Overview:
- Eight-bill "Momnibus" package passes Senate Committee on Housing and Human Services
- Legislation aims to address Black maternal mortality rate, which is three times higher than for white mothers
- Package includes doula scholarship program, midwife support, and anti-discrimination measures
- Full Senate vote expected by end of October 2024
- Implementation would begin in early 2025 if passed
A comprehensive legislative package aimed at addressing racial disparities in maternal healthcare cleared a significant hurdle Oct. 16, as the Michigan Senate Committee on Housing and Human Services voted to advance eight bills focused on maternal health reform.
The legislation, known as the “Momnibus” package, comes amid concerns about maternal mortality rates in Michigan and nationwide. The United States currently reports the highest maternal mortality rate among high-income countries globally, with 23.8 deaths per 100,000 live births – nearly triple France’s rate of 8.7 deaths per 100,000 live births, according to Wayne State University research.
Recent data underscores these disparities in Michigan. Detroit recorded 101 Black infant deaths in 2022, equating to 16.5 deaths per 1,000 live births, while documenting four white infant deaths during the same period.
The package, comprising Senate Bills 818-823, 825, and House Bill 5826, proposes several changes to state healthcare policies:
- SB 818 would require the Department of Health and Human Services to track and publish data on biased perinatal care
- SB 819 would create a patient reporting system for obstetric racism through the Department of Civil Rights
- SB 820 would mandate hospitals to document patient protection policies
- SB 821 would require data collection on malpractice insurance policies related to perinatal care
- SB 822 would protect patient advocate rights regardless of pregnancy status
- SB 823 would expand civil rights protections to include pregnancy and lactation status
- SB 825 would add licensed midwives to state loan repayment programs
- HB 5826 would establish a scholarship fund for doula training in underserved areas
Policy impact
Sen. Erika Geiss (D-Taylor), the package’s lead sponsor, cited mortality rate disparities during committee testimony.
“Black women and birthing people are still three times more likely to die during childbirth compared to their white counterparts,” she said, calling the situation “unacceptable.”
The legislation builds on existing initiatives, including Henry Ford Health System’s WIN Network. The network’s founder, Dr. Kimberlydawn Wisdom, emphasized systemic factors affecting maternal health outcomes.
“If stress levels are high, it can result in poor birth outcomes,” she said. “We have to look at their access to food, housing and education. You can have the very best healthcare systems and some of the poorest healthcare outcomes.”
The package aims to transform multiple aspects of maternal healthcare delivery. Sen. Sarah Anthony (D-Lansing) emphasized provisions protecting patient autonomy while expanding the healthcare workforce.
MORE REPORTING
Michigan Black moms at center of ‘Momnibus’ healthcare reform effort
A community-driven legislative package aims to uplift Black maternal healthcare, proposing systemic changes to address racial disparities impacting Black mothers and babies.
Black infant mortality rates spiked in Detroit after record low in 2019
Black mothers and babies fare worse than white counterparts in the city and state–and it’s worsened since the pandemic. Here’s why and what’s being done to address it.
To cut Black infant mortality, Henry Ford program supports Black moms
The odds are against Black babies who die at three times the rate of white babies in Michigan. This maternal care program aims to change that.
“My legislation ensures that everyone’s decisions about life-sustaining treatments are honored and respected, regardless of pregnancy status,” she said. “By including midwives in the state’s student loan repayment program, we are also building a stronger, more inclusive network of care for expectant mothers.”
Healthcare providers have voiced support for the legislation’s comprehensive approach. Licensed Midwife Nicole White, Director of MI State of Birth Justice, highlighted how the package would affect care delivery across settings.
“The Michigan Momnibus package was designed in response to our communities’ hopes, dreams, and needs,” she said. “It will expand access to midwifery care and honor and affirm the dignity and human rights of all birthing families in every birth setting, home birth, birth center, and hospital.”
Lawmakers emphasized the urgency of addressing existing healthcare disparities. “Black expectant mothers and other mothers of color face numerous barriers during their pregnancy, resulting in disproportionate health outcomes for them and their babies,” Sen. Stephanie Chang (D-Detroit) said. “This legislation will help eliminate and track these obstacles and move us forward toward healthy pregnancies and births, regardless of race.”
Sen. Mary Cavanagh (D-Redford Twp.) pointed to systemic issues driving these disparities. “Adverse maternal health outcomes disproportionately impact women of color due to systemic racism, disinvestment, and disregard — we deserve and demand so much better,” she said.
Support from Michigan Hospital Association
Michigan hospitals have supported much of the Momnibus package while helping shape its implementation. The package would require significant changes to hospital policies and reporting systems across Michigan’s healthcare facilities, including new protocols for tracking biased care and implementing patient protection policies.
According to the organization’s legislative update, the Michigan Health and Hospital Association worked with legislators to modify several bills in committee “to ensure that hospitals are trusted partners in this work.” The MHA ultimately backed Senate Bills 818, 819, 820, 825 and House Bill 5826.
In a statement to Planet Detroit, John Karasinski, senior director of communications for MHA, said the organization supports the bills “due to our long-standing support towards improving maternal health outcomes. “
He declined to specify the modifications secured as part of the MHA’s support, saying “any changes we suggested to the bill sponsors was to ensure hospitals are treated as trusted partners in this work and recognize hospitals’ commitment to addressing maternal health disparities.”
Elizabeth Kutter, representing the MHA, registered support for these bills during committee testimony.
Opposition from Michigan Catholic Conference
The Michigan Catholic Conference voiced opposition to Senate Bill 822, which would allow patient advocates to make life-sustaining treatment decisions regardless of pregnancy status. It was the only opposing voice at the hearing.
In written testimony to the committee, Rebecca Mastee, MCC policy advocate, argued the bill could endanger unborn children. “Because these difficult circumstances involve two human beings, life-sustaining treatment should not be withdrawn from a pregnant woman if continued treatment may benefit her unborn child,” she wrote.
While acknowledging “many positive aspects of this bill package and its intent to help mothers and address disparities in maternal health,” the MCC expressed concern that the bill would allow patient advocates to direct, “in advance of unknown circumstances, that life-sustaining treatment is not desired, regardless of the stage of one’s pregnancy or the likelihood of the baby’s survival.”
Next steps
The bills now advance to the full Senate for consideration, marking the next phase in the legislative process. If approved, the package would move to the House.
Final implementation would require the governor’s signature, after which state agencies would determine specific timelines and funding mechanisms through the regulatory process.