Sen. Dodd: Maternity Care Proposal Clears Committee
SACRAMENTO – Legislation from Sens. Bill Dodd, D-Napa, Holly Mitchell, D-Los Angeles and Assemblymember Autumn Burke, D- Inglewood, to improve access to high-quality maternity care in California, cleared a key committee today with overwhelming, bipartisan support. Senate Bill 1237, sponsored by the California Nurse-Midwives Association and Black Women for Wellness, also would curb disparities in outcomes for black women and infants and counter the obstetrician shortage – projected to be critical in some counties by 2025.
“Because of the strains placed on our health care system by the coronavirus, it is more important than ever that women get access to quality maternity treatment,” Sen. Dodd said. “By increasing access to nurse-midwives, we can improve outcomes for mothers and babies, especially those in rural or inner-city settings. The current disparity for women of color is absolutely unacceptable. My bill will help bridge the gap.”
SB 1237 would expand access to care by authorizing nurse-midwives to conduct routine services without direct physician supervision, following the lead of 46 other states. California’s current model has not been shown to increase the safety or quality of maternity care. States that allow autonomous practice within a more integrated, collaborative model between physicians and midwives show significantly lower rates of cesarean, preterm birth, low birth-weight infants and neonatal death. Nurse-midwives perform 50,000 births a year in California.
Sen. Dodd’s bill comes as experts from the California Maternal Quality Care Collaborative report black women in California still die at a rate that is 3-4 times higher than white women during pregnancy, childbirth and postpartum. Furthermore, babies born to black women were more than three times as likely to die of a preterm, birth-related issue as babies born to white women in 2017. National and international organizations including the March of Dimes and the World Health Organization agree improved access to midwives is a necessary and innovative strategy to reduce and eventually eliminate racial disparities.
"We already see how existing health inequities are being exasperated by the pandemic with black people disproportionately making up the deaths,” said Nourbese Flint, Executive Director of Black Women for Wellness Action Project. “The same communities that are disproportionately dying from COVID-19 are at most risk for pregnancy-related death due to structural and systemic barriers. More than ever we need to be using all the tools in the toolbox to preserve and expand safe quality care for birthing people.”
“The burden of morbidity and mortality falls largely on black and indigenous women and those from marginalized communities who cannot receive the care they need and desire,” said Kathleen Belzer, CNMA president. “This is unacceptable. SB 1237 is about CNMs working with physicians and creating a collaborative model to best meet the needs of birthing people and provide the safest care possible.”
The bill is also sponsored by the United Nurses Association of California/Union of Health Care Professionals and NARAL Pro-Choice California. It passed the Senate Business, Professions and Economic Development committee on an 8-0 vote.
The American College of Obstetricians and Gynecologists has stated that the obstetric workforce crisis cannot be abated without the help of nurse-midwives in a model of integrated, collaborative care. In 2018, ACOG released a new version of their Joint Statement of Practice Relations which highlighted the critical shortages and misdistribution of maternity care providers, and called for autonomous practice for nurse-midwives under a model of team-based care. SB 1237 is proposed during the World Health Organization’s Year of the Nurse and the Midwife, and on the heels of recent statements by leading patient advocacy organizations, including the March of Dimes, California Health Care Foundation, and the Pacific Business Group on Health, calling for the immediate reduction in regulatory barriers to nurse-midwifery practice and greater investment in California’s nurse-midwifery workforce.
Senator Bill Dodd represents the 3rd Senate District, which includes all or portions of Napa, Yolo, Sonoma, Solano, Sacramento and Contra Costa counties. More information on Senator Bill Dodd can be found at www.senate.ca.gov/dodd.