House Passes Comprehensive Maternal Health Bill

Bill expands access to midwifery care and out-of-hospital birth options

JUNE 21 2024

Representative Bill Driscoll Jr. (D-Milton) joined his colleagues in the Massachusetts House of Representatives in passing An Act promoting access to midwifery care and out-of-hospital birth option (H.4773) a comprehensive maternal health bill this week, 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.

“This legislation, which is the fourth significant health care bill that the House has passed this session, is the latest example of our ironclad commitment to increasing access to quality, affordable health care for all residents of Massachusetts,” said House Speaker Ronald J. Mariano (D-Quincy). “While the Commonwealth’s health care system is amongst the best in the world, inequities in maternal health remain prevalent, and certain aspects of care are woefully insufficient. That’s why the reforms included in this legislation are so important, as they will help to close racial inequities and improve maternal health care statewide. I want to thank Chair Marjorie Decker for her tireless work on this legislation, as well as the bill sponsors, and all my colleagues in the House, for recognizing the need for action on this critical issue.”

"This comprehensive maternal healthcare bill will help Massachusetts close gaps related to the care that is readily available, affordable, and covered by insurance for all birthing families. The hope here is that not only will we be able to address glaring inequities through this legislation but that once implemented it will, over time, help the Commonwealth realize better health related outcomes regardless of your zip code in Massachusetts,” said Driscoll.

“This bill represents a commitment to strengthening and expanding access to maternal health care. This legislation responds to recommendations from the Special Commission on Racial Inequities in Maternal Health, helping to improve maternal health outcomes for all birthing families, particularly for families of color,” said Representative Marjorie C. Decker (D-Cambridge), House Chair of the Joint Committee on Public Health. “I continue to be grateful for Speaker Mariano's ongoing commitment to patient care and interest in developing a comprehensive maternal health bill. This bill will reduce racial disparities, close the gap in health inequities, save lives, and bring more joy and support to families across the Commonwealth.”

The legislation 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.

H.4773 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.

The bill passed 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.

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.

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

An Act promoting access to midwifery care and out -of-hospital birth options 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.

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

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