Groups that advocate for maternal health in Massachusetts are urging the General Court not to let legislation to increase access to out-of-hospital births go by the wayside.

The Joint Committee on Healthcare Financing recently sent nine bills relating to maternal health "to study," meaning they're unlikely to get any more activity this legislative session.

One bill would increase access and safety in out-of-hospital births, and another would increase access to nurse-midwifery services.

Tiffany Vassell is a labor and delivery nurse who is currently pregnant and planning a home-birth. She said home-births have increased during the pandemic, especially for Black mothers.

"When you have choices, such as being able to birth at home," said Vassell, "you can decide who you want present, you can you have more control over the birthing process, as opposed to it being very rigid in the hospital."

Vassell said it's important that Certified Professional Midwives are able to be licensed in Massachusetts, so that folks who prefer a home birth can find a provider they know is certified.

She added that Massachusetts is world-renowned for hospitals and medical care, and it's important to follow the example of 37 other states and pass these laws.

Emily Anesta, co-founder of the Bay State Birth Coalition, said licenses for Certified Professional Midwives and other provisions are necessary if there is to be equitable access to home births and birth centers in the Commonwealth.

She said without that system in place, it's not possible to properly build out the midwifery workforce.

"We can't push any of that forward until we have the most basic thing," said Anesta, "which is these midwives who already provide this care to be licensed and integrated into our health-care system."

Vassell emphasized the importance of choice when it comes to giving birth. She noted that Black women are three to four times more likely to die during childbirth than white women in the U.S.

"Black women are shown to do better with home births than with hospital beds," said Vassell. "Hospitals can be very restrictive. A lot of times, you don't feel like the provider's listening to you. You feel very controlled, which is part of the reason also why I'm deciding on a home birth."

Vending machines commonly found in workplace break rooms generally contain soft drinks or snacks but one machine in Indianapolis dispenses unconventional items at the turn of a knob.

The Plan B morning-after pill, pregnancy tests and condoms are displayed in a clear glass case inside a colorful blue and orange dispenser. The items provide easy access to protection against an unwanted pregnancy and are free of charge.

Melissa Gruver, organizing director of the feminist organization Indiana Task FORCE, said it operates like a traditional vending machine.

"You just push whenever you want and it falls down, and you reach your hand through the little door and you pull it out, take it with you," Gruver explained.

A 2022 Indiana Department of Health Termination Report indicated 9,600 pregnancies were aborted, with Marion County recording the highest number of unwanted pregnancies. The report also noted the average age of a woman in Indiana who sought an abortion was 27, and 67% of all terminated pregnancies occurred within four to eight weeks of conception.

The state's contentious near-total abortion ban, which was upheld by the Indiana Supreme Court last year, has stoked fears lawmakers may begin restricting a woman's choice of birth control.

Indiana Task FORCE and reproductive health groups All-Options and the Midwest Access Coalition want the emergency contraceptive vending machine to serve as a gathering spot for community conversations on reproductive rights and sexual health.

"We've long been organizing our communities to bring about reproductive justice, which we didn't have before and we definitely don't have it now," Gruver pointed out. "But what we know to be true is that there are more of us that want access to reproductive care than those that try to stop it. We're excited to continue to work to meet this need now, and to organize for a better community."

Gruver hopes to have one dispenser in every Indiana region in the future to add to the single machine currently in an eastside Indianapolis grocery store. She added some universities in the state already have vending machines offering similar contraception products but users have to purchase the items.

This story is based on original reporting by Mary Claire Molloy for Mirror Indy.


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