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The Mamas First Act would expand Medicaid to cover doula care and midwifery

Washington, D.C. - Today, U.S. Senators Bob Casey (D-PA), Elizabeth Warren (D-MA), and Cory Booker (D-NJ) introduced the Mamas First Act, legislation that directly and meaningfully addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care. A House companion bill was also introduced today by Representatives Gwen Moore (D-WI), Ayanna Pressley (D-MA), Lauren Underwood (D-IL), Alma Adam (D-NC), and Debbie Dingell (D-NC).

“Every mother deserves support and care before, during, and after birth,” said Senator Bob Casey (D-PA). “This legislation will help address the maternal health crisis in this country by ensuring that Medicaid covers the full spectrum of care that mothers and infants need.”

“The United States has a terrible track record when it comes to maternal mortality, and it’s costing women their lives,” said Senator Warren (D-MA). “Now is the time to use all available tools to combat the maternal health crisis, including by expanding Medicaid to cover access to doulas, midwives, and tribal midwives. The Mama’s First Act will take care of our mommas and babies, and will help us root out the deep disparities and systemic racism in our health care system.”

“Expanding Medicaid to include doula and midwifery care is imperative to combating the maternal mortality crisis disproportionately impacting Black and indigenous mothers,” said Senator Booker (D-NJ). “Doula-assisted mothers are less likely to experience complications at birth, and midwife-led care is associated with healthier outcomes for mothers and their babies. All mothers deserve support and care throughout their pregnancy and postpartum journeys, and this legislation is a critical step toward ensuring more equitable access to quality maternal health care.”

“America’s ongoing maternal health crisis magnifies the need for federal interventions that can save lives. The Mamas First Act is an important effort because it will expand access to providers who can offer emotional and physical support during and after the birthing process – comprehensive beyond the hospital setting where nearly all U.S. births occur. Our legislation is an opportunity to empower more mothers with doulas and midwives – perinatal professionals who advocate for a mother’s needs. I am thrilled to join my amazing House and Senate maternal health champions in re-introducing this vital legislation,” said Congresswoman Gwen Moore.

“As we’re seeing today at the state level in North Carolina, Medicaid expansion continues to improve outcomes for mothers, babies, and all Americans,” said Congresswoman Alma S. Adams, Ph.D., co-founder and co-chair of the Black Maternal Health Caucus. “That’s why I’m proud to support the reintroduction of Congresswoman Moore’s Mamas First Act. Maternal mortality remains significantly higher in the United States than in other comparable countries, especially for Black mothers. This legislation addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care, because having trusted partners in the birthing process saves lives. Mothers are less than half of the population, but we give birth to 100% of it - Congress needs to put Mamas First because our Mamas can’t wait.”

America is facing a maternal mortality crisis, with the highest maternal mortality rate among similar nations. According to a study conducted by the Journal of the American Medical Association (JAMA), maternal mortality rates have doubled between the years of 1999 and 2019 while decreasing in other similar nations. Black and Native mothers have maternal mortality rates that are two to three times the rate of white mothers. There is also a lack of access to maternity health care providers in communities across the country, also called maternity care deserts, impacting nearly 7 million women and nearly 500,000 births nationwide.

The Mamas First Act amends the Social Security Act to allow doulas, midwives, and tribal midwives to be reimbursed by Medicaid.

  • Allowing Medicaid reimbursement for doula care and midwife access would significantly improve health outcomes for mothers and babies.
  • This legislation would improve access to care before, during, and after pregnancy to under-served and under-resourced communities as both doulas and midwives have been proven to reduce the rates of C-sections, decrease maternal anxiety, and improve communication between pregnant women and their health care providers.
  • Expanding access to these health care professionals will allow all communities to access these critical services, increase the focus on culturally competency, and patient-centered care while improving  health outcomes.

Senator Casey has a long record of leading the fight for maternal health. Casey spent more than a decade fighting to pass the Pregnant Workers Fairness Act. The law was finally passed into law in 2022, and went into effect in the summer of 2023. In 2023, he secured almost $1 million in federal funding for a pilot workforce development program in Delaware County to train perinatal community health care workers and doulas to slash racial disparities in maternal and infant health outcomes.