[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 231 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. RES. 231
Recognizing the longstanding and invaluable contributions of Black
midwives to maternal and infant health in the United States.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 18, 2025
Ms. Moore of Wisconsin (for herself, Ms. Adams, and Ms. Underwood)
submitted the following resolution; which was referred to the Committee
on Energy and Commerce, and in addition to the Committee on Armed
Services, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
RESOLUTION
Recognizing the longstanding and invaluable contributions of Black
midwives to maternal and infant health in the United States.
Whereas recognizing the day of March 14, 2025, as ``Black Midwives Day''
underscores the importance of midwifery in helping to achieve better
maternal health outcomes by addressing fundamental gaps in access to
high-quality care and multiple aspects of well-being;
Whereas the Black Midwives Day campaign, founded in 2023 and led by the National
Black Midwives Alliance, establishes Black Midwives Day as a day of
awareness, activism, education, and community building;
Whereas this day is intended to increase attention for the state of Black
maternal health in the United States, the root causes of poor maternal
health outcomes, and for community-driven policies, programs, and care
solutions;
Whereas the United States is experiencing a maternity care desert crisis in
which 2,200,000 women of childbearing age live in maternity care deserts
where they do not have access to hospitals or birth centers offering
maternity care or obstetric providers;
Whereas maternity care deserts lead to higher risks of maternal morbidity and
mortality as most complications occur in the postpartum period when
birthing people are far away from their providers;
Whereas midwife-led care has been shown to result in cost savings, reduced
medical interventions, lower cesarean rates, decreased preterm births,
and improved health outcomes for both mothers and infants;
Whereas midwives provide essential maternal health care services across diverse
settings, including homes, communities, hospitals, birth centers,
clinics, and health units, ensuring accessibility and continuity of
care;
Whereas increasing the number of Black midwives in the workforce is critical to
addressing maternal health disparities, as Black midwives offer
culturally competent care that builds trust, enhances maternal
satisfaction, and improves health outcomes for Black mothers and their
infants;
Whereas incorporating midwives fully into the United States maternity care
system would reduce maternal health disparities and help to address the
maternity care desert crisis;
Whereas, despite the medicalization of childbirth in the United States, the
maternal mortality rates in the United States are among the highest in
the high income countries, increasing rapidly, and disproportionately
higher among Black birthing people;
Whereas Black birthing people in the United States suffer from life-threatening
pregnancy complications, known as ``maternal morbidities'', twice as
often as White birthing people;
Whereas these deaths have devastating effects on Black children and families,
and the vast majority are entirely preventable through assertive efforts
to ensure Black birthing people have access to information, services,
and supports to make their own health care decisions, particularly
around pregnancy and childbearing;
Whereas, according to a 2023 Centers for Disease Control and Prevention Report,
the United States maternal mortality rate for Black women has
continuously increased to 50.3 deaths per 100,000 live births compared
to the decreased rate for White (14.5), Hispanic (12.4), and Asians
(10.7) women;
Whereas the high rates of maternal mortality among Black birthing people span
across income levels, education levels, and socioeconomic statuses;
Whereas structural racism, gender oppression, and the social determinants of
health inequities experienced by Black birthing people in the United
States significantly contribute to the disproportionately high rates of
maternal mortality and morbidity among Black birthing people;
Whereas Black birthing people are more likely to report experiences of
disrespect, abuse, and neglect when birthing in facility-based settings
as compared to White people;
Whereas Black families benefit from access to Black midwives to receive
culturally sensitive and congruent care established through trust and
respect, backed with the wisdom of time-honored techniques and best
practices;
Whereas the work and contributions of past and present midwives have ushered in
new life have done so despite a history fraught with persecution,
enslavement, violence, racism, and the systematic erasure of traditional
and lay Black midwives throughout the 20th century;
Whereas the decimation of midwifery across the Southern United States reduced
the numbers of Black midwives from thousands to dozens in a 50-year
period from the 1920s to the 1970s, leaving many communities without
care providers;
Whereas some States have criminalized and suppressed direct-entry midwives,
despite rising maternal mortality rates across the United States;
Whereas the criminalization and overregulation of midwifery disproportionately
impacts Black midwives and birthing families, exacerbating maternal
health disparities and reducing access to culturally competent care;
Whereas the resurgence of Black midwifery is a testament to the resilience,
resistance, and determination of spirit in the preservation of healing
modalities that are practiced all over the world;
Whereas the focus on holistic care, which involves caring for the whole person,
family, and community, is what makes a difference in midwifery;
Whereas midwifery--
(1) honors a birthing person's right to bodily autonomy; and
(2) can be facilitated at home, in a birth center, or hospital, and
works in tandem with doulas, community health workers, obstetricians,
pediatricians, and other maternal, reproductive, and perinatal health care
providers;
Whereas the Midwifery Model of Care has been proven to have better pregnancy
outcomes through preventing infant mortality and morbidity, lowering
preterm births, reducing medical interventions, and providing the
birthing person continuous support;
Whereas, in 2022, the Committee on the Elimination of Racial Discrimination
(referred to in this preamble as ``CERD'') of the United Nations
expressed concerns regarding the impact of systemic racism and
intersecting factors on access to comprehensive sexual and reproductive
health services for women, and the limited availability of culturally
sensitive and respectful maternal health care, particularly for those
with low incomes, rural residents, individuals of African descent, and
Indigenous communities;
Whereas CERD recommended that the United States further develop policies and
programs to eliminate racial and ethnic disparities in the field of
sexual and reproductive health and rights, while integrating an
intersectional and culturally respectful approach in order to reduce the
high rates of maternal mortality and morbidity affecting racial and
ethnic minorities, including through midwifery care;
Whereas, in 2023, the Human Rights Committee of the United Nations expressed
similar concerns as CERD and further recommended that the United States
take measures to remove restrictive and discriminatory legal and
practice barriers to midwifery care, including those affecting Black and
Indigenous peoples;
Whereas a fair distribution of resources, especially with regard to reproductive
health care services, is critical to closing the racial disparity gap;
Whereas an investment must be made in robust, quality, and comprehensive health
care for Black birthing people, and policies that support and promote
affordable, holistic maternal health care that is free from gender and
racial discrimination;
Whereas it is fitting and proper on Black Midwives Day to recognize the
tremendous impact of the human rights, reproductive justice, and birth
justice frameworks on protecting and advancing the rights of Black
birthing people;
Whereas Black Midwives Day is an opportunity to acknowledge the fight to end
maternal mortality locally and globally;
Whereas maternal health is intractably linked to infant health and the United
States infant mortality rate rose 3 percent from a rate of 5.44 infant
deaths per 1,000 live births in 2021 to 5.60 infant deaths per 1,000
live births in 2022, the largest increase in the infant mortality rate
in two decades; and
Whereas Congress must mitigate the effects of systemic and structural racism, to
ensure that all Black people have access to midwives, doulas, and other
community-based, culturally matched perinatal health providers: Now,
therefore, be it
Resolved, That the House of Representatives--
(1) encourages Federal, State, and local governments to
take proactive measures to address racial disparities in
maternal health outcomes by supporting initiatives aimed at
diversifying the perinatal workforce, increasing access to
culturally congruent maternal health care;
(2) commits to collaborating with relevant stakeholders to
develop and enact policy solutions that promote health equity,
address systemic racism, and support the advancement of Black
midwifery;
(3) calls for increased funding for education and training,
increased access to Black preceptors, removing barriers and
restrictions to said preceptors, providing financial pathways
to support students and preceptors, and mentorship programs
that focus on promoting and sustaining Black midwifery and
removing barriers related to accreditation by recognizing
midwives across all training pathways;
(4) encourages Federal and State governments to authorize
the autonomous practice of all midwives to the full extent of
their training;
(5) promotes the authorization or reauthorization of
funding for TRICARE and Medicaid coverage of maternity care
provided by midwives of all training pathways;
(6) encourages Federal, State, and local governments to
take active steps to destigmatize and decriminalize midwifery
pathways in the pregnant person's setting of choice, including
their homes, birth centers, clinics, or health units; and
(7) supports and recognizes the longstanding and invaluable
contributions of Black midwives to maternal and infant health
in the United States.
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