Kilmer, Ciscomani Introduce Legislation to Expand Midwifery Care Coverage for U.S. Servicemembers and Their Families

August 16, 2024

Washington, DC - Today, U.S. Representatives Derek Kilmer (WA-06) and Juan Ciscomani (AZ-06) introduced the Maternal and Infant Delivery: Wellness, and Integration with Vital Expertise Support (MIDWIVES) for Servicemembers Act. This legislation would increase access to maternity care for servicemembers by extending TRICARE coverage to additional types of certified midwives through a 5-year pilot program.

Certified Midwives (CMs) and Certified Professional Midwives (CPMs) are licensed healthcare providers who specialize in maternity care and women's health, and are more likely to practice in birth centers and maternity care deserts. TRICARE already covers midwifery services provided by Certified Nurse Midwives, but not for CMs and CPMs. The legislation would provide more care options for servicemembers, and would provide the Department of Defense with the option to permanently expand coverage based on the success of the pilot program.

In Rep. Kilmer's district, the closure of Naval Hospital Bremerton's labor and delivery unit has left many pregnant servicemembers without access to close care, often requiring expectant mothers to travel a significant distance to the next available provider. This legislation will ensure that these servicemembers and their dependents would have readily available access to midwifery care in nearby medical treatment facilities and birth centers.

"If you serve this country, Congress should have your back and invest in you and your family," said Rep. Kilmer. "By expanding access to midwife care under TRICARE, this legislation makes significant strides in supporting servicemembers and their dependents who rely on accessible maternity healthcare. This would directly ensure that those affected by labor and delivery unit closures, like the one at Naval Hospital Bremerton, are covered by other available providers and are able to get the medical care they need when they need it."

"As our troops and military families selflessly serve our nation, it is our duty to take care of them and ensure they have access to the care they need," said Rep. Ciscomani. "While planning to welcome a new child to your family is an exciting time, serving in the military or having a spouse in uniform can pose additional difficulties for our mothers-to-be. I am proud to join Rep. Kilmer on a bipartisan effort to expand access to midwifery care to those enrolled in TRICARE so military mothers can receive the care they need."

This legislation was inspired by the William M. Thornberry National Defense Authorization Act for Fiscal Year 2021, "Extramedical Maternal Health Providers Demonstration Project " and Senator Cory Booker's (NJ) DOULA for Vet Act (S.2465), establishing a 5-year pilot expanding coverage of TRICARE to additional types of midwives who meet certain international training and education standards.

The MIDWIVES Act is supported by the American Association of Birth Centers (AABC), the National Association of Certified Professional Midwives (NACPM), the American College of Nurse-Midwives (AACN), and the True North Birth Center in Poulsbo, WA.

"NACPM is excited about the introduction of the MIDWIVES for Servicemembers Act, marking a pivotal step toward broadening access to credentialed midwifery care for military families," said National Association of Certified Professional Midwives Executive Director Cassaundra Jah, MSM, LM. "This legislation is vital in guaranteeing that all service members and their families receive the highest quality maternal care, no matter where they are stationed. By supporting this bill, we are one step closer to addressing disparities and improving maternal outcomes in the United States."

"The American College of Nurse-Midwives thanks members of Congress for recognizing the critical role midwives play in providing high-quality care to patients of all ages and backgrounds throughout the lifespan," saidAmerican College of Nurse-Midwives Chief Executive Officer Michelle Munroe. "We are especially grateful that the needs of members of our armed services will be addressed by increasing access to midwifery care with Tricare reimbursement for certified midwives. As a retired Colonel, I personally understand the value this gives to our military families."

"The American Association of Birth Centers is pleased to support the Midwives for Servicemembers Act," said American Association of Birth Centers President Aubre Brouillette Tompkins, CNM. "Expanding midwifery coverage to include certified professional midwives and certified midwives will dramatically increase access to midwifery-led birth center care. We applaud Rep. Kilmer's efforts to improve access to high-quality maternity care for our service members and their families."

"For 5 years, TRICARE allowed True North Birth Center, a CPM-only practice, to be in network due the unique "maternity desert" of Kitsap County. Since the loss of our Tricare contract in November of 2023, when it was decided an exception would no longer be made, we have seen a significant impact in lack of care options to service members in our community," saidAshley Jones, Executive Director of True North Birth Center & President of the Washington Association of Birth Centers, Chapter of American Association of Birth Centers. "In an already strained community, limiting care providers by revoking our contract has only made things worse. We are honored that Congressman Kilmer heard our story and is working so hard to bring this bill to light. This bill is a crucial step toward restoring access to the full spectrum of credentialed midwifery care for military families. This bill will finally open access to Certified Professional Midwives (and CMs) not only in Kitsap County, but across the nation which is vital in ensuring that all families, regardless of the type of midwife they choose, can receive the comprehensive, compassionate care they deserve."

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