Access to midwifery for all
We did it!
On August 15, 2024, the Massachusetts Legislature passed the bill H.4999, An Act promoting access to midwifery care and out-of-hospital birth options, a “Momnibus” package of legislation that expands access to midwifery care, birth centers, home births, and much more. After unanimous votes in the House (June 20) and the Senate (July 30), the conference committee combined the two versions into a final compromise bill that has now been passed. The bill was signed into law on August 23 with a ceremonial signing event on August 26 by Governor Maura Healey.
Massachusetts families can look forward to greater access to midwifery care and out-of-hospital birth options at home or in birth centers.
The bill is excellent, and the result of so much hard work from advocates, legislators, and legislative staff. This would not have happened without all of you, making your voices heard, sharing your stories, spreading the word, educating legislators, and advocating for the best possible bill. Beacon Hill really heard us when we said: “Midwives save lives,” and this labor of love has resulted in meaningful change that will impact families for generations.
Midwifery components of the bill:
License certified professional midwives (CPMs), protecting autonomous practice and establishing a board of midwifery
Require MassHealth to cover CPM care
Require MassHealth to reimburse nurse midwives equitably (100% of what physician rate would be)
Update state birth center regulations
Allow CPMs and CNMs to staff and lead birth centers
In addition to midwives and birth centers, the bill expands access to postpartum mental health screenings and creates a grant program for community based maternal mental health support. The bill also has provisions for a MassHealth postpartum home visiting program, doula access, lactation consultant licensure, and more.
“Maternal health bill passed on Beacon Hill could change the game ‘for generations’” (WGBH)
“State lawmakers agree on maternal health bill” (WBUR)
“Mass. Legislature votes to expand access to midwives, improve maternal health care” (Boston Globe)
Just before the vote: “Massachusetts will have a path to more midwives and birth centers — if lawmakers can agree” (WGBH)
Bills
legislation in Massachusetts for the 2023-2024 session:
AUGUST UPDATE: The Massachusetts legislature has unanimously passed H.4999, An Act promoting access to midwifery care and out-of-hospital birth options on August 15 that includes our legislative priorities to expand equitable access to midwifery care, birth centers, and more. The bill is now headed to the Governor for her signature.
Our legislative priorites:
Certified Professional Midwife Licensure: H.2209/S.1457, An Act promoting access to midwifery care and out-of-hospital birth options, was filed by Representative Kay Khan, Representative Brandy Fluker Oakley, and Senator Becca Rausch to create a pathway to licensure for certified professional midwives and make their care reimbursable by Medicaid/MassHealth. STATUS: This legislation is part of the comprehensive maternal health bill H.4999 passed unanimously by the Massachusetts legislature!
Updating Birth Center Regulations: H.3616/S.1335, An Act updating the regulations governing licensed birth centers in Massachusetts, was filed by Representative Manny Cruz, Representative Chynah Tyler, and Senator Jo Comerford to address onerous and outdated birth center regulations. STATUS: This legislation is part of the comprehensive maternal health bill H.4999 passed unanimously by the Massachusetts legislature! In addition, the Healey-Driscoll Administration has directed the Department of Public Health to start updating the regulations now. Stay tuned for updates!
Nurse Midwifery Reimbursement Parity: H.1069/S.607, An Act to Increase Access to Nurse-Midwifery Services, sponsored by Rep. Kay Khan, Sen. Brendan Crighton for parity in reimbursement for nurse midwives, who currently get reimbursed at a lower rate than physicians even when providing the exact same services. STATUS: The MassHealth provisions in this legislation (but not private insurers) are part of the comprehensive maternal health bill H.4999 passed unanimously by the Massachusetts legislature! In addition, the Healey-Driscoll Administration has directed MassHealth to start updating the reimbursement rates now. Stay tuned for updates!
An Act relative to birthing justice in the Commonwealth, S.1415, was filed by Senator Liz Miranda, and includes language of the midwifery and birth center bills as well as additional urgently needed policies to improve maternity care and birth outcomes and address longstanding racial inequities. STATUS: This legislation led to the comprehensive maternal health bill H.4999 passed unanimously by the Massachusetts legislature!
Join us in taking action to expand access to midwives, birth centers, and home birth in Massachusetts. We deserve a better maternal health care system and real birthing choices.
Current status of midwifery in Massachusetts:
- Bottom 1/3 of states for midwifery integration
- No insurance or Medicaid coverage for most home births
- No state recognition or licensure for the Certified Professional Midwife credential (despite being available in 37 other states!)
- Lack of integration of care across home and hospital birth settings
- Only 1 freestanding birth center statewide (with the closures of Cambridge Birth Center and North Shore Birth Center)
Families and birthing people deserve access to midwives and out-of-hospital birth settings such as home birth and birth centers. Your voice is needed to tell lawmakers to stop blocking progress and let midwifery flourish in Massachusetts!
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