Democrats aim to expand maternal health care, midwifery coverage

A group of House and Senate Democrats on Friday introduced legislation that would expand Medicaid to cover midwife care in an effort to improve the state of maternal health care.

Introduced during Black Maternal Health Week, the Mamas First Act would amend the Social Security Act to provide coverage under the Medicaid program for doulas and midwives. Medicaid currently covers 40 percent of all births, and 65 percent of Black mothers’ births, in the U.S. each year.

“As Black mothers continue to bear the burden of our maternal health crisis, dying at three to five times the rate of white mothers, making these investments will have an immediate impact on the most vulnerable mothers,” Rep. Gwen Moore (D-Wis.), a sponsor of the bill, said in a statement.

Black women are more than three times as likely to die from a pregnancy-related causes than white women, according to data from the Centers for Disease Control and Prevention. 

The U.S. also has the highest maternal mortality rate compared to other high-income developed countries, a 2020 Commonwealth Study found. The study also found that demand for access to midwives grew during the coronavirus pandemic, with several states issuing emergency orders to expand midwifery services.

The Affordable Care Act strengthened access to midwives by making state Medicaid programs include it as a covered benefit. However, access to these benefits can vary depending on out-of-pocket fees and geographic location, according to the Center for American Progress. 

Only a limited number of state Medicaid programs cover home births, where midwives and doulas are often wanted, and some require them to be certified nurses, according to the Urban Institute. Unlike certified nurse midwives, doulas are trained to provide physical, emotional and educational support throughout pregnancy and labor.

“My colleagues and I are introducing this bill to increase access to doulas, midwives, and tribal midwives in Medicaid to help combat disparities and systemic racism in our health care system — expanding access to these services is powerfully important,” Sen. Elizabeth Warren (D-Mass.), a sponsor of the bill, wrote.

Sens. Cory Booker (D-N.J.) and Bob Casey (D-Pa.) also sponsored the bill in the Senate. 

Vice President Harris held the first-ever Cabinet meeting on maternal health care Wednesday, discussing the Biden administration’s efforts to decrease rates of maternal mortality in the U.S. The Department of Health and Human Services also announced Wednesday millions of dollars to support maternal and infant care in eight states.