Rep. Roybal-Allard, Assistant Speaker Clark Introduce Legislation to Address Maternal Mortality Crisis
WASHINGTON, D.C. – Today, U.S. Representative Lucille Roybal-Allard (CA-40), Vice Chair of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS), and House Assistant Speaker Katherine Clark (D-MA), introduced two pieces of legislation designed to combat the nation’s maternal mortality crisis by expanding affordable, high-quality maternal care. Rep. Roybal-Allard introduced the Midwives for Maximizing Optimal Maternity Services (MOMS) Act to establish two new funding streams for midwifery education to expand educational opportunities for midwives while prioritizing low-income, Latino, Black, and AAPI midwifery students. Rep. Clark introduced the Birth Access Benefiting Improved Essential Facility Services (BABIES) Act to expand access to freestanding birth centers for Medicaid recipients. Both bills are also led by U.S. Representatives Jaime Herrera Beutler (WA-3) and Ashley Hinson (IA-1). Companion legislation in the Senate is being led by Senator Ben Ray Luján (NM).
“I am proud to be introducing the Midwives for MOMS Act and helping to lead the BABIES Act along with my colleagues, Reps. Herrera Beutler, Clark and Hinson,“ said Roybal-Allard. “The United States spends significantly more per capita on childbirth than any other country in the world, yet continues to rank far behind most developed nations in positive birth outcomes for both mothers and babies. With Medicaid as the primary payer for 45 percent of childbearing women and 47 percent of newborns, the federal government has a major responsibility to ensure the quality and value of maternal-newborn care. Decades of research have shown that midwifery care and birth centers provide exactly that type of high-quality, cost-effective care for low risk women. These two bills will expand access to midwifery care and birth centers so that we can give all moms and babies the care that they need and deserve.”
“As maternal mortality rates continue to rise in the U.S., we need to be innovative about tackling this crisis,” said Assistant Speaker Clark. “We have seen clear evidence that birth centers and midwifery care have positive outcomes for mothers and babies, but these services are underfunded, and in some rural areas, nonexistent. The BABIES Act and Midwives for MOMS Act will expand access to birth centers, develop a new generation of diverse midwives, and increase the availability and affordability of maternity care across the country. Thank you to Congresswomen Roybal-Allard and Herrera Beutler for your leadership on these bills, and for everything you do for our nation’s moms as co-chairs of the Congressional Caucus on Maternity Care.”
“New Mexicans have long trusted midwives to safely deliver their children,” said Senator Luján. “I’m proud to introduce legislation in the Senate to increase the number of midwives across America and support birth centers that rely on the midwifery model. This commonsense approach will increase access to maternity care and combat the maternal and infant mortality crisis that has disproportionately impacted African American, Native, and Hispanic families. As America faces this crisis of maternal and infant mortality, I’ll continue looking for opportunities for improve the health and well-being of New Mexico’s families.”
“With high rates of maternal mortality, preterm births, and lack of prenatal care for mothers, maternity care has reached a crisis level across our country,” said Rep. Herrera Beutler. “That’s why I’m proud to introduce both the Midwives for MOMS Act that will expand midwifery education to give moms increased access to quality maternal care, and the BABIES Act that will increase access to birth centers across the United States. To see more healthy pregnancies and thriving babies we need to support and strengthen care for moms and their infants in Southwest Washington and across America, which is exactly what these legislative solutions will do.”
“Expecting moms in rural Iowa often cannot access the care they need during pregnancy or for their infants once they are born,” said Rep. Hinson. “It’s heartbreaking that so many women haven’t been able to receive adequate maternal health services because they live in maternity care deserts. Both the bipartisan Midwives for MOMS Act and the BABIES Act will help address inadequate maternal and infant health care options to support healthy moms and babies.”
Midwives for MOMS Act:
Despite spending more than any other country for maternity care, the US ranks behind almost all other developed countries in childbirth outcomes for both mothers and babies. According to the CDC, each year about 700 women die because of pregnancy or delivery complications, and 60% of these losses are preventable. The racial and geographic disparities in these statistics are appalling, and maternal mortality is just the tip of the iceberg. More than 50,000 women experience severe complications of pregnancy that adversely impact their health. Our infant mortality rates are higher than 33 other countries with similar wealth, and we have made some of the slowest progress in the world in reducing stillbirth rates. Simultaneously, the U.S. is facing a growing shortage of trained maternity care providers, and the March of Dimes reports that more than 5 million women in the US currently live in a “maternity care desert,” an area where hospitals do not offer obstetric care, birthing services or specialized providers.
Decades of research have shown that midwives provide safe, satisfying and cost effective care, but compared to other countries they are vastly underused as providers. The Midwives for MOMS Act is designed to expand educational opportunities for midwives by establishing two new funding streams for midwifery education: one in the Title VII Health Professions Training Programs, and one in the Title VIII Nursing Workforce Development Programs. Additionally, the bill will address the significant lack of diversity in the maternity care workforce by prioritizing students from minority or disadvantaged backgrounds.
Birth centers have promising results to both support the health of infants and mothers while also resulting in cost saving. From 2013 to 2017, the Center for Medicare and Medicaid Services (CMS) conducted the Strong Start initiative for Mothers and Newborns. This project funded three models of prenatal care for Medicaid and CHIP beneficiaries and found that birth centers, a midwifery model of care, resulted in lower rates of preterm birth, lower rates of low birthweight, lower rates of C-section, and cost savings of $2,000 per mother-infant pair.
The BABIES Act would build off the Strong Start initiative by creating a demonstration payment program under Medicaid. The legislation provides guidance to develop a prospective payment system (PPS) that would reimburse birth centers for prenatal care, perinatal, and postpartum mother and infant care. By providing a model of cost coverage for freestanding birth centers, we can continue to use cost-effective, creative solutions to improve maternal mortality and infant outcomes.