On August 15, I joined my colleagues in both the Senate and the House to unanimously pass a comprehensive maternal health bill, An Act promoting access to midwifery care and out-of-hospital birth options (H.4999). Governor Healey signed H.4999 into law on August 26.
This legislation 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. It also mandates that insurers provide coverage for postpartum depression and major depressive disorder screenings for perinatal individuals.
The provisions to encourage the creation of more freestanding birth centers, which operate independently from hospital systems, are encompassed in a bill that I filed, An Act updating the regulations governing licensed birth centers in Massachusetts (S.1335), directing the Department of Public Health (DPH) to promulgate updated regulations governing the licensure of these freestanding birth centers to ensure safe, equitable, and accessible birth options.
Additionally, numerous recommendations from the Special Commission on Racial Inequities in Maternal Health are incorporated into the final legislation. I was proud to serve as the Senate Chair of this Commission. The Commission’s final report can be found here.
Here’s a summary of the full legislation:
The legislation creates a new state license for certified professional midwives, 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 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.
The legislation 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. The bill requires all 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, 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 support for 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 insurers cover screenings for postpartum depression and major depressive disorder. 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 to improve maternal outcomes and prevent 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 bill 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 both chambers, the bill now goes to the Governor’s desk for her signature.
