Casey to introduce bill that would expand Medicaid maternity care to include doulas, midwives • Pennsylvania Capital-Star

Pennsylvania U.S. Senator Bob Casey will introduce the “Mamas First Act” on Thursday to require Medicaid coverage for prenatal, birth and postpartum care by doulas, midwives and tribal midwives.

The federal legislation follows the passage of a similar bill that passed the Pennsylvania House of Representatives to cover doula services for pregnant women and new mothers here.

Both bills aim to help address the racial and ethnic disparity in maternal mortality rates among women in the United States.

According to a draft of Casey’s bill, the Centers for Disease Control and Prevention finds that the maternal mortality rate of 69.9 deaths per 100,000 live births for black women is nearly three times higher than that for black women. White women. Deaths among American Indian and Alaska Native women amount to approximately 49 per 100,000 live births, while there are 28 deaths per 100,000 live births among Hispanic women.

“While maternal mortality unequally affects Black and Indigenous women, this urgent public health crisis cuts across race, ethnicity, socioeconomic status, educational attainment, and geography,” the bill says. Casey.

About 80% of these deaths are preventable, Casey’s bill says, but U.S. maternal mortality rates are the highest in the developed world and are rising rapidly. In Pennsylvania, a report this year from the newly formed Maternal Mortality Review Committee showed that 107 Pennsylvania women died in 2020 during pregnancy or within a year after giving birth.

Doulas are trained non-medical professionals who provide emotional, informational, and physical support before, during, and after pregnancy and childbirth, such as assisting with breastfeeding and breathing techniques during childbirth.

According to the NIH, mothers who have the help of a doula are four times less likely to have a low birth weight baby, two times less likely to have a birth complication with their baby or themselves, and significantly more likelihood of starting to breastfeed.

A midwife is a trained medical professional who provides care to healthy mothers during pregnancy, childbirth, and after childbirth. Midwives deliver babies at home, in birthing centers, and in hospitals.

A tribal midwife is a person recognized by an Indian tribe to practice midwifery for that tribe, Casey’s bill says.

Midwife-led care is correlated with cost savings, lower intervention rates, lower cesarean section rates, lower preterm birth rates, and healthier outcomes for mothers and babies, according to Casey’s bill.

Pennsylvania House Bill 1608 is part of a package of Black maternal health legislation, dubbed “Momnibus” by supporters, that also includes a requirement that Medicaid cover blood pressure monitors for pregnant women and new moms.

Both state House bills will now move to the Republican-controlled state Senate for consideration, where last year Sen. Judith Schwank (D-Berks) introduced a similar bill to require Medicaid reimbursement to doulas. It has not yet been considered since it was referred to the Senate Health and Human Services Committee in January 2023.

Other bills in the Momnibus package call for investments in maternal health care, maternal mental health, eliminating implicit bias in maternal health care, and providing new parents with supplies to care for newborns.