Bill expands access to midwifery care and out-of-hospital birth options
BOSTON – State Representative Richard M. Haggerty (D-Woburn) was pleased to join his colleagues in both the House and Senate to pass “An Act promoting access to midwifery care and out-of-hospital birth options,” a comprehensive maternal health bill which creates a state licensure pathway for midwives and lactation consultants, encourages the creation of more freestanding birth centers, establishes a grant program to address maternal mental health and substance use disorder, and expands the statewide universal postpartum home visiting program. This legislation also mandates that insurers provide coverage for postpartum depression and major depressive disorder screenings for perinatal individuals.
“As a father of a 2-year-old, I’ve had the fortune to witness firsthand the important role maternal healthcare plays in the health and well-being of both the child and mother,” said Representative Haggerty. “This bill addresses critical gaps in our maternal health care by expanding access to midwifery services, increasing birthing options through freestanding birth centers, covering postpartum depression care, and tackling the racial and socioeconomic disparities inherent in the system – ensuring that all families in the Commonwealth have the care and support they need before, during and after childbirth. This legislation underscores the Commonwealth’s continued commitment to the health and well-being of mothers and infants regardless of their race, ethnicity, or socioeconomic status.”
The legislation establishes a state license that certified professional midwives must receive in order to practice midwifery, and requires certain insurance providers, such as MassHealth, to cover doula and midwifery services including prenatal care, childbirth, and postpartum care. The bill creates the Board of Registration in Midwifery within the Department of Public Health (DPH) to license and provide oversight of licensed certified professional midwives. Licensed certified professional midwives would be required to coordinate emergency care if needed and would also be able to issue prescriptions for certain drugs, under regulations to be promulgated by the Board and DPH. The bill also ensures equitable reimbursement of certified nurse-midwives by requiring that they receive payment rates equal to those for the same services performed by a physician under MassHealth.
To encourage the creation of more freestanding birth centers, which operate independent from hospital systems, the bill requires DPH to promulgate updated regulations governing the licensure of freestanding birth centers to ensure safe, equitable, and accessible birth options.
In response, the legislative measure modernizes the Commonwealth’s laws to ensure common paths to parentage may be utilized equally by all families, regardless of marital status. Additionally, it introduces a new path to parentage for individuals who are ‘de facto’ parents and ensures that every child and parent has the same rights and protections without regard to the marital status, gender identity or sexual orientation of their parents, or the circumstances of their birth.
Under this legislation, MassHealth is mandated to cover noninvasive prenatal screenings to detect whether a pregnancy is at increased risk for chromosomal abnormalities for all pregnant patients regardless of age, baseline risk, or family history. The bill requires health insurers to provide coverage for medically necessary pasteurized donor human milk and products derived from it, serving as a critical source of nutrition for the growth and development of babies, particularly for vulnerable premature infants. To better support new mothers in their feeding journeys, the bill also authorizes the Board of Allied Health Professionals to license lactation consultants to ensure their services are eligible for reimbursement through the patient’s insurance.
The legislation provides critical assistance to birthing people and their families during the postpartum period, including requiring DPH to conduct a public awareness campaign about perinatal mood and anxiety disorders, and to develop and maintain a digital resource center that will be available to the public. It also requires that perinatal individuals be offered a screening for postpartum depression and major depressive disorder, and that those services be covered by health insurance plans. To better address barriers in access to care and reduce racial inequities in maternal health, the bill expands the universal postpartum home visiting program administered by DPH and provides coverage for the program’s services.
Additionally, the bill requires DPH to develop and disseminate public information about pregnancy loss to the public and perinatal health care workers to prioritize the physical and mental health care of patients affected. It also requires DPH to establish a program to conduct fetal and infant mortality reviews (FIMR) to identify social, economic, and systems level factors associated with fetal and infant deaths and inform public health policy programs. The bill also includes a provision that will allow Massachusetts residents to use earned paid sick time in the event of a pregnancy loss.
The bill ensures that the Maternal Mortality and Morbidity Review Committee will have access to essential records required to conduct thorough and timely reviews of maternal deaths and pregnancy complications. This will enable the Committee to formulate comprehensive recommendations for improving maternal outcomes and preventing mortality. The bill also establishes a grant program under the Executive Office of Health and Human Services aimed at addressing maternal mental health. This program will support the establishment or expansion of initiatives serving perinatal individuals, particularly those in underserved populations, to improve mental health, behavioral health, and substance use disorder.
The legislation creates a nine-member task force to study the current availability of, and access to, maternal health services and care, as well as essential service closures of inpatient maternity units and acute-level birthing centers. The task force will identify methods of increasing financial investment in, and patient access to, maternal health care in the Commonwealth.
Having passed both chambers, the bill now goes to the Governor’s desk for her signature.
