Massachusetts Lawmakers Pass Sweeping Maternal Health Bill

A woman holds the foot of a baby in a file photo. Loic Venance/AFP via Getty Images

A bill aimed at improving maternal health outcomes in Massachusetts is on its way to Gov. Maura Healey’s desk after receiving final approval from state lawmakers.

At present, Massachusetts offers no pathway to licensure for certified professional midwives or lactation consultants. That’s just one policy that would change upon the bill’s signing.

Other provisions codify Medicaid coverage for midwife and doula services, require private insurance coverage for donor breast milk and perinatal mental health screenings, encourage the creation of freestanding birth centers, and establish a task force to evaluate access to maternal health care across the state.

The comprehensive legislation comes amid rising rates of maternal mortality and pregnancy-related complications across the Bay State. It combines aspects of various proposals that all targeted the same goal: expanding available care options for pregnant and postpartum women, particularly in rural and underserved communities.

“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,” Democrat state House Speaker Ronald Mariano said in a statement. “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.”

A Massachusetts Department of Public Health report published in July 2023 found that the state’s rate of severe maternal morbidity—or serious labor and delivery complications—nearly doubled from roughly one per 191 deliveries in 2011 to about one in every 100 deliveries in 2020.

While rates rose across the board, they were highest among black, non-Hispanic patients—for whom complications were more than twice as common as their white, non-Hispanic counterparts—and among those age 40 and older.

Those findings—coupled with the closure of a Leominster hospital’s inpatient obstetrics unit—prompted the governor to order a review of maternal health services across the state.

“We have the greatest health care system in the country, but there is work we must do to ensure that all of our residents, especially in rural communities and communities of color, have access to comprehensive maternal health care,” Healey said in issuing the directive in September 2023.

The Public Health Department’s review found that while Massachusetts does not have any maternity service “deserts,” recent hospital closures had increased the distance that residents in 29 towns were required to travel to obtain care.

The new bill, if approved, would address that issue by loosening licensure requirements for freestanding birth centers that operate independently from hospital systems.

The legislation would also require the Public Health Department to launch a public awareness campaign regarding pregnancy loss and to conduct fetal and infant mortality reviews to identify contributing factors and better inform public health programs.