Comprehensive maternal health legislation expands physical and mental health care options for all pregnant women’

Boston - On August 23, 2024, Governor Maura Healey signed An Act promoting access to midwifery care and out-of-hospital birth options. This comprehensive legislation will overhaul maternal health practices in Massachusetts and expand coverage for midwifery, birth centers, doulas and screening and treatment for postpartum depression, among several other initiatives to save lives.    

“Massachusetts is home to the best health care, but there was work to be done to improve birth options and health equity for families across the state,” said Governor Healey. “These important expansions in the law will help make it both safer and easier to start and grow a family here in Massachusetts, while making sure that women can make the best health care decisions for themselves.”  

“Midwife services and doula services are essential family planning tools that should be guaranteed for everyone in Massachusetts,” said Lieutenant Governor Kim Driscoll. “At a time when this country faces a maternal health crisis, I am proud to stand alongside Governor Healey to sign these significant initiatives into law.” 

This legislation would require MassHealth to cover doula services for pregnant people up to 12 months postpartum while mandating insurance coverage for postpartum depression screenings for any member who recently became a parent or lost a pregnancy. MassHealth will also be required to cover midwifery services. This legislation establishes the Board of Registration in Midwifery within the Department of Public Health, a nine-member board appointed by the Governor, charged with establishing regulations to govern the practice of midwifery and overseeing the licensure of midwives.   

This legislation also creates a new grant program for non-profits or community-based health centers addressing mental health conditions, behavioral health conditions or substance use disorders for perinatal individuals. It will also establish a task force within the Executive Office of Health and Human Services to report on maternal health access and birthing patient safety.   

“These investments are part of our commitment across agencies to eliminate disparities in maternal health care that have led to worse outcomes in some communities and for people of color – especially Black birthing people,” said Health and Human Services Secretary Kate Walsh. “We are taking specific steps in designated communities to support the most disproportionately impacted residents and help provide much needed access to equitable perinatal and postpartum care.”

“Racism has a devastating impact in public health and health care and contributes to disparities in access to care and outcomes – including in maternal health,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “The Department will continue to take the necessary steps to close the gaps in maternal health care so that families can access the care and support they need for healthy pregnancies, healthy parents, and healthy babies.” 

This legislation will also direct DPH to regulate freestanding birth centers, create minimum staffing standards and encourage more centers. This legislation will also require DPH to create a new program to provide Universal postpartum home visiting services and mandate insurance covers these services. 

As part of the Healey-Driscoll administration’s commitment to supporting maternal health care, late last year the administration announced that MassHealth would cover doula services for members. Since then, MassHealth has surpassed its original goal of enrolling 50 doula providers by the end of June, with more than 120 doula providers from across Massachusetts having now signed onto the agency’s doula services program. Ensuring diversity in doula providers is an intentional effort to reach all MassHealth members, respect the differences in MassHealth demographics, and advance maternal health equity.   

"MassHealth is committed to ensuring families have the support they need,” said Assistant Secretary for MassHealth Mike Levine. “We will continue to grow our diverse doula network to ensure members can find the doula that is right for them.”   

"Expecting a child and being a parent is one of the most rewarding experiences in someone's lifetime," said Senate President Karen E. Spilka (D-Ashland). "By expanding access to physical and mental healthcare for expecting parents and new families, we are allowing people to focus more on the rewarding parts of being a parent, and less on the health concerns that too many residents face during their parentage journey. I'm thankful for the Governor's signature, Senator Friedman's leadership, the work of the conferees, and our partners in the House to get this across the finish line." 

“While the Commonwealth’s health care system is amongst the best in the world, inequities in maternal health remain prevalent, and certain aspects of care are woefully insufficient. That’s why the reforms included in this legislation are so important, as they will help to close racial inequities and improve birth outcomes statewide,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Governor Healey, my colleagues in the House, and our partners in the Senate for recognizing the need for action on this critical issue.” 

Statements of Support:

Representative Marjorie Decker (D-Cambridge), House Chair of the Joint Committee on Public Health and of the conference committee:

"This legislation is one of the most comprehensive maternal health packages to be signed into law nationwide. With the signing of this legislation today, Massachusetts is taking critical steps to address the maternal health crisis facing our Commonwealth by prioritizing ongoing maternal health needs of birthing families, particularly birthing people of color who often face worsened outcomes. This bill is centered on upholding our commitment to reproductive equity, birthing choice, and advancing racial and economic justice. I would like to thank Speaker Ron Mariano for his unwavering support and leadership, my fellow conferees, especially my Conference co-Chair, Senator Cindy Friedman, my Committee co-Chair, Senator Julian Cyr, Governor Maura Healey for prioritizing maternal health and signing this legislation into law, and most importantly, to all of the advocates, mothers, and fathers who shared their stories and helped shape this legislation. This bill will both save lives and bring joy to families in our Commonwealth."

Senator Cindy F. Friedman (D-Arlington), Senate Chair of the Joint Committee on Health Care Financing and of the conference committee:

“Once again Massachusetts is taking needed steps to expand coverage and protections for essential health services that are key to improving maternal and perinatal health outcomes, as well as increasing access to care for those whose needs and pain have often been ignored. I thank the Healey-Driscoll Administration for their partnership with the Legislature on this matter and for listening and responding to the physical and mental health needs of pregnant people and new parents across the Commonwealth.”

Senator Liz Miranda (D-Boston):

"Today, we celebrate not just the signing of a monumental bill, but the triumph of compassion and resilience. This legislation marks a significant step forward in Massachusetts for improved maternal and infant care, shaped by the voices of those who transformed their personal struggles into powerful advocacy. By creating pathways to licensure for midwives and lactation consultants, expanding mental health resources, and ensuring comprehensive support through MassHealth, we honor the strength of individuals who turned their pain into policy. Their courage has paved the way for a more inclusive and supportive system, particularly for our most vulnerable constituents and communities of color, who face disproportionate challenges and disparities in maternal health." 

Senator Julian Cyr (D-Truro), co-chair of the Joint Committee on Public Health:

"Massachusetts has some of the best health outcomes in the country, but we have a glaring and persistent disparity in maternal health outcomes, especially when it comes to the experience of Black mothers. The maternal health bill signed by Governor Healey will expand access to care for all mothers and ameliorate the maternal mortality and morbidity crisis here in Massachusetts. I am proud to stand behind so many brilliant women colleagues in advancing this vital legislation.” 

Senate Minority Leader Bruce Tarr (R-Gloucester):

“Massachusetts is a global leader in health care, and yet we have seen serious deficiencies develop in our state when it comes to maternal health care. They involve basic issues such as timely access to care and options for care. This bill takes important actions to improve the situation and sets the stage for even more action in the future.” 

House Minority Leader Bradley H. Jones, Jr. (R-North Reading):

“Massachusetts is renowned for its world-class hospitals and health care facilities, and this legislation builds on that legacy by prioritizing maternal health care needs and providing expanded childbirth options for the Commonwealth’s residents. In addition to creating a formal licensing process for certified professional midwives and lactation consultants, this legislation will offer expectant parents access to a wide range of services to ensure a successful pregnancy and childbirth, including universal postpartum home visits and postpartum depression screenings.”

Representative Kimberly Ferguson (R-Holden):

“I’m so pleased that the House and Senate were able to work together to come to an agreement on this bill, and that it has been signed into law.  This critical bill will expand access to non-hospital childbirth options for expectant parents in Massachusetts and establish a formal licensing process for certified professional midwives and lactation consultants. The maternal health care bill will also ensure that new mothers have access to postpartum depression screenings, universal postpartum home visiting services, and additional resources to help them maintain a healthy balance in their lives throughout their pregnancy and after they give birth.  I am proud to have served on the conference committee and to assist in seeing this through.  My sincere thanks to everyone who played a role in getting this legislation passed.” 

Senator Becca Rausch (D-Needham):

“I am so very happy, proud, and grateful that the midwives and maternal health bill is now law. In addition to joining the 38 other states that already license certified professional midwives, this single legislative package squarely addresses our maternal health crisis, honors patient choice in maternal care, improves patient outcomes, reduces inequities in maternal health care, lowers health care costs, enhances access to pediatric care, boosts post-pregnancy mental health care, and much more. With this reproductive justice legislation, we significantly uplift people deciding for themselves whether, when, and how to parent. Today is the culmination of years of work by so many advocates, experts, and lawmakers, to save and improve lives as we reaffirm that Massachusetts values women’s health and choice.” 

Representative Manny Cruz (D-Salem):

"I want to express my gratitude to Speaker Mariano for putting forward a comprehensive maternal health package that will significantly improve healthcare for patients and providers across Massachusetts. By expanding access to midwifery care, birthing centers, and other maternal health options for families, the House, is tackling the systematic inequities that disproportionately negatively impact low income, and BIPOC communities". Said State Representative Manny Cruz. "Both of my children, and our family had the privilege of being care for by midwives at the North Shore Birthing Center and at Salem Hospital. This legislation includes critical protections for birthing centers that will ensure they can both remain open and scale up, and this becomes an option for all families and patients. I am thrilled to see Governor Healey signing this necessary bill into law". 

Senator Patrick O’Connor (R-Weymouth):

“I am optimistic that this groundbreaking legislation will be a step in the right direction toward addressing the disparities in maternal healthcare. Strengthening access to physical and mental health in Massachusetts will provide a more inclusive support system that keeps parents and children healthy as they embark on their new journey. Every single family in our Commonwealth deserves high quality care and support system. Not only are we taking protective measures regarding the health of new families, but we are also laying a solid foundation for future generations. I want to thank my fellow conferees, bill sponsors, and advocates for their dedication and hard work in getting this bill passed.”

Representative Lindsay Sabadosa (D-Northampton):

"Six years ago, I was honored to join an incredible group of legislators to work on legislation to ensure access to doula care in Massachusetts. When the bill was first filed, we were often told that it was an impossible mountain to climb. Yet each year, through conversation and hard work, including incredible collaboration with colleagues, the administration, and advocates, consensus grew and what had been impossible, became possible. So many parts of this legislation experienced that same journey. Whether licensing midwives, improving birth center regulations, or bringing pregnancy loss out of the shadows - and making it a qualifying event for earned sick time - this bill represents hundreds of thousands of hours of work toward the common goal of improving maternal health and ensuring that this is the best state in the country in which to start a family."

Representative Carole Fiola (D- Bristol):

“Today marks a monumental step in improving maternal health, I am especially proud that we have expanded access to postpartum depression screening that will identify issues before this treatable condition leads to devastating outcomes. We've heard from mothers who have suffered alone, but will now have medical professionals who will not only identify this very prevalent mental health concern, but also provide support and resources for them. Postpartum depression is vastly underdiagnosed, but this expanded screening coverage will significantly improve treatment access and improve maternal health outcomes.”

Representative Christopher Worrell (D-Boston):

“Today, Massachusetts has taken significant steps to confront racial health disparities and create policy that will save the lives of women and children. Being there to watch the Governor sign it into law is very emotional, because this issue is deeply personal to me and my family.”

Representative Kay Khan (D-Middlesex):

"Today, I feel proud to stand with my colleagues in recognition of the autonomy of all birthing people to make important decisions about where they give birth – whether in a hospital, at home, or in a birthing center – and ensure that all parents feel strong, empowered, and in charge of their health at such a formative time in their lives. In passing this historic maternal health package, we have further elevated the midwifery model of care and moved mountains toward addressing the needs of all birthing people in the Commonwealth, regardless of their race, ethnicity, or socioeconomic status. I am deeply grateful to the unwavering commitment of the Speaker, Chair Aaron Michlewitz, Chair Marjorie Decker, Chair Julian Cyrs, Chair John Lawn, as well as my determined co-leads: Rep. Brandy Fluker Oakley, Sen. Liz Miranda, and Sen. Becca Rausch. Uplifting the midwifery care model in the Commonwealth has been an uphill battle spanning several decades and could not have been achieved without the voices of countless community advocates, self-advocates, and midwifery experts. "

Emily Anesta, President, Bay State Birth Coalition:

"Midwives save lives, and we are thrilled that Governor Healey has signed this life-saving bill today. Massachusetts has long been a leader in health care and reproductive freedom, and this legislation advances both. Licensing certified professional midwives and making their care accessible through MassHealth is a critical and evidence-based approach to improving our maternal care system. We look forward to seeing more birth centers open in communities across the state, greater access to midwifery care in all settings, and expanded supports for families throughout pregnancy, birth, and postpartum. We applaud this huge step forward in ensuring healthy births and thriving families!"

Rebecca Hart Holder, President, Reproductive Equity Now:

“We are so proud that the commonwealth is taking decisive and bold action to address the maternal health crisis, eliminate racial inequities in birthing outcomes, and integrate midwives into our maternal health care infrastructure. With Governor Healey’s signature today, Massachusetts is making its values clear: we will continue to stand up for reproductive equity, center birthing people, and ensure that every person has the ability to start or grow their family with autonomy and dignity. We’re grateful to Governor Healey for signing this critical bill into law, and we look forward to turning the corner in the fight for maternal health equity in Massachusetts.”

Katherine Rushfirth, Midwife and Policy Director, Neighborhood Birth Center:

"I cannot overstate the positive impact this legislation will have on Neighborhood Birth Center as we work to open Boston's first freestanding birth center.  From expanding the midwife pool that we can hire, to improving the regulations under which we operate, to fair reimbursement that is central to our financial sustainability.  It's the beginning of a time in Massachusetts where birth centers, especially those led by and anchored in communities of color, can open and thrive."

Yaminah Romulus and Jallicia Jolly, co-chairs Birth Equity & Justice Massachusetts:

“We thank the Healey-Driscoll Administration and the Legislature for their commitment to expanding critical access to maternal health care services. This landmark legislation, a culmination of decades of collective efforts, will significantly improve the lives of birthing people and their families. We applaud the efforts that have brought us to this point, as they reassure us that the future of healthcare and birth justice in the Commonwealth is bright and promising.”