Legislation expands mental health, midwifery, doula offerings
(BOSTON—7/30/2024) Today the Massachusetts Senate unanimously passed legislation to strengthen access to physical and mental health care for pregnant people and new parents in Massachusetts, an expansion of support systems that is intended to keep parents and newborns healthy as they are welcomed into the world.
S.2899, An Act relative to increasing access to perinatal health care, builds on and improves existing perinatal health resources across the Commonwealth, including mental health resources, midwifery, and doula services.
“Expecting a child is one of the most exciting and anxious experiences in someone’s lifetime,” said Senate President Karen E. Spilka (D-Ashland). “At that moment, no individual should bear the additional burden of not having access to the care they need to stay healthy, or worse, the care to ensure the health and wellbeing of their new child. The Senate’s actions today bring us one step closer to a Commonwealth that delivers care to all expecting individuals—a step that will allow more people to focus on excitement, rather than concern, when they are expecting. I am grateful to Chair Rodrigues for his work on this legislation, and Senators Friedman, Lovely, Miranda, Rausch, and Cyr for their leadership.”
“The Senate has made maternal health a priority for this session, and this legislation creates a pathway for bringing down maternal morbidity that predominantly affects women of color in the Commonwealth,” said Senator Michael J. Rodrigues (D-Westport), Chair of the Senate Committee on Ways and Means. “The bill increases access to freestanding birth centers, freeing up hospitals for higher risk individuals who need those critical care services. In addition, there is an increased awareness on postpartum depression by mandating primary care providers offer full screenings and evaluations. Alternate birthing services and certified midwife provider services now have full insurance coverage under this legislation.”
“Far too often, we see and hear stories that demonstrate how important it is that we act to reduce maternal health disparities and barriers to access safe and adequate maternal health care,” said Senator Cindy F. Friedman (D-Arlington), Senate Chair of the Joint Committee on Health Care Financing and Vice Chair of the Senate Committee on Ways and Means. “While we still have a long way to go, this legislation makes important strides towards these efforts from the moment pregnancy starts through a year after birth, while increasing access to perinatal health care with reforms to midwifery licensure and birthing centers.”
“I would like to thank my colleagues for all their hard work to get this bill to the floor. Maternal health is not a privilege but a right for everyone regardless of economic status and access,” said Senator Joan B. Lovely (D-Salem), Assistant Senate Majority Leader. “Our work on this doesn’t end today. We took this important step, now we as a Commonwealth must become a leader on robust maternal health options for everyone.”
“Today, the Senate passed the maternal health omnibus bill that directly elevates the voices of Black women and birthing people who served on the Special Commission on Racial Inequities in Maternal Health,” said Senator Liz Miranda (D-Roxbury), Senate Chair of the Joint Committee on Racial Equity, Civil Rights, and Inclusion. “Racism, not race, is the primary driver of poor maternal health outcomes and once again, the Senate went further to align with diverse
communities and center Black women’s voices by establishing a universal postpartum home visiting program, and by codifying Medicaid coverage of doula care. Black and brown communities are experiencing a public health crisis of severe morbidity and mortality, and the Senate is responding with passing a bill that is carefully designed to reduce the stark racial inequities we experience in our communities. I am immensely proud that through the collective work of community, coalitions, and those who are working to create a safe and nurturing place where all birthing people feel empowered and protected.”
“This reproductive justice bill gives me immense pride, pleasure, and gratitude,” said Senator Rebecca L. Rausch (D-Needham), Senate Vice Chair of the Joint Committee on Children, Families and Persons with Disabilities. “In a single legislative package, we are squarely addressing our maternal health crisis, uplifting patient choice in maternal care, improving patient outcomes, reducing inequities in maternal health care, lowering costs, enhancing access to pediatric care, boosting post-pregnancy mental health care, and much more. Plus, we’re finally joining the more than three dozen other states that already license certified professional midwives. Today is a great day in Massachusetts, as we pass additional legislation to support people deciding for themselves whether, when, and how to parent.”
“Massachusetts has some of the best health outcomes in the country, but we have a glaring and persistent disparity in maternal health outcomes, especially when it comes to the experience of Black mothers,” said Senator Julian Cyr (D-Truro), Senate Chair of the Joint Committee on Public Health. “The maternal health bill passed by the Senate will expand access to care for all mothers and ameliorate the maternal mortality and morbidity crisis here in Massachusetts. I am proud to stand behind so many brilliant women colleagues in advancing this vital legislation.”
In an effort to proactively address mental health needs, the legislation requires MassHealth and commercial insurance coverage for post-pregnancy depression screenings. It also mandates the Department of Public Health (DPH) to develop and maintain a comprehensive digital resource center on perinatal mood and anxiety disorders.
It requires postnatal individuals receiving care from a postnatal professional to be offered a screening for post-pregnancy depression. Pediatricians will also offer screenings to postnatal individuals during infant wellness visits.
The bill allows earned sick time to be used for pregnancy loss, failed assisted-reproduction, adoption, or surrogacy. Further, it establishes a grant program to award funds to community-based organizations to address mental health conditions and substance use disorders for medically underserved perinatal individuals.
To improve access to midwifery care, the bill creates a licensure program for professional midwives to be certified by DPH. Licensed certified professional midwives will be authorized to dispense certain medications and administer necessary controlled substances under a statewide standing order to be issued by DPH. Additionally, the legislation mandates insurance coverage for services provided by certified nurse-midwives, making midwifery care more accessible and affordable.
The bill requires MassHealth to cover doula services for pregnant individuals, postpartum individuals up to 12 months following the end of pregnancy, and adoptive parents of infants until the infants reach one year of age. This provision recognizes the vital role that doulas play in supporting perinatal health and ensures that more families can benefit from their care.
Further notable provisions of the legislation include:
· Requiring DPH to create regulations for the operation and maintenance of birth centers licensed as freestanding birth centers.
· Codifying and expanding access to the DPH universal postpartum home visiting program.
· Prohibiting the administration of ultrasound services unless supervised by a licensed healthcare professional providing medical care for pregnant individuals.
· Changing the frequency of covered pediatrician wellness visits from annually to once per calendar year.
A previous version of this bill having passed the House of Representatives, the two branches will now reconcile the differences between the bills, before sending a version to the Governor’s desk.
