WASHINGTON – Today ahead of Mother’s Day, Congresswoman Ayanna Pressley (MA-07), alongside Representatives Gwen Moore (W-04I), Lauren Underwood (IL-14), Alma Adams (NC-12) and Debbie Dingell (MI-06), and Senators Elizabeth Warren (D-MA) Cory Booker (D-NJ), and Bob Casey (D-PA) announced the re-introduction of the Mamas First Act, legislation that directly and meaningfully addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care. 

“Maternal health justice is racial justice. While we work to confront the Black maternal morbidity crisis in America, the Mamas First Actwould save lives by ensuring pregnancy-related care includes expansive and comprehensive health care coverage for doulas and midwifery services – including prenatal, delivery, and postpartum services,” said Congresswoman Ayanna Pressley, co-founder of the Black Maternal Health Caucus. “Comprehensive, culturally-congruent care should be a reality for all, not just some, and I am proud to reintroduce this vital legislation alongside Rep. Moore and my colleagues. Congress must pass this bill without delay.”

“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,” saidCongresswoman 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.”

“Good care and support from a doula or midwife can make the difference between a positive and healthy pregnancy outcome, and a devastating one. Every mom should be able to access this critically important care,” said Congresswoman Lauren Underwood, co-founder and co-chair of the Black Maternal Health Caucus.. “As Co-Founder and Co-Chair of the Black Maternal Health Caucus, I’m proud to join Congresswoman Gwen Moore to introduce the Mamas First Act, a bold step to address our country’s maternal mortality crisis by expanding Medicaid coverage to include doula and midwife care. Together, we can, and must, take decisive action to save lives and end disparities.”

“The quality of care a pregnant woman receives should not depend on the color of her skin, where she lives, or her ability to pay. Each childbirth is different, and women and their doctors should be empowered to decide what care is best. By providing access to adequate and proper maternal services, including doulas and midwives, we will help end the maternal mortality crisis in our country and ensure our children start their lives out healthy and strong,” said Congresswoman Debbie Dingell.

“The United States has a terrible track record when it comes to maternal mortality, and it’s costing women their lives,” said Senator Elizabeth Warren. “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 Cory Booker. “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.”

“Every mother deserves support and care before, during, and after birth,” said Senator Bob Casey. “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.”

America is facing a maternal mortality crisis, with the highest maternal mortality rate among wealthy 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 wealthy 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, according to the March of Dimes.

The Mamas First Act amends the Social Security Actto 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 C-sections, decrease maternal anxiety, and improve communication between pregnant women and their health care providers.
• Expanding access to these non-clinical and health care professionals will allow all communities to access these critical services, increase the focus on culturally competency, and patient-centered care while contributing to better health outcomes.

The Mamas First Act is endorsed by: Black Mamas Matter Alliance (BMMA), March of Dimes, The Association of Maternal & Child Health Programs (AMCHP), National Birth Equity Collaborative, Common Sense Childbirth Inc., American College of Nurse Midwives (ACNM), Centers for Reproductive Rights, What to Expect Project, Futures Without Violence, Seattle Indian Health Board, African American Breastfeeding Network, Momsrising, and Ujima.

“The African American Breastfeeding Network supports and fully endorses the Mammas First Act because it is essential that Wisconsin provides Medicaid reimbursement coverage so that doulas and birth workers can earn equitable pay without having to work multiple jobs,” said Dalvery Blackwell, Executive Director, Co-Founder of the African American Breastfeeding Network.

“Every mom deserves the respectful, responsive, nurturing and empowering care she needs to deliver a healthy beginning and a healthy future to herself and the baby she loves. Research shows that midwives and doulas deliver that care best – along with lower rates of complications, c-sections and epidurals, perinatal mood and anxiety disorders and birth trauma, higher rates of breastfeeding success…and lower healthcare costs. The Mamas First Act delivers that care where it’s needed most to the moms who need it most, by ensuring Medicaid coverage of doulas, midwives and tribal midwives. That’s why the What to Expect Project and I are proud to endorse this critical bill,” saidHeidi Murkoff, author of What to Expect When You’re Expecting and founder of the What to Expect Project.

“Across the country, African American, American Indian, and Alaskan Native mothers are dying at rates three to four times that of white mothers. In addition, we are seeing expanding maternity care deserts in cities and rural areas across the U.S. where seven million women live, and nearly 150,000 babies are being born, who have no or limited access to maternity care. Expanding access to care, by increasing access to doulas and midwives, is a key component to reversing these alarming trends. With 42% of pregnant women utilizing Medicaid for coverage, the Mamas First Act would take a major step in the right direction in getting pregnant women the access to care they need and ensure that their infants have the best start to life possible,” saidStacey Y. Brayboy, Sr. Vice President, Public Policy & Government Affairs.

“As a Mama, OB/Gyn and the Founder and President of the National Birth Equity Collaborative, I am so excited about the opportunity we have to improve birth outcomes for all by passing the Mamas First Act in 2024. As we look for solutions to ensure Black Mamas, babies and their villages thrive, Doula support must be covered by all State Medicaid Plans,” said Joia Crear Perry, MD, Founder & President of the National Birth Equity Collaborative. 

“BMMA applauds the continued efforts of Representative Gwen Moore and all the co-sponsors of the Mamas First Act as it will allow for Midwifery and Doula services to be reimbursable through Medicaid. Many states, especially in the southern region of the U.S., are in significant need of high-quality, holistic, and comprehensive maternity care. Passage of the Mamas First Act can help strengthen maternity care workforce efforts,” said Angela D. Aina, Executive Director, Black Mamas Matter Alliance, Inc (BMMA).

“Ujima celebrates Congresswoman Moore’s reintroduction of the Mama First Act and her continued fight to ensure equitable and comprehensive maternal health options for all. Doulas and Midwives not only provide expansive perinatal care, but also have proven to be a valuable asset to combat maternal mortality and morbidity. Medicaid coverage for these services removes barriers for parents, particularly the 65% of Black birthing people who rely on Medicaid for pregnancy and postpartum assistance. The Mama First Act demonstrates actionable steps toward disparate  maternal care. Ujima applauds Representative Moore, Senator Elizabeth Warren and all the co-sponsors for their commitment to holistic maternal care for women,” said Karma Cottman, CEO, Ujima, The National Center on Violence Against Women in the Black Community. 

As a founding member of the Black Maternal Health Caucus, Congresswoman Pressley has been a longtime champion of maternal health and reproductive justice.

• Throughout her time in Congress, Congresswoman Pressley has convened roundtable meetings with maternal health advocates and practitioners in the Massachusetts 7^th Congressional District.
• In October 2023, Rep. Pressley and Senator Cory Booker reintroducedthe MOMMIES Act to improve maternal health outcomes.
• In May 2023, Congresswoman Pressley and Congresswoman Gwen Moore (WI-04) introduced a resolution recognizing the role doulas play in providing culturally competent maternal health care, addressing racial inequities, and supporting healthier outcomes for mothers and their babies.
• In December 2022, the House passed Congresswoman Pressley’s amendment to strengthen maternal health care for people who are incarcerated.
• In September 2022, Rep. Pressley hosted HHS Secretary Xavier Becerra for a convening on their work to address the Black maternal health crisis and the criminalization of abortion care following the Dobbs decision.
• In November 2021, at a briefing held by the U.S. Commission on Civil Rights (USCCR), Congresswoman Pressley delivered testimony on the growing racial disparities in maternal health and the urgent need to combat the Black maternal mortality crisis. Her full testimony at the briefing is available here.
• In May 2021, she introduced the Healthy MOMMIES Act, to extend postpartum Medicaid coverage for pregnant people and expand coverage to include culturally competent and community based doula care.
• In March 2020, she first introduced the Justice for Incarcerated Moms Act, legislation to improve maternal health care and support for pregnant individuals who are incarcerated, as part of the Momnibus legislative package. 
• In 2019, she introduced The People’s Justice Guarantee ─ a comprehensive framework to transform the American criminal legal system into one that guarantees justice for all.  She also introduced the Healthy MOMMIES Act with Senator Cory Booker (D-NJ) to expand Medicaid coverage for new moms from 60-days postpartum to one year.

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