis. Midwifery care improves outcomes, gives families better experiences, and lowers health care spending. This comprehensive package makes it possible for pregnant people to choose the provider and location that is right for them and promises to improve access to reproductive and sexual health throughout the Commonwealth."

Rebecca Herman, CPM, MPH, National Association of Certified Professional Midwives (NACPM): “As a Certified Professional Midwife, I have seen the deep benefits of the midwifery model of care and the freedom to decide how and where your birthing journey takes place. This bill will allow Massachusetts to leverage the benefits of independent midwifery to expand the maternal care workforce, increase patient autonomy, increase access to community-based care, and improve maternal and newborn outcomes.”

Lilly Marcelin, Executive Director of The Resilient Sisterhood Project: “Today, the Massachusetts Legislature has made important progress in addressing our state's deeply rooted health and medical inequities. By expanding access to midwifery care and out-of-hospital birth centers, this bill will center the needs of birthing people, address racial and social disparities in maternal health outcomes, and transform the birthing experience for pregnant people across Massachusetts. I also believe that providing CPM access and services to birthing people is a wise investment in women’s reproductive health and rights.”

A July 2023 Massachusetts DPH report showed that maternal morbidity nearly doubled in the state from 2011 to 2020. Black women were 2.3 times more likely than white women to experience labor and delivery complications. Studies have shown that access to licensed midwives leads to lower mortality rates in both mothers and infants, reduced C-section rates, and increased breastfeeding rates, and that midwifery care reduces racial inequities in maternal health outcomes. 

Access to adequate and equitable maternal health care is also severely lacking in Massachusetts, further exacerbated by eleven maternity ward closures across the state since 2010. Two freestanding birth centers, Cambridge Birth Center and North Shore Birth Center, have also ceased operations, leaving only one birth center in Massachusetts (Seven Sisters in Northampton). Massachusetts ranks 35th out of 44 states for share of births in birth centers. New Hampshire has four birth centers and Maine has three, both states with 80% fewer births each year than Massachusetts. With this legislation, Massachusetts will join the 38 other states– including New Hampshire, Maine, Vermont, and Rhode Island– already have a pathway to licensing certified professional midwives, a key workforce for birth centers as well as home births, across the U.S.

This legislation responds to the needs and reflects the experiences of Black women most acutely impacted by our maternal health crisis, expressed through the testimony and work of the Special Commission on Racial Inequities in Maternal Health. The package will help reduce racial inequities while improving the maternal care system for all.

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