By Erin Butts

At the end of August, Governor Maura Healey fulfilled one of her top priorities: addressing maternal health in the Commonwealth. On Friday, August 23rd, HB4999 (An Act promoting access to midwifery care and out-of-hospital birth options) was signed into law. This law overhauls practices related to midwifery, birthing centers, and postpartum depression treatment  to address worsening maternal health outcomes that are disproportionately impacting pregnant people of color.

Although it was not passed during formal session, the House and Senate were ultimately able to reconcile differences get the bill on the Governor’s desk. Instrumental in this process was Senator Liz Miranda. She has been a legislative leader in the fight for maternal health equity, and she stood beside Governor Healey when the bill was signed.

HB4999 impacts nearly every player in the Massachusetts healthcare landscape. Insurers will have new coverage requirements, patients will have access to new care options, and providers will see relief through the expansion of midwifery services, as well as a grant program to address patient mental health as it relates to pregnancy.

Insurers, including MassHealth, will be required to provide coverage for post-pregnancy depression screenings, medically necessary pasteurized donor human milk or related products, and universal postpartum home visiting services. Beyond that, MassHealth will cover noninvasive DNA prenatal screening, doula services for pregnant and postpartum individuals and adoptive parents of infants, and midwifery services, including prenatal care, childbirth, and postpartum care provided by a licensed certified nurse midwife.

For providers, there will be a new grant program to help establish or expand initiatives that address mental health, behavioral health, or substance use disorders for pregnant and postpartum individuals, with a focus on medically underserved populations.

The program will give preference to community-based organizations, particularly those who operate in areas with high rates of adverse perinatal health outcomes or significant disparities in perinatal health outcomes. It also establishes a 9-member Board of Registration in Midwifery within the Department of Public Health (DPH) to develop regulations for the practice of midwifery.

A final key feature of this bill is accountability and oversight, with a focus on research. It creates a task force on maternal health access and birthing patient safety. This will include review of past closures of inpatient maternity units and birthing centers, as well as an analysis of closures of community-based and preventative maternal health care services.

Additionally, DPH has been directed to conduct an in-depth fetal and infant mortality review. This review hopes to identify social, economic and systems factors, and develop educational programs and collect data concerning pregnancy loss, perinatal health care, and postnatal health care. This will include a statewide system of universal postpartum home visiting services.

While extensive, this is just one piece of the Legislature’s approach to healthcare regulation and support from this past session. We will continue to monitor other bills that address pharmaceuticals, hospital oversight, and more, and look forward to what will be introduced in the new year.