Moore, Warren, Booker, Casey, Pressley, Underwood, Adams, and Dingell Re-Introduce Mamas First Act Ahead of Mother’s Day

Moore, Warren, Booker, Casey, Pressley, Underwood, Adams, and Dingell Re-Introduce Mamas First Act Ahead of Mother's Day

Today, Congresswoman Gwen Moore (D-WI), Senators Elizabeth Warren (D-Mass.) Cory Booker (D-N.J), Bob Casey (D-PA) and Congresswomen Ayanna Pressley (D-Mass.), Lauren Underwood (D-Ill.), Alma Adams (D-N.C.), and Debbie Dingell (D-Mich) announced the re-introduction of the Mamas First Act, legislation that directly and meaningfully addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care. In response, the Members released the following statement:

"America's ongoing maternal health crisis magnifies the need for federal interventions that can save lives. The Mamas First Act is an important effort because it will expand access to providers who can offer emotional and physical support during and after the birthing process - comprehensive beyond the hospital setting where nearly all U.S. births occur. Our legislation is an opportunity to empower more mothers with doulas and midwives - perinatal professionals who advocate for a mother's needs. I am thrilled to join my amazing House and Senate maternal health champions in re-introducing this vital legislation," said Congresswoman Gwen Moore.

"The United States has a terrible track record when it comes to maternal mortality, and it's costing women their lives," said Senator Elizabeth Warren. "Now is the time to use all available tools to combat the maternal health crisis, including by expanding Medicaid to cover access to doulas, midwives, and tribal midwives. The Mama's First Act will take care of our mommas and babies and will help us root out the deep disparities and systemic racism in our health care system."

"Expanding Medicaid to include doula and midwifery care is imperative to combating the maternal mortality crisis disproportionately impacting Black and indigenous mothers," said Senator Cory Booker. "Doula-assisted mothers are less likely to experience complications at birth, and midwife-led care is associated with healthier outcomes for mothers and their babies. All mothers deserve support and care throughout their pregnancy and postpartum journeys, and this legislation is a critical step toward ensuring more equitable access to quality maternal health care."

"Every mother deserves support and care before, during, and after birth," said Senator Bob Casey (D-PA). "This legislation will help address the maternal health crisis in this country by ensuring that Medicaid covers the full spectrum of care that mothers and infants need."

"Maternal health justice is racial justice. While we work to confront the Black maternal morbidity crisis in America, the Mamas First Act would save lives by ensuring pregnancy-related care includes expansive and comprehensive health care coverage for doulas and midwifery services - including prenatal, delivery, and postpartum services," said Congresswoman Ayanna Pressley. "Comprehensive, culturally-congruent care should be a reality for all, not just some, and I am proud to reintroduce this vital legislation alongside Rep. Moore and my colleagues. Congress must pass this bill without delay."

"Good care and support from a doula or midwife can make the difference between a positive and healthy pregnancy outcome, and a devastating one. Every mom should be able to access this critically important care," said Congresswoman Lauren Underwood. "As 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 to include doula and midwife care. Together, we can, and must, take decisive action to save lives and end disparities."

"As we're seeing today at the state level in North Carolina, Medicaid expansion continues to improve outcomes for mothers, babies, and all Americans," said Congresswoman Alma S. Adams, Ph.D., 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 remains significantly higher in the United States than in other comparable countries, especially for Black mothers. This legislation addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care, because having trusted partners in the birthing process saves lives. Mothers are less than half of the population, but we give birth to 100% of it - Congress needs to put Mamas First because our Mamas can't wait."

"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. 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," said Congresswoman Debbie Dingell.

"The African American Breastfeeding Network supports and fully endorses the Mammas First Act because it is essential that Wisconsin provides Medicaid reimbursement coverage so that doulas and birth workers can earn equitable pay without having to work multiple jobs", said Dalvery Blackwell, Executive Director, Co-Founder of the African American Breastfeeding Network.

"BMMA applauds the continued efforts of Representative Gwen Moore and all the co-sponsors of the Mamas First Act as it will allow for Midwifery and Doula services to be reimbursable through Medicaid. Many states, especially in the southern region of the U.S., are in significant need of high-quality, holistic, and comprehensive maternity care. Passage of the Mamas First Act can help strengthen maternity care workforce efforts," said Angela D. Aina, Executive Director, Black Mamas Matter Alliance, Inc (BMMA).

"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 Y. Brayboy, Sr. Vice President, Public Policy & Government Affairs, March of Dimes.

Commonsense Childbirth and the National Perinatal Task Force strongly endorses The Mamas First Act. We remain committed to training and supporting a diverse perinatal workforce of autonomous, community-based midwives and doulas who are fully integrated, recognized and reimbursed by Medicaid for their service. These essential maternal health workers address and mitigate the unjust health disparities disproportionately experienced by Black, indigenous and other people of color, and this important and timely legislation will protect marginalized birthing people and ultimately save lives," said Jennie Joseph, LM, CPMFounder and President of Commonsense Childbirth Inc.

"The Association of Maternal & Child Health Programs (AMCHP) is pleased to endorse the reintroduced Mamas First Act, which would expand Medicaid to include doula support and midwifery care. Policy and public health leaders across the country are recognizing the complex history and important role comprehensive, continuous, and culturally congruent perinatal support and care must play in protecting positive birth outcomes and pregnancy and postpartum experiences of our nation's mothers. This legislation demonstrates a national commitment to and partnership with the comprehensive perinatal workforce, especially birth workers of color, as we urgently work to reduce maternal health inequities and provide every pregnant person with the care and support they deserve," said AMCHP CEO, Terrance E. Moore. "AMCHP applauds Representatives Gwen Moore, Debbie Dingell, Ayanna Pressley, Lauren Underwood, and Alma Adams as well as Senators Cory Booker, Elizabeth Warren, and Bob Casey in recognizing the essential skills and expertise of the full cascade of birth workers who support and protect healthy, safe, and celebratory pregnancies, births, and postpartum experiences."

"Every mom deserves the respectful, responsive, nurturing and empowering care she needs to deliver a healthy beginning and a healthy future to herself and the baby she loves. Research shows that midwives and doulas deliver that care best - along with lower rates of complications, c-sections and epidurals, perinatal mood and anxiety disorders and birth trauma, higher rates of breastfeeding success…and lower healthcare costs. The Mamas First Act delivers that care where it's needed most to the moms who need it most, by ensuring Medicaid coverage of doulas, midwives and tribal midwives. That's why the What to Expect Project and I are proud to endorse this critical bill," said Heidi Murkoff, author of What to Expect When You're Expecting and founder of the What to Expect Project.

"We have a maternal health crisis in this country that is causing devastating harm, in particular to Black and Indigenous women and families," said MomsRising Senior Vice President Monifa Bandele. "The Mamas First Act offers real promise for helping to address this crisis by making Medicaid reimbursement available for care provided by doulas, midwives, and tribal midwives. With experts telling us that four out of five maternal deaths are likely preventable, there's no time to waste. America's moms want lawmakers in both chambers of Congress to prioritize passage of the Mamas First Act now."

"As a Mama, OB/Gyn and the Founder and President of the National Birth Equity Collaborative, I am so excited about the opportunity we have to improve birth outcomes for all by passing the Mamas First Act in 2024. As we look for solutions to ensure Black Mamas, babies and their villages thrive, Doula support must be covered by all State Medicaid Plans," said Joia Crear Perry, MD, Founder & President of the National Birth Equity Collaborative.

"Ujima celebrates Congresswoman Moore's reintroduction of the Mama First Act and her continued fight to ensure equitable and comprehensive maternal health options for all. Doulas and Midwives not only provide expansive perinatal care, but also have proven to be a valuable asset to combat maternal mortality and morbidity. Medicaid coverage for these services removes barriers for parents, particularly the 65% of Black birthing people who rely on Medicaid for pregnancy and postpartum assistance. The Mama First Act demonstrates actionable steps toward disparate maternal care. Ujima applauds Representative Moore, Senator Elizabeth Warren and all the co-sponsors for their commitment to holistic maternal care for women," said Karma Cottman, CEO, Ujima, The National Center on Violence Against Women in the Black Community.

"The safety and health of Native women and children has always been a priority within Indigenous communities," said Esther Lucero (Diné), President and CEO of Seattle Indian Health Board. "We are grateful to Congresswoman Moore for her work to increase access to doulas, which will preserve Indigenous families and save lives."

"We applaud Congresswoman Moore and Senator Booker for championing access to midwives and doulas for Medicaid beneficiaries. Guaranteeing Medicaid coverage of midwives and doulas isn't merely a matter of health care policy, it's a profound affirmation of human rights. Every individual, regardless of socioeconomic status, deserves access to dignified and supportive pregnancy, birth, and postpartum care. Expanding access to midwives and doulas will help ensure that no person is left behind, upholding the fundamental right to quality healthcare for all," said Vandana Ranjan, Senior Federal Policy Adviser, Maternal Health, Center for Reproductive Rights.

"The Mamas First Legislation will provide critical services to help survivors of domestic and sexual violence more safely deliver healthy babies," said Esta Soler, President and Founder of Futures Without Violence. "Survivors of intimate partner violence often particularly benefit from trauma- informed birth support from trained doulas and midwives who can provide the layered care and support needed during their birthing experience. It is critical that coverage for these services be made accessible and available to help reduce racial disparities and improve birthing outcomes, especially for black and indigenous women."

Background

America is facing a maternal mortality crisis, with the highest maternal mortality rate among wealthy nations.[1] According to a study conducted by the Journal of the American Medical Association (JAMA), maternal mortality rates have doubled between the years of 1999 and 2019 while decreasing in other similar wealthy nations.[2] Black and Native mothers have maternal mortality rates that are two to three times the rate of white mothers. There is also a lack of access to maternity health care providers in communities across the country, also called maternity care deserts, impacting nearly 7 million women and nearly 500,000 births nationwide, according to the March of Dimes.

In Wisconsin, racial disparities are especially acute, with Black mothers dying at five times the rate of white mothers. According to the Centers for Disease Control (CDC) 4 out of 5 maternal deaths are preventable. Numerous studies show that access to doulas and midwives leads to improved outcomes for mothers and their babies, including increased rates of breastfeeding, healthier birth weights, and a lower likelihood for infant or maternal complications[3]. With more than 40 percent of births covered through Medicaid, the Mamas First Act will help save lives and reduce maternal health disparities by making these perinatal professionals more accessible to expectant women.

Read a summary of the Mamas First Act here.

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.

Endorsing Organizations

Black Mamas Matter Alliance (BMMA), March of Dimes, The Association of Maternal & Child Health Programs (AMCHP), National Birth Equity Collaborative, Common Sense Childbirth Inc., American College of Nurse Midwives (ACNM), Centers for Reproductive Rights, What to Expect Project, Futures Without Violence, Seattle Indian Health Board, African American Breastfeeding Network, Momsrising, and Ujima.

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