WE ARE IN a national maternal health crisis that is impacting families right here in Massachusetts. Despite being a bastion of medical care and biotech innovation, the rate of severe pregnancy complications has doubled statewide over the past 10 years, according to the Department of Public Health.
Current metrics often fail to capture the full scope of the problem, while discrepancies in reporting and data collection methods can lead to underreporting and misclassification, masking the true extent of maternal mortality. The ongoing controversy surrounding how maternal death rates are measured only heightens the need for comprehensive legislative action. The introduction of the Maternal Health Omnibus Bill (Momnibus) presents a pivotal opportunity to address maternal mortality and morbidity across the state, head-on.
Even one death is far too many. With the cited impact of structural racism compounding this crisis for Black birthing people, we must take every opportunity to reverse these dire outcomes that are preventable and ensure safe, healthy pregnancies and births.
The Massachusetts Legislature took action in January 2021, creating the Special Commission on Racial Inequities in Maternal Health, a 28-member body charged with studying the issue and making public policy recommendations. This interdisciplinary commission brought together health care professionals, public health experts, and members of the community with lived experience of a severe maternal injury or a maternal death in their family.
Most of the commissioners are Black women, one of the communities most impacted by our deficient maternal care system. Through painstaking hearings and a review of the best available evidence, the one-year commission generated a comprehensive blueprint for improving maternal care in Massachusetts, published in June 2022.
Two years later, the Legislature has yet to enact the commission’s recommendations, but the pending Momnibus bill would advance many of the highest priorities outlined in their report. It advances a multi-pronged solution, taking aim at inequities and barriers to optimal maternal care and patient autonomy.
In June of this year, the House passed H.4785, An Act Promoting Access to Midwifery Care and Out-of-Hospital Birth Options, which includes expanding access to midwives, birth centers, lactation consultants, paid pregnancy loss leave, and postpartum depression screenings. There is only a matter of days to get this bill over the finish line. It is currently pending in Senate Ways and Means, ready to be brought to the floor for a vote.
For too long families in Massachusetts have been denied access to midwives and birth centers, evidence-based solutions to improving maternal health. Some components of this bill such as midwife licensure have been in the pipeline for many years, while others have been crafted to respond to recent events, such as birth center closures and alarming maternal mental health complications.
In the absence of this legislation, Massachusetts remains in the bottom third of states for midwife integration, despite the benefits, including fewer infant deaths, fewer postpartum complications, fewer unnecessary C-sections, higher breastfeeding rates, and lower health care costs. Massachusetts now has an opportunity to close the gaps left by cascading closures of birth centers and hospital maternity units across the state, to ensure birth safety, equitable access to care, and bodily autonomy, and to reverse our worsening maternal health outcomes.
The Legislature must take urgent and immediate action to move forward on meaningful maternal health care reforms, guided by the recommendations of the commission, which was established by the Legislature and informed by the people most impacted by our deficient maternity care system.
We urge the Senate to pass the Maternal Health Omnibus Bill and leaders in both the House and Senate to shepherd the bill over the finish line, ensuring that the final version centers on racial and economic equity. Don’t let this report sit on the shelf. All families deserve safety, health, and joy when bringing new life into the world. It’s time for policymakers to act.
Ndidiamaka Amutah-Onukagha is the Julia A. Okoro Professor of Black Maternal Health at Tufts University, founder and director of the Center for Black Maternal Health and Reproductive, co-founder of Birth Equity and Justice Massachusetts, and a Commissioner on the Massachusetts Special Commission for Racial Inequities in Maternal Health. Jo-Anna Rorie is an associate professor at Boston University, advisor to Neighborhood Birth Center, co-founder of Birth Equity and Justice Massachusetts, and a commissioner on the Massachusetts Special Commission for Racial Inequities in Maternal Health Tiffany Vassell is author of “Preparation for a Hospital Birth,” manager of community engagement and communications at Neighborhood Birth Center, vice president of Bay State Birth Coalition, and member of the steering committee of Birth Equity and Justice Massachusetts.
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