House Passes Maternal Health and Midwife Access Legislation

Representative Mike Connolly joined with his Cambridge and Somerville colleagues in the House today to pass H.4773, 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, and mandates that certain health care professionals perform, and that health insurers provide coverage for, postpartum depression screenings.

"The ongoing maternal health crisis in Massachusetts and across our nation is heartbreaking and truly outrageous. That's why I am very proud to join with my House colleagues to pass legislation to improve maternal health outcomes by offering greater choices and ensuring compassionate care during one of life’s most transformative moments," Representative Mike Connolly said. "With the passage of this omnibus bill, we reaffirm our commitment to supporting families, enhancing healthcare options, advancing maternal and fetal health outcomes, supporting those who experience pregnancy loss, promoting access to doulas, and reducing racial disparities across our Commonwealth."

The legislation passed today creates a state license that midwives must receive in order to practice midwifery, and requires certain insurance providers, such as MassHealth, to cover 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 midwives. Licensed 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.

Second, the bill encourages the creation of more freestanding birth centers, which operate independent from hospital systems, by requiring DPH to promulgate updated regulations governing the licensure of freestanding birth centers to ensure safe, equitable, and accessible birth options.

Third, it also requires that MassHealth 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. 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.

Fourth, the bill requires 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 new mothers be offered a screening for postpartum depression, and that those services be covered by health insurance plans.

Fifth, 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, via an amendment sponsored by Rep. Sabadosa and cosponsored by Rep. Connolly, a provision that will allow Massachusetts residents to use earned paid sick time in the event of a pregnancy loss.

Rep. Connolly was also pleased to see other cosponsored amendments be adopted into the final version including broadening the population of expectant parents that can access covered midwife care (Rep. Fluker Oakley), requiring DPH to publish maternal health related communications in more languages (Rep. Gonzalez), and increasing coverage for certified nurse midwives (Rep. Fluker Oakley), among others.

Lastly, it establishes 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.

Rep. Connolly would like to thank Chair Marjorie Decker for her leadership in advancing this bill, along with the Bay State Birth Coalition and Repo Equity Now for their advocacy in support of this bill. In addition, Rep. Connolly thanks Speaker Mariano, Chairs Michlewitz, Lawn, and Fiola, and Reps. Fluker Oakley, Khan, Sabadosa, O'Day, Worrell, Sousa, and all of his colleagues who worked to advance “An Act promoting access to midwifery care and out-of-hospital birth options” this afternoon.

Having passed the House of Representatives 153-0, the bill now goes to the Senate for further consideration.