MAMA+ Health Policy Agenda: 2022 Regular Session Report

Mama+ Health Policy Agenda Enters Year Two

The Mama+ Health Policy Agenda is a policy focused initiative aimed at addressing the maternal health emergency and closing maternal health gaps for Black birthing people in New Orleans and Louisiana. Loosely structured after the Black Maternal Health Momnibus Act of 2020, a federal legislative package created to address the national Black maternal health crisis, the Mama+ Health Policy Agenda will comprise local and state level policy. Recommendations from state-led initiatives, such as mortality review committees, and issues identified by lay people are uplifted in the titles of the policy agenda. The aims of the policy initiative are to address areas that most impact the health and birth outcomes of Black birthing people in Louisiana. The six titles for the 2022 version are listed below.

• Address social determinants of health that affect maternal health outcomes.
• Diversify and increase perinatal workforce.
• Invest in maternal mental health care and substance use disorder treatments.
• Improve telehealth and other digital tools to provide maternal health care to underserved areas.
• Increase payment for group prenatal care.
• Address abortion access and reproductive rights issues.

A Glance at the 2022 Louisiana Regular Legislative Session

The 2022 Louisiana Regular Legislative Session took place from Monday, March 14 to Monday, June 6. Advocates worked throughout the legislative session to build coalitions to advance maternal and child health policies and defeat legislation harmful to moms and babies.

The National Birth Equity Collaborative’s (NBEC) primary coalition was the 2022 Mama+ Health Policy Agenda workgroup. The focus of the workgroup was to support the Mama+ Health Policy Agenda, which was comprised of legislation drafted or led by the Mama+ Policy Core group, workgroup members, and the core group’s partner agencies. The group’s work was supported by The Amandla Group.

In an effort to uplift Black Maternal health issues across the state and legislation included in the policy agenda, NBEC co-hosted Black Maternal Health Advocacy Day with our core group members The Amandla Group, Birthmark Doula Collective, and Institute of Women & Ethnic Studies (IWES). This event was hosted in partnership with Black maternal health and social justice agencies during Black Maternal Health Week at the Louisiana State Capitol.

Unprecedented Attacks on Women’s Health and Reproductive Justice

This legislative session was a challenging and disappointing session for reproductive justice advocates. We witnessed many attempts to advance bills to eliminate women’s bodily autonomy and sadly many of these bills crossed the finish line despite aggressive opposition from advocates every step of the way.

Making its way to the desk of Governor Edwards and being signed into law was SB 342, banning all abortions from the “moment of fertilization,” without a clause for rape and incest. It also penalizes abortion providers with jail time and fines.

Also signed into law was SB 388, which among many restrictions, criminalizes the online and mail-order distribution of abortion pills, making it illegal for anyone to send abortion pills by mail to Louisiana residents. Breaking this law could mean serving one to five years in prison and being fined up to $50,000.

The passage of bills banning abortions is cause for tremendous concern for maternal health in our state that already has the highest rate of maternal mortality in the nation. In addition to concerns about clinical standards of care for women in our state, social and societal systemic factors such as substance use disorder accidental deaths and homicide, impact pregnant and postpartum people in Louisiana at critically alarming rates. We know that lack of abortion care will have dire consequences for Black women and women of color navigating health and maternal health in Louisiana.

Major Advancements in Maternal and Infant Health

Maternal and infant health advocates celebrated a major victory this session, resulting from the work of the LA Perinatal Maternal Mental Health Task Force which was created by a bill sponsored by Representative Royce Duplessis in 2021. The task force brought forth a significant piece of legislation, HB 784, also sponsored by Representative Duplessis. Task force members brought forth key legislative recommendations to the state legislature to address shortcomings in maternal mental health care.

HB 784, was led by the Mama+ core group, The Amandla Group, and March of Dimes LA. A maternal mental health coalition was formed to support the challenges advocates faced early on regarding mandated screenings and the type of screening tools used. Although there was some negotiations with several medical interest groups, the bill remained close to its original format to improve maternal mental health outcomes for moms, babies, and families. Ultimately, the bill passed unanimously and is now Act 188 and took effect on 8/1/2022.

Additional bills included on the Mama+ Health Policy Agenda included SB 268 to provide Medicated Assisted Treatment (MAT) to pregnant people experiencing opioids addiction, SB 116 which created the Office of Women’s Health, HB 516 providing support for high school students during pregnancy and the postpartum period, HB 557, providing a six-month continuous supply of contraceptive coverage by Medicaid, HB 1083 (Crown Act), providing protection from hair discrimination, and HBs 650 and 651 which provide public and private insurance coverage for human donor milk coverage.

A key bill worthy of mentioning that advocates were able to support defeating, alongside several anti vaccine bills, was SB 60 which would have created an avenue to blood test mothers for substances during and after labor, contradictory to any known best practices for substance use disorder prevention and/or treatment. The bill was killed by advocates and a study commission was formed by SR 131 to explore the state’s substance use disorder needs and resources, with emphasis on rural population needs. Several maternal and health equity organizations secured a seat on the commission.

Looking Ahead

As we closed out the session, our work focused on public education on Act 188 (maternal mental health) to ensure moms and families know what to expect in the clinical settings regarding screening, how to access maternal mental health resources, and general education on recognizing perinatal mood disorders. National Birth Equity Collaborative alongside partners, hosted a community town hall during Black Maternal Mental Health Week to kick off a series of public education webinars on the new law and associated resources.

We are also continuing our efforts to lead the doula impact and accessibility work to remove barriers to doula care for both birth workers and birthing people. We are entering year four of a multi-year strategic plan to provide public and private insurance coverage, equitable insurance coverage rates for doulas, and general education on the essential nature of doulas as a part of the birthing person’s support team. We anticipate working with policymakers and insurers to pass legislation that will support positive birth outcomes related to doula care resulting from the work of the Louisiana Doula Registry Board, spearheaded by the Mama+ Health Policy Agenda workgroup in partnership with Representative Matthew Willard.

We look forward to continuing our work with policymakers and advocates dedicated to reforming our state’s maternal and infant mental health infrastructure by advancing the policy recommendations of the LA Perinatal Maternal Mental Health Task Force and partnering agencies and serving as an active stakeholder in the efforts to secure paid family leave and paid sick leave.

More broadly, our work continues to advance the seven key areas of the Mama+ Health Policy Agenda.

A condensed list of bills supported, opposed, or monitored by the Mama+ Health Policy Agenda team are listed below in figure 1. Congratulations to all partners and lead agencies organizing and advocating on their respective efforts!

This report was written by Frankie Robertson, a social justice activist, is a policy consultant for National Birth Equity Collaborative. @frankiebrla on Twitter and Instagram.