6/20/24 - The Massachusetts House of Representatives passed 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.
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. 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 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.
This legislation would allow midwife professionals to obtain licensure, expanding their practice and giving Massachusetts families greater autonomy in childbirth. Importantly, it addresses equity by improving outcomes for Black and Latina women, who face higher rates of maternal morbidity and mortality. Given recent closures of birth centers and hospital delivery wards, more licensed midwives will ensure every family has access to high-quality, culturally congruent care close to home.
The bill passed 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.
H4773 is a significant legislative step in addressing perinatal mood disorders in Massachusetts. This bill provides crucial support for new parents by improving access to comprehensive mental health care during the perinatal period. By focusing on early detection and intervention, we can ensure better health outcomes for both parents and their babies. Postpartum depression is vastly underdiagnosed, but this expanded screening coverage will significantly improve treatment access and improve maternal health outcomes.
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 passed 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.