Measures, new birth center, take aim at disparities in maternal health care

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Nicole White is the policy director BirthDetroit.


Nicole White is the policy director BirthDetroit.

Capital News Service

LANSING – New legislation may allow Michigan to join 41 other states in licensing and reimbursing birth centers for their services.

The bills focus on such problems as maternal and infant mortality and access to medical care, according to the sponsors who cite growing disparities in maternal health.

The proposal comes as a Detroit organization, BirthDetroit, plans to open a Black-led birth center later this year. Policy director Nicole White said the organization now helps Black and brown mothers and pregnant women with services through an Easy Access Clinic. 

“We opened a clinic in 2020 during the pandemic to do prenatal and postnatal care and trial birth education for anybody, regardless of ability to pay,” White said.

Currently, BirthDetroit isn’t reimbursed by Medicaid or insurance companies for the care that it provides, such as ultrasounds, OB screenings and lab tests, she said. Funding comes from donors, grants and other sources.

 “We shouldn’t have to do that,” she said.

The legislation would require hospitals to have a policy to protect patients and add licensed midwives to the state’s essential health provider repayment program.

It also would require private insurers to reimburse licensed midwives for their services and designate an annual Black Maternal Health Week.

“Medicaid covers midwifery care in a lot of states, and Michigan could choose to cover us, so we’re working hard at that,” said White.

She said health conditions for Black and brown mothers “have actually gotten worse instead of better, despite all of the money that has been spent on maternal and infant health.”

In the U.S., Black mothers die from pregnancy-related causes at three times the rate of white mothers, according to the Centers for Disease Control and Prevention.

“The disparities are still rampant,” White said. 

“Those statistics are well-known, well-documented and have been the same as long as statistics have been recorded,” she said. 

She said health outcomes are typically better with midwives. One reason is that their patients are usually low-risk. 

“That’s not the same case with typical obstetrics,” said White. 

Chelsea Wuth, the associate public information officer for the Department of Health and Human Service, said the department has extended Medicaid to provide 12 months of postpartum coverage. That includes doula services under Medicaid and expanded home visit programs as part of the Healthy Moms, Healthy Babies initiative.

To address implicit maternal bias problems, “Michigan adopted licensing rules requiring training for all health care professionals. The state also requires Health and Human Services employees to receive similar training on diversity, equity and inclusion,” Wuth said. 

Other measures included eliminating the 5-year waiting period for children and pregnant women legally residing in the state to qualify for Medicaid and reducing disparities in health insurance status, she said. 

John Karasinski, the senior director of communications at the Michigan Health and Hospital Association, said his organization was actively involved when the Department of Licensing and Regulatory Affairs adopted new administrative rules requiring implicit bias training for licensing and registration of health care professionals.

The association “believes implicit bias training is important for all health care workers to ensure equitable access and care for all patients. Eliminating health disparities is crucial to the mission of advancing the health of individuals and communities,” Karasinki said.

The maternal health equity legislation is pending in the Senate Housing and Human Services Committee. 

The lead sponsors are Democratic Sens. Erika Giess of Taylor, Stephanie Change of Detroit, Sarah Anthony of -Lansing, Mary Cavanagh of Redford Township and Sylvia Santana of Detroit.

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