May 09, 2024

Ahead of Mother’s Day, Warren and Lawmakers Reintroduce Mamas First Act to Combat Maternal Health Crisis

Bill Text (PDF) 

Washington, D.C. — Today, U.S. Senators Elizabeth Warren (D-Mass.), Cory Booker (D-N.J), and Bob Casey (D-Pa); along with U.S. Representatives Gwen Moore (D-Wis.), Ayanna Pressley (D-Mass.), Lauren Underwood (D-Ill.), Alma Adams (D-N.C.), and Debbie Dingell (D-Mich.), reintroduced the Mamas First Act, legislation that would address the maternal mortality crisis by expanding Medicaid to include doula and midwifery care. America has the highest maternal mortality rate among wealthy nations, with Black, Brown, and indigenous women disproportionately impacted.

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

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

The Mamas First Act would: 

  • Amend the Social Security Act to allow doulas, midwives, and tribal midwives to be reimbursed by Medicaid. 

  • 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.

  • Expand access to care and increase the focus on cultural-competency, and patient-centered care while contributing to better health outcomes.

The bill is also cosponsored by Senator Padilla (D-Calif.), Duckworth (D-Ill.), Sanders (D-Vt.), Heinrich (N.M.), and Blumenthal (D-Ct.).

It 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,” said Heidi 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,” said Stacey 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).

Senator Warren has consistently fought to lower maternal mortality rates and tackle racial disparities in maternal health outcomes. 

  • In May 2023, Senator Warren, Representatives Pressley and Lee reintroduced the Anti-Racism in Public Health Act.

  • In December 2022, Senator Warren, Representative Underwood, lawmakers reintroduced Maternal Health Pandemic Response Act to combat maternal mortality and prepare for the next pandemic.

  • In July 2022, Senators Warren, Markey and Representative Seth Moulton fought to save the North Shore Birth Center.

  • In February 2021, Senator Warren cosponsored Senator Booker and Representative Underwood's Black Maternal Health Momnibus Act of 2021, a series of 12 bills to save moms’ lives and end racial and ethnic disparities in maternal health outcomes.

  • In April 2020, Senator Warren and Patty Murray (D-Wash.) released a GAO report underscoring the need to address the maternal mortality crisis. 

  • In August 2020, Senator Warren and Representative Underwood introduced the Maternal Health Pandemic Response Act to improve research and data collection, safeguard the health of pregnant and postpartum individuals, and dedicate resources to combat the maternal mortality and morbidity crisis during the COVID-19 pandemic. 

  • In February 2021, Senator Warren and Representative Underwood led their colleagues in sending a letter to Senate and House leadership urging the inclusion of provisions of the Maternal Health Pandemic Response Act in an upcoming COVID-19 relief package.  

  • Senator Warren is also a co-sponsor of Senator Booker's Black Maternal Health Week Resolution, Senators Jeff Merkley (D-Ore.) and Bill Cassidy’s (R-La.) Maternal and Child Health Stillbirth Prevention Act, Senator Booker’s MOMMIES Act, and Senator Richard Durbin's (D-Ill.) Mothers and Offspring Mortality and Morbidity Awareness (MOMMA) Act.

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