Sen. Liz Miranda recalled a colleague asking her why she was speaking so much about Black women when she was working on a major maternal health reform bill a few years ago.
“I was like one, news flash, I’m Black,” Miranda said Tuesday to a room full of laughs and a few baby cries. “Two, there’s a crisis – news flash number two.”
While a sweeping maternal health care bill from 2024 aims to make progress, racial disparities in maternal health remain stark. In 2023, Black women had a rate of maternal mortality that was approximately 3.5 times higher when compared with white women in the U.S., according to a U.S. Centers for Disease Control and Prevention report released in February.
“We pride ourselves in being this leader, right? And yet we know that too many families and too many Black women and women of color continue to experience these inequitable outcomes,” Miranda said. “The reality is actually truly unacceptable.”
Advocates for birth centers and midwives say the services are proven to improve maternal health outcomes. Meanwhile, the state’s only birthing center is at risk of closing, mainly as a result of lagging reimbursement rates that are also slowing the progress of new centers opening.
Those backing birth centers and midwives say increased state funding and bills pending on Beacon Hill could help open more birth centers and close racial gaps.
Among their budget requests are maintaining funding for the Perinatal Mental Health Trust Fund, which was established in the 2024 maternal health law and supports culturally coordinated and community-based support to boost mental health and well-being of new parents. Also, they are asking for investments in the midwifery workforce to boost training and education, enable student loan forgiveness for midwives and diversify the midwifery workforce to boost health equity and economic opportunities.
Massachusetts has just one Black community midwife, out of approximately 30 to 40 statewide, said Nashira Baril, who is planning to open Neighborhood Birth Center in Roxbury in 2027.
“That is a really significant disparity in who has access to that level of education,” Baril said Tuesday.
Another bill (S 784 / H 5016) that advocates say could help would ensure that licensed certified professional midwives or certified nurse midwives are paid no less than physicians and hospitals for delivering the same services. A redrafted version of the Senate bill cleared the Senate side of the Committee on Health Care Financing 6-0 with Sen. Kelly Dooner declining to vote yes or no. It is now pending in Senate Ways and Means. A redrafted version of the House bill cleared the chamber’s side of the Committee on Financial Services 11-0 and is currently pending in the Health Care Financing Committee.
Another bill (S 697 / H 4334) requires midwives to get paid equally as licensed physicians offering the same services. Also, insurers could not reduce payments to physicians to meet this requirement. The Senate version cleared its side of the Committee on Health Care Financing 6-0 with Dooner opting out of voting yes or no. The Senate bill is now pending in Senate Ways and Means. A redrafted version of the House bill cleared the chamber’s Financial Services committee 11-0 and is now in front of the Committee on Health Care Financing, which has until June 15 to report on it.
“Every midwife should be getting paid the full value to deliver a baby,” Rep. Marjorie Decker of Cambridge, an original sponsor of both House bills, said this week.
She noted that when employees are paid more, there are more opportunities, which can lead to more diversity within the workforce. Then, the state “will start seeing a diversity of people who can actually meet the needs of the diversity of people who actually are giving birth and wanting to get pregnant,” Decker said.
She told the News Service there is “incredible momentum” surrounding the issue from colleagues in the State House and among advocates.
The House’s fiscal 2027 budget proposal unveiled Wednesday included no maternal health funding, according to House Ways and Means staff. They indicated there are ongoing talks about funding for maternal health in another legislative vessel.
Pressed for more information about this, House Speaker Ron Mariano told reporters, “Obviously there’s a couple of things in committee I think that are being considered right now.”
“You want the details, I didn’t commit them to memory, but there are two bills we know of,” Mariano added when asked specifically what committees were considering.
Rep. Aaron Michelwitz, chairman of the House Ways and Means committee, added those vehicles are something representatives will “certainly look at going forward.”
Decker and Rep. Manny Cruz, who is also an original sponsor of H 5016, signaled Tuesday that they would consider filing budget amendments related to the midwife and birthing center advocates’ requests.
Katie Castellani is a reporter for State House News Service and State Affairs Pro reach her at kcastellani@statehousenews.com.
