Daily Hampshire Gazette – Massachusetts maternal health bill nears finish line

BOSTON – Pregnant women and those who have just given birth could have access to expanded care options in Massachusetts under a compromise maternal health bill that still needs to be approved by Gov. Maura Healey.

The House and Senate had passed largely similar comprehensive maternal health legislation that, among other things, allowed certified midwives to be licensed in the state, reduced regulatory barriers to opening birth centers for low-risk pregnancies, improved access to screening for postnatal depression, and provided more resources for perinatal mood and anxiety disorders.

The compromise bill allows for the licensure of lactation consultants, a provision included in the House version but not in the Senate. The agreement also requires health insurance to cover donated breast milk or products derived from it, strengthens MassHealth coverage of doula care and increases oversight of ultrasound services.

“I think the most important thing this bill does is it really allows us to have a very strong, comprehensive approach to maternal health,” said Rep. Marjorie Decker, co-chair of the Public Health Committee, who noted that the bill is based on recommendations from the Special Commission on Racial Disparities in Maternal Health. “I think to the leadership of the House, to myself, and to our colleagues on the other side, that this would not be a commission report that would not be implemented, so I'm really proud.”

The Cambridge Democrat added that the bill “goes a long way toward providing significantly more autonomy, choice, care and protection for maternal health.”

Decker and lead Senate negotiator, Senator Cindy Friedman, issued a joint statement saying the bill “expands coverage of mental health care and services provided by midwives and doulas, creates a pathway to licensure for certified professional midwives and lactation consultants, and strengthens out-of-hospital birth options for our residents.”

Advocates and lawmakers have characterized the bills as a response to declining maternal health, which disproportionately affects people of color. Rates of severe maternal morbidity nearly doubled from 2011 to 2020, with black individuals experiencing the highest rates of complications during pregnancy or childbirth.

“Massachusetts lawmakers understand that the right to reproductive health care, including pregnancy, birth, miscarriage and abortion care, is not a realized right unless every person can receive that care safely and with dignity,” Rebecca Hart Holder, president of Reproductive Equity Now, said in a statement Wednesday. “By empowering midwives and removing burdensome barriers to opening freestanding birth centers, this legislation can bring real progress in birth equity and help combat a worsening maternal health crisis in the Bay State. Agreement on this legislation means our lawmakers are ready to turn the tide in the fight for maternal equity in Massachusetts, and we look forward to getting this across the finish line together.”

Dr. Robbie Goldstein, commissioner of the Department of Health, described the maternal health bill as a priority on Wednesday morning.

“You may have read in the news that many of our priority public health bills did not survive last-minute conference negotiations, including comprehensive maternal health and substance use disorder legislation. However, we are confident that our work to promote understanding and acceptance of issues such as overdose prevention centers, supporting the workforce of certified nurse midwives and recovery counselors, and the possibility of a nonpunitive treatment pathway for newborns with a history of substance use puts us in a particularly strong position to advance these issues,” Goldstein told the Public Health Council.

Leading Democrats have said they plan to continue working on other key bills during informal sessions, which under legislative rules are often limited to non-controversial matters. Decker, without citing specific legislation, said talks have continued in recent weeks.

“I can only speak for my colleagues in the House. They are still working on the House issues that are before them,” Decker said. “Those conversations have not stopped.”