On April 26th, the Regional Health Commission submitted testimony in support of policies that would increase access to maternity care by expanding insurance coverage for maternity services by midwives and doulas. The statement is available below, or click here to download a pdf version.

HB1148 and HB 900 would require each health carrier or health benefit plan that offers or issues health benefit plans on or after January 1, 2024, and that provides coverage for maternity services to provide coverage for health care services provided by a midwife. Such health benefit plans cannot differentiate between services performed by a midwife, within the midwife’s lawful scope of practice, and services performed by a physician with respect to co-payments, annual deductible amounts, or coinsurance percentages.

Midwives are healthcare professionals who provide a range of healthcare services for women including gynecological examinations, contraceptive counseling, prescriptions, and labor and delivery care. Providing expert care during labor and delivery, and after birth is a specialty that makes them unique. Midwives can play a critical role in improving birth outcomes and advancing maternal health equity in our state.

Maternal and infant mortality rates in Missouri are consistently one of the highest in the nation, and people of color are at increased risk for poor maternal and infant health outcomes compared to their White peers. Missouri’s maternal mortality rate is especially dire for Black women, who are three to four times more likely than white women to die within a year of pregnancy. In the St. Louis region, Black babies are three times more likely to die in their first year of childbirth compared to white babies. Midwives are part of their local community – sharing its culture, strengths, and vulnerabilities – and can reduce these health disparities, bridge gaps in healthcare and support maternal and child wellbeing. HB 1148 and HB 900 would improve access to maternity services such as prenatal care, labor and delivery and postpartum care by requiring insurance coverage for maternity services by midwives.

Doulas are non-medical professionals who provide continuous emotional, physical, informational support and guidance for pregnant, birthing, and postpartum people. Recent studies have shown that having continuous emotional support during this time can provide significant health benefits, such as the decreased need for pain medication during birth, lower rate of C-section, faster labor and more positive birthing experience. These benefits are increased for communities of color. Increasing access to doulas is one intervention to address the stark racial disparities in maternal and infant mortality in our state.

HB 1148 and HB 900 would increase access to doula services and promote health equity. This legislation would require the Department of Health and Senior Services to review and approve doula registration to allow for health insurance reimbursement for doula services. Allowing reimbursement for doulas services would be a step in the right direction to address the maternal and infant mortality crisis in Missouri.

With maternal health outcomes worsening and Black women and birthing people being disproportionately harmed, it is critical that midwifery and doula care be made financially accessible for Black families and communities. For this reason and those outlined above, we encourage you to support HB 1148 and its companion bill HB 900.

If you have any additional questions or requests for information, please contact Kate Kasper, Director of Policy and Advocacy at kkasper@stlrhc.org.

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