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Report: MA Needs to Reduce Barriers to Community Births


Tuesday, May 3, 2022   

A new report found care provided in community birth settings, whether at home or in what are known as birth centers, can improve maternal health outcomes, especially for Black, brown and Indigenous women.

The U.S. has a far higher maternal mortality rate than other high-income nations, and Black and Indigenous women are two to three times more likely to die from pregnancy-related causes than their white peers.

Carol Sakala, director for maternal health at the National Partnership for Women and Families and co-author of the report, said community births often lead to better outcomes around preterm birth, Caesarean birth and breastfeeding.

"These models are especially powerful when they are community based and led," Sakala contended. "And they have the potential to do an incredible job of meeting the needs of birthing people of color, and mitigating effects of racism and trauma."

She noted a bill before the General Court would create a system for licensing Certified Professional Midwives (CPMs), who can attend to out-of-hospital births. It also would reimburse CPMs through MassHealth, the state's Medicaid program.

Currently, many families who opt for community births have to pay for care out-of-pocket.

Sakala added hospital care has received a lot of publicity for its shortcomings during the pandemic, which has increased demand for community births.

"That was greatly magnified when the pandemic set in," Sakala asserted. "We're asking healthy people to go into hospitals and potentially be exposed to the virus, and also to be separated from their loved ones and their support networks and often from their newborns as well if there were certain issues or concerns. "

The report added community births are cost-effective, and there are a number of steps to help increase access, from ensuring midwives and birth centers are covered by insurance, to supporting schools and programs trying to get more midwives into the workforce and expanding into underserved areas.

It also recommended increasing funding for community birth care and including midwifery as an eligible profession for loan forgiveness.

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