Mamas First Act would expand Medicaid coverage to include prenatal, delivery, and postpartum care provided by doulas, midwives, tribal midwives, and lactation support providers

America has highest maternal mortality rate among wealthy nations, with Black, Brown, and indigenous women disproportionately impacted

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WASHINGTON – Today, Congresswoman Ayanna Pressley (MA-07), alongside Senators Elizabeth Warren (D-Mass.) and Cory Booker (D-N.J.) and Representatives Gwen Moore (D-Wis.), Debbie Dingell (D-Mich.), Alma Adams (D-N.C.), and Lauren Underwood (D-Ill.) led colleagues in reintroducing the Mamas First Act, legislation that would address the maternal mortality crisis by expanding Medicaid coverage to include prenatal, delivery, and postpartum care provided by doulas, midwives, tribal midwives, and lactation support providers. These services have been proven to reduce C-sections, decrease maternal anxiety, and improve communication between pregnant women and their health care providers.

“It is incumbent upon us all to treat mothers with the dignity, respect, and care that they deserve—and that means tackling the maternal morbidity crisis head on, especially for Black communities who feel the disproportionate impact of this crisis,” said Representative Pressley. “Our Mamas First Act would save lives and improve the quality of care by expanding coverage for doula and midwifery care. I’m proud to co-lead this legislation with my colleagues to put an end to the maternal morbidity crisis and protect mothers now.”

“Instead of slashing health care for millions of Americans like Republicans in Congress are hellbent on doing, we should be expanding access to care to protect every momma and baby,” said Senator Warren. “It’s unthinkable that the richest country in the world would also have one of the highest maternal mortality rates. The Mamas First Act will help fix this crisis by improving access to high-quality care and rooting out the deep disparities and systemic racism in our health care system.”

“The Mamas First Act meets a crisis that is costing mothers their lives—especially Black and Indigenous women who walk into delivery rooms carrying risks no family should bear,” said Senator Booker. “By ensuring Medicaid reimburses doulas, midwives, tribal midwives, and lactation support professionals, this bill delivers the trusted care that keeps mothers safe and babies alive. Congress must act now.”

“Across this nation, 40 percent of moms depend on Medicaid when they give birth. Instead of gutting Medicaid, we need to strengthen it so we can save lives. The Mamas First Act would provide mothers with access to evidence-based supportive care that can lead to healthier outcomes for them and their babies,” said Representative Moore. “At a time when stark disparities in maternal mortality continue to hit our communities hard, I am thrilled to have such incredible colleagues and advocates supporting the Mamas First Act and the ongoing fight to save lives.”

“The quality of care a pregnant woman receives should not depend on the color of her skin, where she lives, or her income. 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 Representative Dingell.

“Support from care workers like doulas and midwives 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 Representative Lauren Underwood. “As Co-Founder and Co-Chair of the Black Maternal Health Caucus, I’m proud to join my colleagues and introduce the Mamas First Act, a bold step to address our country’s maternal mortality crisis by expanding Medicaid coverage to include doula, midwife, and lactation care. Together, we can, and must, take decisive action to save lives and end disparities.”

“Every mother deserves the care and support needed for a healthy pregnancy and safe delivery,” said Representative Adams, Co-Founder and Co-Chair of the Black Maternal Health Caucus. “That is why I am proud to support the reintroduction of the Mamas First Act. Research shows that doula and midwife care can improve maternal health outcomes and reduce pregnancy-related complications. Yet the United States continues to face an unacceptable maternal mortality crisis, and Black women are nearly three times more likely to die from pregnancy-related causes than women of other racial and ethnic groups. Moms can’t wait, and neither should Congress. We must expand access to high-quality maternal care and ensure every mother has the opportunity to thrive before, during, and after pregnancy.”

The Mamas First Act would:

• Amend the Social Security Act to allow doulas, midwives, tribal midwives, and lactation support providers to be reimbursed by Medicaid. 
• Improve access to care before, during, and after delivery for underserved and under-resourced communities.
• Increase the focus on culturally competent and patient-centered care to facilitate better health outcomes.

The bill is cosponsored by Senators Alex Padilla (D-Calif.), Bernie Sanders (I-Vt.), Martin Heinrich (D-N.M.), Richard Blumenthal (D-Conn.), and Tammy Duckworth (D-Ill.).

The bill is cosponsored by Representatives Eleanor Holmes Norton (D-D.C.), Ted Lieu (D-Calif.), Al Green (D-Texas), Adelita Grijalva (D-Ariz.), and Jan Schakowsky (D-Ill.).

This bill is endorsed by Ujima, The National Center on Violence Against Women in the Black Community, the Academy of Lactation Policy and Practice, the National Health Law Program, HealthConnect One, BMMA Inc. (Black Mamas Matter Alliance, Incorporated), Futures Without Violence, Every Mother Counts, the American Association of Birth Centers, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, the National Partnership for Women and Families, Birth Center Equity, Families USA, and the What to Expect Project.

“The Mamas First Act will help address our country’s devastating maternal health crisis, which is causing vast, disproportionate harm to Black and Indigenous mothers and newborns, by ensuring that Medicaid reimburses doulas, midwives, and other birthing care workers for the vitally important care they provide,” said Esta Soler, president and founder of Futures Without Violence. “We thank Senator Warren and Representative Moore for championing this legislation, which will ensure these critical providers can continue providing quality care to the millions of people who rely on Medicaid for coverage. We urge leaders in both the House and Senate to prioritize its passage.”

“The Mamas First Act recognizes a simple but important truth: better support leads to better outcomes for mothers and babies,” said Anthony Wright, Executive Director of Families USA. “By expanding access to trusted community-based providers, including doulas, midwives, tribal midwives, and lactation support professionals, this legislation will help ensure that more families receive the high-quality, culturally congruent care they deserve during a time of immense change, vulnerability and excitement. Families USA is proud to endorse it.”

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 May 2026, Rep. Pressley, alongside Senator Patty Murray (D-WA) and Senator Tammy Duckworth (D-IL), reintroduced the Reproductive Health Care Accessibility Act, legislation to help people with disabilities—who face discrimination and extra barriers when seeking care—get better access to reproductive health care and the informed care they need to control their own reproductive lives.
• In May 2025, Rep. Pressley, alongside Congressman Zach Nunn (IA-03), and Congresswoman Lauren Underwood (IL-14), reintroduced legislation to address rising maternal mortality rates by increasing access to comprehensive care for pregnant women on Medicaid. The Harnessing Effective and Appropriate Long-Term Health for Moms on Medicaid (HEALTH for MOM) Act would support state-led efforts to coordinate maternity care through maternal health homes.
• In May 2024, Rep. Pressley (MA-07) and Senators Tammy Duckworth (D-IL) and Patty Murray (D-WA), in partnership with disability justice and reproductive justice advocates, unveiled a bicameral resolution calling for equitable access to reproductive and sexual healthcare for people with disabilities, and designating a day in May as “Disability Reproductive Equity Day.”
• In May 2024, Rep. Pressley 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.
• In May 2024, Rep. Pressley marked Mother’s Day with a powerful speech on the House floor in which she called for meaningful policy change to better support mothers and caregivers, including maternal health justice, affordable childcare, universal paid leave, reproductive freedom, home and community-based services, and more.
• 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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