Today, Congresswoman Moore, Senator Elizabeth Warren (D-Mass.), along with Senator Cory Booker (D-N.J) and Representatives Deborah Dingell (D-Mich.), Ayanna Pressley (D-Mass.), Lauren Underwood (D-Ill.), and Alma Adams (D-N.C.) announced the re-introduction of the Mamas First Act, vital legislation to address the maternal mortality crisis that would expand Medicaid to include doula and midwifery care. In response, she released the following statement:
“Medicaid covers 40 percent of all births and 65 percent of Black mothers’ births. As Black mothers continue to bear the burden of our maternal health crisis, dying at 3-5 times the rate of white mothers, making these investments will have an immediate impact on the most vulnerable mothers. Mothers who have access to doulas and midwives are more likely to have healthier outcomes and deliveries free of complications for them and their babies.
I am so thrilled to join Senators Elizabeth Warren and Cory Booker, co-chairs of the Black Maternal Health Caucus, Representatives Lauren Underwood and Alma Adams, and Congresswomen Debbie Dingell, and Ayanna Pressley in introducing this essential legislation,” said Congresswoman Moore.
“The U.S. maternal mortality and morbidity crisis is shameful, and it hits Black and Brown people the hardest. My colleagues and I are introducing this bill to increase access to doulas, midwives, and tribal midwives in Medicaid to help combat disparities and systemic racism in our health care system – expanding access to these services is powerfully important,” said Senator Warren.
“The United States is facing a maternal mortality crisis that disproportionately impacts Black and Indigenous communities, which has only been exacerbated by the COVID-19 pandemic,” said Sen. Booker. “Building upon my past work on this critical issue, including the MOMMIES Act, I am proud to join this bicameral effort that would expand Medicaid services to cover doulas and midwives, helping our nation take steps to improve health care outcomes for all birthing people.”
“Every mother deserves to be cared for and supported—before, during and after giving birth, but too often, this is not the case. The maternal health crisis, which disproportionately affects Black and Brown women, must be addressed. I am proud to introduce this legislation to ensure that Medicaid covers the support so many mothers and infants rely upon and I will work with my colleagues to get this bill across the finish line,” said Senator Bob Casey.
“Medicaid recipients should have the option to receive care and support from doulas and midwives through pregnancy, labor and delivery, and the postpartum period, regardless of what they can pay,” said Representative Lauren Underwood. “As a Co-Founder and Co-Chair of the Black Maternal Health Caucus, I’m proud to join Congresswoman Gwen Moore to introduce the Mamas First Act, a bold step to address our country’s maternal mortality crisis by expanding Medicaid coverage of doula and midwife care and support. Together, we can – and must – take decisive action to save lives, end disparities and achieve true maternal health justice.”
“This week, we observe Black Maternal Health Week in recognition of the challenges Black parents and children face. It’s a solutions-oriented observance, and one of the solutions we stress is that Medicaid expansion improves outcomes for mothers, babies, and all Americans,” said Congresswoman Alma Adams, co-founder and co-chair of the Black Maternal Health Caucus. “That’s why I’m proud to support the reintroduction of Congresswoman Moore’s Mamas First Act. Maternal mortality is significantly higher in the United States than in other comparable countries, so Rep. Moore’s legislation addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care. Having trusted partners in the birthing process saves lives. Our mamas can’t wait for Congress to put Mamas First.”
“Birthing while Black should not be a death sentence. But for far too many, maternal health justice is deeply entwined with racial justice. With health systems deeply rooted in racist and discriminatory policies and practices, we must acknowledge the Black maternal morbidity crisis and attack it head on. Our understanding of pregnancy-related care must include expansive and comprehensive health care coverage for doulas and mid-wife services – including prenatal, delivery, and postpartum services – that will save lives. I am proud to join my colleagues in re-introducing the Mamas First Act to continue the fight for maternal health justice and make this comprehensive, culturally-sensitive care a reality,” said Congresswoman Ayanna Pressley.
“The quality of care a pregnant woman receives should not depend on the color of her skin, where she lives, or her ability to pay,” said Congresswoman Debbie Dingell. “Each childbirth is different, and women and their doctors should be empowered to decide what care is best. By providing access to adequate and proper maternal services, including doulas and midwives, we will help end the maternal mortality crisis in our country and ensure our children start their lives out healthy and strong.”
“We celebrate the reintroduction of the Mamas First Act, which allows doulas, midwives, and tribal midwives to be reimbursed by Medicaid,” said Angela D. Aina, MPH, co-founding Executive Director of Black Mamas Matter Alliance. “If passed, this bill would directly support Black perinatal workers in our Alliance, as well as Black women and birthing people seeking holistic maternity care. Particularly as we commemorate the fifth annual Black Maternal Health Week, this bill exemplifies the policy action we need to end the maternal health crisis in the United States. BMMA commends Representative Gwen Moore, Senator Elizabeth Warren, and their co-sponsors for championing policies that advance Black maternal health, rights, and justice.”
Across the country, African American, American Indian, and Alaskan Native mothers are dying at rates three to four times that of white mothers. In addition, we are seeing expanding maternity care deserts in cities and rural areas across the U.S. where seven million women live, and nearly 150,000 babies are being born, who have no or limited access to maternity care. Expanding access to care, by increasing access to doulas and midwives, is a key component to reversing these alarming trends. With 42% of pregnant women utilizing Medicaid for coverage, the Mamas First Act would take a major step in the right direction in getting pregnant women the access to care they need and ensure that their infants have the best start to life possible,” said Stacey D. Stewart, President and CEO of the March of Dimes.
“I’ve always said that doulas are the missing link in maternal health—a cost-effective, easily scalable, family-focused, community-centered source of the physical and emotional support, information, and empowerment that all moms— especially moms of color and underserved moms—need. The urgent imperative to expand access to doulas under Medicaid is greater than ever—with the COVID-19 pandemic casting its dark shadow on maternal health, widening the already huge gaps in care, increasing maternal mortality and morbidity, and leaving so many moms, particularly our most at-risk moms, feeling unsupported and alone. We must ensure passage of the Mamas First Act so that every mom can expect the healthy pregnancy, the safe delivery, and the healthy future she and her baby deserve. The What to Expect Project and I are grateful for the leadership, tireless efforts, and commitment from Representative Moore on behalf of all our moms,” said Heidi Murkoff, author of What to Expect When You’re Expecting and founder of the What to Expect Project.
“Commonsense Childbirth and the National Perinatal Task Force fully support and endorse The Mamas First Act and remain committed to strengthening and deploying a diverse perinatal workforce where community-based midwives and doulas are recognized and reimbursed by Medicaid for their service. These essential community health workers continue to address and redress the unjust health disparities disproportionately experienced by Black Americans and Native Americans, and therefore must be supported through this important and timely legislation,” said Jennie Joseph, LM, CPM, Founder and President of Commonsense Childbirth.
“The MAMA’s First Act is a step in expanding access to culturally humble care and addressing a serious gap for birthing people and new parents. Through access to midwives and doulas we are not just telling the community that we are here to help but showing them what it means to show up for future generations in a meaningful and tangible way,” said Chanel L. Porchia- Albert CD, CPD, CLC, CHHC Founder & CEO of Ancient Song Doula Services.
Mamatoto Village supports Rep. Gwen Moore’s, Mama First Act – a critical component in eliminating gaps in coverage, care, and access. We join our colleagues in celebrating this legislation that centers the realities and needs of Black women and birthing people who are seeking covered care and access to dignified culturally congruent community providers.
“The National Birth Equity Collaborative (NBEC) applauds Congresswoman Moore for reintroducing the Mamas First Act. Our goal at NBEC is to promote birth equity, so that Black mamas, babies, and their villages can thrive. This bill would address birth equity by expanding access to doulas and midwives who promote patient-centered care and reproductive autonomy. Allowing for Medicaid reimbursement of doulas and midwives will not only improve access to care during the entirety of the perinatal period, it will also improve health outcomes for birthing people and their babies. The ongoing Black maternal health crisis requires strong legislation from our Congressional leaders, and we applaud those who introduce legislation that addresses hundreds of years of systemic racism which is the root cause of the crisis,” said Dr. Joia Crear Perry, Founder & President, National Birth Equity Collaborative.
Doulas and midwives can play a key role in supporting Black birthing people who are also survivors of domestic and sexual violence. Because their models of care allow for more time with birthing people, doulas and midwives are able to build the trust that is needed for survivors to feel comfortable reaching out to them for support. Mamas First will help create a patient-centered care team that increases access to domestic violence advocacy programs, and other community based supports to increase safety,” said Virginia Duplessis, MSW Associate Director, Health/Director, National Health Resource Center on Domestic Violence.
Read the full text of the legislation here.
America is Experiencing a Maternal Health Crisis, with Mothers of Color Shouldering the Burden.
According to the Center for Disease Control and Prevention, the United States is experiencing a maternal mortality crisis among our nation’s African American, American Indian, and Alaskan Native mothers who are dying at four to five times the rate of white women. In Wisconsin, the rate is even higher with African American mothers dying at over five times the rate of white women. In many hospital settings, women of color face systematic barriers and racial biases regarding delays in recognizing symptoms, not acknowledging the patient’s pain, not fully elaborating on treatment options, and pushing for C-sections.
That is why I have introduced, The Mamas First Act, to help combat discrimination that millions of women face in our health care system by expanding access to doulas and midwives who promote patient-centered care like birthing choice and reproductive autonomy.
Every year, around 4 million women give birth in the U.S. and almost half of them are on Medicaid. By expanding Medicaid reimbursements to doulas and midwives, we can significantly impact maternal and infant health outcomes and disparities. This far-reaching solution adds an important tool to help our states and localities address and reduce high maternal and infant mortality rates, especially about communities of color.
Summary of Mamas First Act:
The Mamas First Act amends the Social Security Act to allow doulas, midwives, and tribal midwives to be reimbursed by Medicaid
- Allowing Medicaid reimbursement for doula care and midwife access would significantly improve health outcomes for mothers and babies
- This legislation would improve access to care before, during, and after pregnancy to under-served and under-resourced communities as both doulas and midwives have been proven to reduce C-sections, decrease maternal anxiety, and improve communication between pregnant women and their health care providers.
- Expanding access to these non-clinical and health care professionals will allow all communities to access these critical services, increase the focus on culturally competency, and patient-centered care while contributing to better health outcomes.
Endorsed by: Black Mamas Matter Alliance (BMMA), The National Partnership, National Birth Equity Collaborative, March of Dimes, Futures Without Violence, National Indian Health Board (NIHB), Commonsense Childbirth Inc. and the National Perinatal Task Force, Ancient Song Doula Services, Restoring Our Own Through Transformation (ROOTT), Mamatoto Village, National Association of Certified Professional Midwives (NACPM), the What to Expect Project, African American Breastfeeding Network