Legislature Approves Sen. Dodd’s Maternity Care Access & Equity Plan

SACRAMENTO – Heeding the call for greater access to maternity care, especially for women of color, the Legislature late Monday approved a bill from Sens. Bill Dodd, D-Napa, Holly Mitchell, D-Los Angeles and Assemblymember Autumn Burke, D- Inglewood, to expand the role of nurse-midwives across California. Senate Bill 1237, sponsored by the California Nurse-Midwives Association and Black Women for Wellness, heads next to Gov. Gavin Newsom for a signature.

“I know midwives can deliver for California. In fact, they already do – to the tune of 50,000 babies a year,” said Sen. Bill Dodd. “These dedicated women’s health practitioners are filling a shortage of obstetrical care in our state that is only expected to worsen. By expanding their role now, we increase access to care for all women, especially those in rural or inner-city settings. I thank my fellow lawmakers for seeing this through.”

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. 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. Currently, nurse-midwives perform 10% of all births each 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.

“SB 1237 is a huge step forward for nurse-midwives and birthing people in California,” said Kathleen Belzer, California Nurse-Midwives Association president. “No longer will nurse-midwives constantly fear losing their practices because of the inability to find and sustain a supervisory relationship with a physician. The bill creates an integrated, team-based approach to maternal health in which physicians and midwives work together. It is a strong strategy to addressing the lack of health care access for so many who desperately need the high-quality care midwives offer.  SB 1237 will improve outcomes for those who are tremendously underserved, especially Black, Indigenous, and communities of color, while at the same time substantially lowering health care costs.”

“Clearly, as a nation and a state, we have reached a turning point in our thinking on how we address racial inequities in our institutions that will result in helping people first,” said Nourbese Flint, executive director of Black Women for Wellness Action Project. “Expanding maternity care access by allowing highly trained nurse-midwives to practice independently will help us tackle deep inequality for the women who need good healthcare the most. I thank Sen. Dodd and the Legislature for supporting this important bill.”

The bill is also sponsored by the United Nurses Association of California/Union of Health Care Professionals and NARAL Pro-Choice California.

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.

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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.