News Highlights
Bill will expand access to midwifery care and out-of-hospital birth options
The package passed unanimously by the Massachusetts House on June 20 includes provisions to create a pathway to licensure for Certified Professional Midwives and to instruct the Department of Public Health (DPH) to update and revise the regulations that govern freestanding birth centers in the state.
May 5 is the annual International Day of the Midwife. We love and celebrate midwives this day and every day! Thank you midwives, for all you do to care for us.
“Massachusetts Midwives Push for a Licensing Plan” was the front page headline in the Boston Globe on April 27, 2024. Globe reporter Diti Kholi highlights the important role of midwives, and the lack of a licensure pathway in Massachusetts for the certified professional midwives who attend nearly all home births and are 50% of the national workforce for birth centers. Read the article.
American College of Nurse Midwives-MA, Bay State Birth Coalition, and Neighborhood Birth Center Thank Administration For Their Leadership & Urge Quick Implementation of Recommendations
Maternal health practitioners and reproductive rights supporters applaud Governor Healey’s release this week of reports and recommendations regarding the state of maternal health care and essential services in the Commonwealth. The recommendations laid out in the report, if implemented fully, would result in a marked increase in access to maternal health care across Massachusetts. We particularly thank the Administration for prioritizing the following critical recommendations: (1) Updated regulations governing birth centers to better align with national standards; (2) Equitable reimbursement for Certified Nurse Midwives (CNMs); and (3) Support for integration of Certified Professional Midwives (CPMs) into more pregnancy and birth care settings and coverage for such care in Massachusetts.
Massachusetts currently ranks in the bottom third of states for midwife integration. Midwives save lives!
On October 5, maternal health and reproductive equity groups joined together at the State House to advocate for legislation to expand access to midwives in Massachusetts. Approximately one hundred parents, kids, midwives, nurses, students, community leaders, advocates, and legislators gathered for a powerful rally on the State House steps. Afterwards, supporters and lawmakers gathered inside the State House for a presentation and panel discussion on the value and importance of midwifery care.
Co-hosted by Neighborhood Birth Center, Bay State Birth Coalition, ACNM Massachusetts, NACPM Massachusetts, Reproductive Equity Now, MassNOW, ACLU, Our Bodies Ourselves, Mystic Valley Action for Reproductive Justice, City of Boston Office of Women’s Advancement, Birth Equity & Justice Massachusetts, Center for Black Maternal Health and Reproductive Justice at Tufts Medical School, and the Massachusetts PPD Fund.
September 14-20, 2023 marks the first ever Birth Center Week, an event started by the national non-profit Birth Center Equity to "celebrate and elevate the impact and potential of birth centers, with a focus on community birth centers that provide safe, culturally-reverent, midwifery-led health care for all." We are celebrating Massachusetts birth centers past, present, and future.
In May, the Massachusetts Senate passed a budget that included unprecedented state funding for birth centers. Senator Liz Miranda’s amendment passed unanimously to provide $1M for the development and operation of nonprofit freestanding birth centers like Neighborhood Birth Center and other community based maternal health organizations. In addition, $150K was allocated to Seven Sisters Birth Center to support their doula program. In August, Governor Maura Healey signed the budget into law.
Follow us on Instagram @baystatebirth and check out our Reels to see the recordings of our Live conversations from Black Maternal Health Week.
A conversation with State Senator Liz Miranda
A conversation with State Representative Brandy Fluker Oakley
Discussion of the new art exhibit honoring the foremothers of gynecology with Lilly Marcelin of Resilient Sisterhood Project
Tiffany Vassell, a labor and delivery nurse, left a Boston hospital two days early after giving birth to her son seven months ago, exhausted by what she described as inadequate care that forced the Black maternal health advocate to relentlessly protect her and her baby’s wellbeing.
As her unborn child went into distress for 10 minutes, Vassell herself watched the heart rate monitor, instructing a nurse to not increase a medication used to induce contractions.
And Vassell halted a frenzied recommendation about an emergency C-section, a procedure she later had to undergo to deliver her 10-pound baby, as she lobbied for a “very controlled atmosphere” to reduce the likelihood of infection. Vassell later had to request stronger painkillers — rather than the Motrin she was given — and heating pads as she complained of “excruciating pain” following the abdominal surgery.
Throughout her pregnancy, Vassell managed to make decisions for herself, backed by a maternal care team that extended well beyond the hospital to the home birth midwife and doula she’d hired out-of-pocket.
A new editorial in the Boston Globe calls on the legislature to license certified professional midwives and state regulators to update birth center regulations.
Massachusetts politicians like to hold the Bay State up as a mecca of reproductive rights. Yet while pregnant people can choose whether to carry a baby to term, they have less choice in where to deliver that baby.
While Massachusetts has world-class hospitals — and 99 percent of births occur in a hospital — there is only one birth center, Seven Sisters in Northampton. The North Shore Birth Center, run by Beverly Hospital, closed in December, while the Cambridge Health Alliance-affiliated Cambridge Birth Center closed when COVID-19 hit and never reopened. With nearly 400 birth centers nationally, Massachusetts’ single birth center makes the state an outlier. It is a problem for a state that prides itself on high-quality care but struggles with high health care costs…
There are steps Massachusetts policy makers should take to make birth centers more financially viable. The Department of Public Health should rewrite its regulations to better suit the care modern birth centers provide. The Legislature should allow the licensing of certified professional midwives, a class of childbirth professionals who could expand the workforce.
You may know the story of Elizabeth Freeman (1742-1829), who helped end slavery in Massachusetts when she sued for her freedom under the new state constitution. Did you know that Elizabeth "Mum Bett" Freeman was also a prominent and respected MIDWIFE in Berkshire county? Read more about Elizabeth Freeman.
On the Black History of midwifery in the United States:
“One of the darkest moments in US history was the systematic eradication of the African American midwife from her community, resulting in a legacy of birth injustices.” - Shafia Monroe, Boston native and Queen of the Midwifery Movement
New legislation to expand access to midwives, home birth, and birth centers has been filed in Massachusetts for the 2023-2024 legislative session.
Everyone in Massachusetts should be able to choose where they give birth and the type of maternity care that is most appropriate for their needs. Unfortunately, our state currently lags the nation when it comes to access to midwives, birth centers, home birth, and integration of care -- models that can reverse our rising maternal mortality and growing racial inequities in birth outcomes. Together, these priority bills will propel Massachusetts to a position of leadership in healthy, equitable access to maternity care and birthing choices. Take action now.
There is just 1 birth center left in Massachusetts. What happened? What can we do about it?
Commonwealth Magazine “Opinion: Take pregnant people seriously, support birth centers. Let science in to address failing maternity system.” by Cristina Alonso (Jan 1, 2023)
Boston Globe “Opinion: Birth centers offer options. Why is there only one left in Massachusetts? With the closing of the North Shore Birth Center and the stalled reopening of the Cambridge Birth Center, it seems that midwifery care is often seen as dispensable.” by Nashira Baril, Katherine Gergen Barnett, and Mallika Sabharwal (Dec 30, 2022)
Commonwealth Magazine “Hoping to deliver at a Massachusetts birth center? Good luck. Planned closure of North Shore facility will leave just one birthing center in the state.” by Shira Schoenberg (Nov 20, 2022)
The formal Massachusetts legislative session which began January 2021, ended the morning of August 1, 2022 without the passage of key midwifery and maternal health legislation. The Health Care Financing Committee sent the Out-of-Hospital Birth Access and Safety Act, An Act to Expand Access to Nurse-Midwifery, and 7 other maternal health bills to study in early June, effectively killing the bills with no reason given and no vote. Though there were multiple attempts to resurrect the midwifery legislation be attaching them as amendments to other bills, none were successful.
On July 20, hundreds of community members gathered to testify at a Department of Public Health Hearing in an effort to stop the planned closure of North Shore Birth Center by Beth Israel Lahey Health. “Everyone deserves to have the choice of where they give birth. Unfortunately, in Massachusetts, too few of us do have that choice.”
“Black women are returning to having home births because they see it as having control over their bodies and their babies,” Vassell said. “You can see how many black women are dying while pregnant and during labor, why can’t we fix this?”
On Tuesday, the Massachusetts House voted in favor of a consolidated budget amendment for public health that included $100K for Neighborhood Birth Center, a non-profit led by Black women to open Boston’s first freestanding birth center. Expanding access to midwifery and community birth settings outside of the hospital has been shown to have beneficial impacts on maternal and infant health as well as reduce health care costs. Currently, there are no fully operations birth centers in Eastern Massachusetts, and only one statewide, (Seven Sisters in Northampton). There are 400 birth centers across the U.S.; New Hampshire has four birth centers and Maine has three, both states with 80% fewer births each year than Massachusetts. We applaud the House’s decision to invest in community birth centers, and hope to see the Senate do the same.
Learn more about Neighborhood Birth Center: Watch their new 4 minute video!
Art by Molly Crabapple
By Boston City Councilor Julia Mejia and Tiffany Vassell RN
April 20, 2022
Ask just about any Black or Brown mother or birthing person, and they can tell you their own story about trying to navigate the difficult and often unwelcoming birthing process here in Massachusetts. This is true for us, too.
On April 13th, The Boston City Council unanimously passed a Resolution filed by City Councilor Julia Meija: a RESOLUTION IN SUPPORT OF THE OUT-OF-HOSPITAL BIRTH ACCESS AND SAFETY ACT (H.2341/S.1519) AND RECOGNIZING BLACK MATERNAL HEALTH WEEK IN THE CITY OF BOSTON.
The City Council prioritized this passage in recognition of Black Maternal Health Week in the city of Boston and the need to prioritize public policies that will improve the dismal outcomes for birthing people of color and their babies in the United States. The Resolution underscored that home birth rates have risen dramatically during the ongoing COVID-19 public health crisis. Certified Professional Midwives (CPMs), who perform most home births, are already licensed in 37 states across the country.
“Births at home or in birth centers are a safe, beneficial, and valid reproductive choice that is currently denied to most birthing people here in Massachusetts,” Mejia stated during the Council meeting. City Councilor Kendra Lara added, “We are acknowledging the importance of safer, more equitable access to midwifery care options.”
Even prior to the COVID-19 pandemic, the United States had the highest maternal mortality rate among developed countries, affecting Black women at a much higher rate than their white counterparts.
The home birth rate in Massachusetts rose 47% since the pandemic began according to a new CDC report. This surpasses the 22% rise in home births nationally. The increase was significantly higher among Black birthing people than for the overall population, a trend that has been previously attributed to the intersection of the pandemic and the Black maternal health crisis.
At a June 7, 2021 hearing of the Massachusetts legislature’s Joint Committee on Public Health, legislators heard an outpouring of support for the Out-of-Hospital Birth Access and Safety Act from mothers, midwives, a nurse, a professor of public health, legislators, and organizations including the Bay State Birth Coalition, Resilient Sisterhood Project, Planned Parenthood, ACNM Massachusetts, National Partnership for Women and Families, and Massachusetts League of Women Voters.
Massachusetts State Representative Kay Khan and Senator Becca Rausch refiled the Out-of-Hospital Birth Access and Safety Act on February 19, 2021. The bill would create a pathway to licensure for Certified Professional Midwives practicing in Massachusetts. Most home births are attended by CPMs, who are eligible for licensure in 36 other states including New Hampshire, Vermont, Maine, and Rhode Island.
The bill also ensures that families who use MassHealth/Medicaid can have their CPM care covered. Licensure also expands opportunities for private insurers to reimburse for CPM care.
In the pandemic, there has been a surge in demand for out-of-hospital birthing options that could be provided by Certified Professional Midwives.
As of March 9, 41 legislators have signed on as cosponsors of the legislation.
Although the Out-of-Hospital Birth Access and Safety Act was passed unanimously by the Massachusetts Senate on July 30, 2020, the Massachusetts House did not take up the bill in the extended legislative session that ended early in the morning on January 6, 2021. The bill’s sponsors, Senator Becca Rausch and Representative Kay Khan will refile the legislation in 2021.
From MassLive: “Massachusetts Senate clears bill to license midwives who provide out-of-hospital care”
By Steph Solis
The Massachusetts Senate unanimously passed a bill Thursday that would license midwives in Massachusetts, which Sen. Becca Rausch said would reduce costs and improve health outcomes in births.
Rausch, a Needham Democrat who filed the original Senate bill earlier this session, said the bill was not only a cost reduction tool but a maternal justice issue. She said the issue becomes even more crucial during the coronavirus pandemic.
With the COVID-19 crisis, we urge that all credentialed Massachusetts home birth midwives be included in the emergency planning for maternity care and that the state move quickly to ensure that certified professional midwives be licensed to care for women who seek their services. These midwives, who meet international standards for training, could be swiftly trained in Centers for Disease Control and Prevention and Massachusetts Department of Public Health coronavirus screening algorithms and prevention strategies (if they aren’t already) and thus be of assistance to hospital-based providers who are likely to be overwhelmed in the very near future with symptomatic patients. https://www.bostonglobe.com/2020/04/18/opinion/massachusetts-mothers-need-more-childbirth-options/
"Pregnant women are opting for home births as hospitals prepare for coronavirus," Washington Post, March 20, 2020
“More Babies Being Born At Home Due To Coronavirus Concerns,” WBZ 4 Boston, March 23, 2020
“Midwives in higher demand among expectant mothers during pandemic,” Boston25News, April 1, 2020
“‘Grateful that we have this option': Some pregnant women turn to home births amid coronavirus pandemic,” USA Today, April 4, 2020
The number of states who legally authorize and license Certified Professional Midwives to practice is growing. The CPM credential is nationally-accredited, meets international standards for midwifery education and training, and is recognized in 2/3 of the United States.
Marking International Day of the Midwife and Mothers Day, the Cambridge City Council votes unanimously to support the Out-of-Hospital Birth Access and Safety Act to increase access to midwives in the Commonwealth.
Black Maternal Health in America
Midwives make a difference,
Featuring an interview with midwife Joelle Leacock
by Isabel Oalican, student at Boston Latin High School
April 17, 2019
The National Partnership for Women & Families released their “Blueprint for Advancing High-Value Maternity Care Through Physiologic Childbearing” in June 2018 including the priority recommendation to grow the midwifery workforce. Massachusetts HB4655 “An Act Relative to Out-of-Hospital Birth Access and Safety” meets the Blueprint’s recommendations for Certified Professional Midwife (CPM) regulation.