State Representative Lipper-Garabedian Joins the Massachusetts Legislature to Pass Comprehensive Maternal Health Bill
Bill expands access to midwifery care and out-of-hospital birth options
BOSTON – Thursday, August 15, 2024 – State Representative Kate Lipper-Garabedian (D-Melrose) joined the Massachusetts Legislature in passing a comprehensive maternal health bill which 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. This legislation also mandates that insurers provide coverage for postpartum depression and major depressive disorder screenings for perinatal individuals.
“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,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Chair Marjorie Decker for her tireless work on this legislation, as well as the members of the conference committee, my colleagues in the House, and our partners in the Senate for recognizing the need for action on this critical issue.”
"I was glad to join my colleagues in the Legislature in supporting this critical legislation to enhance maternal health broadly and to reduce maternal health disparities in our communities of color," said State Representative Lipper-Garabedian. "As a mother who suffered from postpartum depression after the birth of my first son, I’m particularly proud of the provisions ensuring that all new mothers be offered a postpartum depression screening covered by insurance. Following the birth of my second son, I received such screenings at each of his pediatrician appointments – something that did not exist with my first motherhood experience – and benefitted firsthand from the attention that such a responsive resource offered.”
“This maternal health bill will save lives for all birthing families in Massachusetts. It responds to the call of action issued by the Special Commission on Racial Inequities in Maternal Health to address the maternal health crisis and improve birthing outcomes for all families, particularly Black birthing people,” said Representative Marjorie C. Decker (D-Cambridge), House Chair of the Joint Committee on Public Health and of the conference committee. “I am so proud that we continue to lead the nation in safeguarding reproductive health and honoring birthing autonomy by allowing more birthing options, expanding equitable access to midwifery care and postpartum support, and providing better insurance coverage for perinatal individuals in the Commonwealth. This bill shows our deep commitment to the entire maternal health experience - before, during, and after pregnancy.”
The legislation passed today creates a state license that certified professional midwives must receive in order to practice midwifery, 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 the Department of Public Health (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.
To encourage the creation of more freestanding birth centers, which operate independent from hospital systems, the bill requires DPH to promulgate updated regulations governing the licensure of freestanding birth centers to ensure safe, equitable, and accessible birth options.
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 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 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 legislation passed today 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 perinatal individuals be offered a screening for postpartum depression and major depressive disorder, and that those services be covered by health insurance plans. 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 improving 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.
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