Friday, 03 February 2023

Sen. Dodd’s maternity care access and equity plan signed into law

Responding to the need for greater access to maternity care, especially for women of color, Gov. Gavin Newsom yesterday signed a bill from Sens. Bill Dodd, D-Napa, Holly Mitchell, D-Los Angeles and Assemblymember Autumn Burke, D- Inglewood, to expand the role of certified nurse-midwives across California.

“Nurse-midwives are the key to filling our statewide shortage of obstetrical care while increasing medical access for all women, especially those in rural or inner-city settings,” Sen. Dodd said. “By expanding their role, we address inequities and help close a gap that is only expected to worsen. I thank Gov. Newsom for recognizing the value of these dedicated women’s health practitioners and signing this bill into law.”

Senate Bill 1237 is sponsored by the California Nurse-Midwives Association and Black Women for Wellness. It expands 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 50,000 deliveries or 10 percent of all births in California each year.

Sen. Dodd’s new law 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 are thrilled that SB 1237 has made it across the finish line!” said Kathleen Belzer, president of the California Nurse-Midwives Association. “The restrictions on midwifery care that have been in place for decades have negatively impacted so many birthing people and nurse-midwives. Now, more individuals will be able to access the care they need and want. We thank Senator Dodd for his years of support and dedication.”

“Black Women for Wellness Action Project could not be more excited that starting next year, birthing people across California will have increased access to quality and safe maternal health services,” said Nourbese Flint, the group’s executive director. “In addition, this is an important step to closing the mortality gap between Black mothers and babies at a time where we know the stress on our health system is leading to deeper disparities among people of color.”

The bill was 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 being signed into law comes 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.

Dodd represents the Third Senate District, which includes all or portions of Napa, Yolo, Sonoma, Solano, Sacramento and Contra Costa counties.

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