Gov.
Maura Healey signs a bill expanding access to midwives, doulas and
postpartum mental health in state at a ceremonial event, Aug. 26.
Supporters of the new law said the legislation will help support the
expansion of out-of-hospital births at home or in birth centers, which
they hope will help reduce maternal health disparities.
(above) Four birth
suites will open to a large porch with seating and access to a private
“labor garden.” (below) One of 4 luxurious birth suites with privacy, a
spacious bathroom, access to the garden, and a large birthing tub.
New bill to provide access to care and jobs at center
Five minutes down the road from Nubian Square, a little parcel of land is in the works to become a place for community members to have a different experience when giving birth.
The pending Neighborhood Birth Center, planned to be built at 14 Winthrop St., will bring access to birth-focused health care outside of a hospital.
Tiffany Vassell, manager of community engagement and communications at Neighborhood Birth Center, has big hopes for the space, which will be a “spa-like” center, according to its website, that includes green space and hosts education and support alongside birthing suites.
“We want folks to feel like they belong,” Vassell said.
The potential for the Neighborhood Birth Center and the array of services it plans to offer — Vassell said they hope to provide access to not only midwives and clinicians, but also mental health professionals and lactation consultants — is bolstered by expanded state support for out-of-hospital birth options.
The Massachusetts Department of Public Health on Oct. 4 announced a $1 million grant going to
Neighborhood Birth Center and two other midwifery organizations in the
state. And new legislation passed this summer creates a pathway to
licensure for certified professional midwives, or CPMs — health care
providers who provide care before, during and after pregnancy — and
requires MassHealth to cover reimbursement for their services. Those
changes, Vassell said, will be important for extending this sort of care
to more people at the Roxbury birth center and in other settings across
the state.
“We want
to make CPMs and the care that they provide, whether at home or birth
centers, as accessible as possible for folks who really want that type
of care,” Vassell said.
Emily
Anesta, president of the Bay State Birth Coalition, said she’s seen a
desire for expanded access to the kinds of at-home and birth-center care
the bill provides.
“This is something that a lot of families and birthing people have said that they want and have been asking for,” she said.
The
bill takes a stab at a number of efforts around maternal health, with
no small focus going toward expanding access to out-of-hospital birth
options.
Under the
legislation, Massachusetts becomes the 39th state to create a way for
certified professional midwives to become licensed. It creates a Board
of Registration in Midwifery within the state’s Department of Public
Health and requires MassHealth to cover the services of midwives, as
well as screenings for postpartum depression and access to doulas —
nonmedical professionals who provide support for the person giving birth
and their family throughout the pregnancy.
It also establishes a task force to monitor and report on maternal health access and birthing patient safety.
Better
access to maternal care might help reduce negative health impacts or
death from pregnancy and birth. Supporters of the legislation say that
the increased access will be especially impactful in communities of
color.
A 2023 report
on maternal and infant health from the Boston Public Health Commission
found that Black infants in Boston were more likely to be born at lower
birthweights and were more likely to be born preterm. In 2021, Boston’s
infant mortality rate for Black infants was over three times the
mortality rate for white infants.
Research
has shown that care from midwives can lead to fewer cases of infant
mortality and severe injury, reduced need for cesarean sections and
fewer premature births.
For
birth center patients with complications, hospitals and their doctors
will serve as a second line of support. Vassell said Neighborhood Birth
Center plans to have a transfer agreement with nearby Boston Medical
Center.
Anesta noted
that a big part of the improvement in care will simply come from a
midwifery care process that tends to be longer, giving patients more
time to have their desires and needs be heard.
“There’s
nothing inherent about the color of people’s skin that needs to result
in worse pregnancy and birth outcomes,” Anesta said. “To
really address the racism and the structural barriers to receiving the
best quality care and for people to really be listened to, there’s a lot
of components in the bill that really get at that.”
It’s one of the reasons Vassell is excited about the Neighborhood Birth Center opening in a predominantly Black neighborhood.
“We’re
so excited about it; the community is excited about it,” she said.
“Roxbury is just such a powerful place for Black and brown folks, and it
just feels so right to center Roxbury as we open this first of its kind
in Boston.”
She said
the legislation will allow new options at the center, which is expected
to break ground next year and open its doors in 2026.
“This bill allows us to be
able to consider CPMs as clinical directors,” she said. “This bill helps
to create a workforce for Neighborhood Birth Center. We’re looking to
start hiring folks as our building is being built and our doors are
going to open.”
Beyond Boston
The legislation’s expanded support offers potential for birth centers across the state, Anesta said.
“We
have a real opportunity in Massachusetts to start seeing these options
more widely available and available in communities that have really
lacked access to birth options, whether that’s because they’re rural
communities, where we’ve seen community hospitals close, or even urban
communities where people want to have access to different birth options
and they just have not been available,” she said.
Currently,
there is just one operational birth center in Massachusetts — Seven
Sisters Midwifery & Community Birth Center in Northampton. Two
others — Cambridge Birth Center, which was operated by Cambridge Health
Alliance near Harvard Square, and North Shore Birth Center on the campus
of Beverly Hospital — closed within the past few years.
The
new support around licensure and insurance, Anesta said, will make it
more possible for birth centers to open across the state.
Worcester Community Midwifery, which, alongside
Neighborhood Birth Center and Seven Sisters, split the $1 million in
grant funding provided by the state earlier this month, is working to
open a birth center in central Massachusetts.
Vassell said a shift toward more birth center access can help balance out the hospital-focused care that currently exists.
“We know Massachusetts is very hospital-heavy.
We
know we have the best hospitals in the world — but birth is more than
just an intervention or an induction,” Vassell said. “It’s so much more
than that, and we know that when folks receive care from midwives, there
are better outcomes for themselves and their baby.”