Sunday, 14 July 2024

Senate passes Dodd maternity care access, equity measure

SACRAMENTO – With a renewed focus on curbing racial inequities in health care, the Senate on Friday overwhelmingly approved 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 treatment in California.

Senate Bill 1237, sponsored by the California Nurse-Midwives Association and Black Women for Wellness, would address disparities in outcomes for Black women and infants and counter the obstetrician shortage – projected to be critical in some counties by 2025.

“I appreciate the support for this proposal, which will improve access to high-quality maternity care and help resolve inequities in treatment for women of color,” Sen. Dodd said. “The current gap is completely unacceptable. By increasing access to nurse-midwives, we can improve outcomes for mothers and babies, especially those in rural or inner-city settings.”

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 are in a moment that both our state and our nation are rethinking how we address racial inequities in our institutions that can better focus on centering people first,” said Nourbese Flint, executive director of Black Women for Wellness Action Project. “By expanding both maternal health and abortion access through the ability of highly trained nurse-midwives to practice independently, we are expanding our ability to tackle deep inequality for the women and birthing people who need quality healthcare the most. I am grateful that we are one step closer to seeing SB 1237 signed into law.”

“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 will improve access to maternal health care by removing physician supervision which is extremely difficult to attain. This will be especially impactful in the community, out of hospital setting. This bill allows CNMs to work independently with low-risk women, and creates a collaborative framework for CNMs to work with physicians when necessary in a team-based model to ensure the safest and highest quality care available.”

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 on a 35 to 1 vote and heads next to the Assembly.

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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