Casey will introduce legislation to expand Medicaid maternity coverage to doulas and midwives

Pennsylvania U.S. Senator Bob Casey is among a group of congressional Democrats who introduced the “Mamas First Act” on Thursday, requiring Medicaid coverage for prenatal, birth and postpartum care provided by doulas, midwives and tribal midwives.

The federal legislation follows a similar bill passed by the Pennsylvania House of Representatives to cover doula services for expectant and fresh mothers in the country.

Both bills are intended to assist address racial and ethnic disparities in maternal mortality rates among women in the United States.

“Every mother deserves support and care before, during and after birth,” Casey said. “This legislation will help address the maternal health crisis in this country by ensuring that Medicaid covers the full spectrum of care mothers and infants need.”

Casey introduced the bill in the U.S. Senate with Sens. Elizabeth Warren (D-MA) and Cory Booker (D-NJ). The House companion bill was also introduced today by U.S. Representatives Gwen Moore (D-WI), Ayanna Pressley (D-MA), Lauren Underwood (D-IL), Alma Adams (D-NC), and Debbie Dingell (D-NC). NC).

“The ongoing maternal health crisis in America increases the need for federal interventions that can save lives. The Mamas First Act is an important effort because it will expand access to healthcare providers who can offer emotional and physical support during and after childbirth – comprehensive beyond the hospital setting in which almost all U.S. births take place,” Moore said.

Under the Senate bill, the Centers for Disease Control and Prevention found that the maternal mortality rate of 69.9 deaths per 100,000 live births for black women is almost three times higher than for white women. Deaths among American Indians and Alaska Natives are approximately 49 per 100,000 live births, while among Latinx women there are 28 deaths per 100,000 live births.

“While maternal mortality differentially impacts Black and Indigenous women, this urgent public health crisis impacts race, ethnicity, socioeconomic status, education, and geography,” Casey’s bill states.

About 80% of these deaths are preventable, according to Casey’s bill, but the United States has the highest maternal mortality rate in the developed world and is rising rapidly. This year’s report from the newly formed Pennsylvania Maternal Mortality Review Commission shows that in 2020, 107 Pennsylvania women died during pregnancy or within a year after giving birth.

Doulas are trained non-medical professionals who provide emotional, informational and physical support before, during and after pregnancy and childbirth, such as assisting with breastfeeding and breathing techniques during labor.

According to the NIH, mothers who employ a doula are four times less likely to have a low birth weight baby, twice as likely to experience birth complications for their baby or themselves, and are significantly more likely to initiate breastfeeding.

A midwife is a qualified medical staff who provides care to a robust mother during pregnancy, childbirth and after childbirth. Midwives deliver babies at home, birthing centers and hospitals.

A tribal midwife is a person recognized by a Native tribe as qualified to practice midwifery on behalf of that tribe, Casey Bill says.

According to Casey’s bill, midwife-led care correlates with cost savings, fewer interventions, fewer cesarean sections, lower preterm birth rates and healthier outcomes for mothers and babies.

Pennsylvania House Act 1608 is part of a legislative package on Black maternal health — called “Momnibus” by supporters — that also includes a requirement that Medicaid cover blood pressure monitors for pregnant women and fresh mothers.

Both House bills now go to the Republican-controlled state Senate, where a similar bill requiring Medicaid reimbursement for doulas was introduced last year by Sen. Judith Schwank (D-Berks). It has not yet been considered, as it was referred to the Senate Health and Human Services Committee in January 2023.

Other bills in the Momnibus package call for investing in maternal health care, maternal mental health, eliminating implicit bias in maternal health care and providing fresh parents with the resources to care for their newborns.

(This article was updated at 2:15 PM on Thursday, May 9, 2024 to include information about Mamas First Act co-sponsors and quotes from Casey and Moore.)

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