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  • Kay Khan

Midwifery Bill Scores Congresswoman Pressley's Support

FOR IMMEDIATE RELEASE:

May 28, 2019


Contact:

Amani Mansour, Communications Director to State Representative Kay Khan

(617) 722-2011, Amani.Mansour@MAhouse.gov

Caroline Sherrard, Chief of Staff to Senator Rebecca L. Rausch

(617) 722-1555, Caroline.Sherrard@MASenate.gov


BOSTON, MA – Representative Kay Khan (D-Newton) and Senator Rebecca L. Rausch (D-Needham) testified before the Joint Committee on Public Health today in support of legislation to license and regulate Certified Professional Midwives (CPMs).


“As an advanced practice nurse and the sponsor of many midwifery bills over the years, I am proud to testify in support of H.1948/S.1332, An Act relative to out-of-hospital birth access and safety, of which I am the lead sponsor along with Senator Rausch,” said Representative Khan, House Chair of the Joint Committee on Children, Families and Persons with Disabilities. “This legislation aligns with the Commonwealth’s efforts to generate evidence-based public health policies that improve outcomes, increase access and reduce costs. If passed, the proposed legislation would improve upon critical safety standards of home births for Massachusetts families.”


“This is one of my favorite bills,” said Senator Rausch. “Passing this bill gives the Commonwealth lower health care costs, reduced number of unnecessary medical interventions, improved health outcomes for moms and babies, and higher rates of breastfeeding success, all while improving reproductive choice. Reproductive freedom and justice is not only about the freedom to choose if and when a person wants to become pregnant; it is also about the freedom to determine how that pregnancy is managed and the professional care both sought and obtained for that pregnancy.”



From left to right: State Representatives Thomas Stanley (D-Waltham), Carmine Lawrence Gentile (D-Framingham),Tommy Vitolo (D-Brookline), Lindsay Sabadosa (D-Northampton), Maria Duaime Robinson (D-Framingham), Denise Provost (D-Somerville), Mindy Domb (D-Amherst), Jack Lewis (D-Ashland) and of course bill sponsors Representative Khan and Senator Rausch, stand before the Joint Committee of Public Health in avid support of H.1948/S.1332, An Act relative to out-of-hospital birth access and safety.

Congresswoman Ayanna Pressley (D-MA-07), the co-sponsor of H.R. 2602, The Healthy MOMMIES Act, which expands Medicaid postpartum coverage and increases access to community-based doula care, submitted written testimony in support of the Out of Hospital Birth Access and Safety Act to the Joint Committee on Public Health. “Racism and trauma have had direct impacts on the health and wellbeing of marginalized communities for generations,” said Congresswoman Pressley. “In Massachusetts, racial disparities in maternal health are killing families at alarming rates, specifically within the black community. The Out of Hospital Birth Access and Safety Act provides equitable services that combat the unjust disparities embedded in the healthcare industry.”


“Midwives have the potential to transform our maternity care system to serve women and all childbearing people with respect and dignity in a model that supports physiologic birth. Moms are suffering physical and emotional traumas from childbirth and it doesn’t have to be this way,” said Emily Anesta, Founder and Director of the Bay State Birth Coalition. “Everyone deserves a midwife. A 2018 study showed that states that integrate midwives into their healthcare system have better outcomes for moms and babies including fewer newborn deaths, fewer premature brits, c-sections and higher breastfeeding rate.”


“I became a midwife to serve families. Unfortunately, home birth midwives currently have to deny care to families who cannot afford to pay us out of pocket,” said Anna Buhler, Certified Professional Midwife.


H.1948/S.1332, An Act relative to out-of-hospital birth access and safety would require all midwives in Massachusetts who are practicing in out-of-hospital settings to become licensed and carry the CPM credential. It would create a multidisciplinary Board of Midwifery to establish state licensing requirements for CPMs and provide regulatory oversight of the profession. It would also permit CPMs to carry and administer lifesaving medication such as antihemorrhagics and mandate reporting of perinatal outcomes to a national database.

The current iteration of the bill mirrors the language changes reported out of the Joint Committee on Public Health last session and includes three (3) new provisions to address access and equity for professionals and consumers:

  • Medicaid/MassHealth coverage for licensed midwives as maternity care providers

  • Financial hardship waivers for licensing fees; and

  • A requirement that at least two (2) members of the Board of Midwifery are situated to address racial justice in birth care, either through direct work experience with existing racial disparities in maternal health or by virtue of membership in a population currently underrepresented in the midwifery profession (Section 2, lines 16-18).

The legislation is consistent with current national and international standards for midwifery education and training. CPM Licensure is supported by every major midwifery organization as well and the American Public Health Association.


In fact, Massachusetts is overdue to seize an opportunity to improve maternal health outcomes, increase access to care for low-income women and women of color, and reduce healthcare spending, through midwifery certification and licensure. Massachusetts lags behind 35 other states that already license and regulate midwives providing out-of-hospital birth care, including all of our New England neighbors except Connecticut.


States that have certified midwifery include large states like California and Texas, small states, such as Rhode Island and Delaware, states with large rural populations, such as Maine and Idaho, and states with large urban centers, such as Minnesota, Virginia, and Maryland. Most recently, the Governors of Kentucky and Hawaii signed legislation to license and regulate midwives.


Studies provide good reason for more than half the country to move in this direction, including reduced birth-related medical risk, lower cesarean section rates, greater success with breastfeeding, decreased rates of preterm births, and millions in overall medical cost savings and recoveries, all with no statistically significant difference in sentinel events (unexpected occurrences resulting in death or significant physical or psychological injury) for mothers or babies. Notably, these outcomes can be achieved while simultaneously improving birth choice access for pregnant people.


“Families choose home birth for a variety of personal and cultural reasons, but under the current system they must seek care from unlicensed and unregulated providers,” said Representative Khan. “I look forward to seeing this legislation move forward so that families are secure in knowing their provider is properly trained, credentialed, and integrated into the broader health care system.”


H.1948/S.1332, An Act relative to out-of-hospital birth access and safety is co-sponsored by a bipartisan group of 96 Massachusetts lawmakers and remains before the Joint Committee of Public Health.

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