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Healthcare Policy

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Opportunities Abound!

With the national focus on health care reform, particularly the passage of the historical Patient Protection and Affordability Act (PPACA, Public Law No: 111-148) into law on March 23, 2010, and the Supreme Court's ruling to uphold the law in June 2012, Americans have an unprecedented opportunity to rethink health care policy at every level.

The window of opportunity is wide open.

Maternal and Child Health Trends

While the United States has the highest per capita spending on health care in the world, this has not led to optimal outcomes. The maternity care sector, in particular, has many trends that are heading in the wrong direction.

  • U.S. infant mortality rate is worse than over thirty other industrial nations
  • U.S. maternal mortality rate has not improved since 1982 and is steadily creeping upward
  • Rates of premature and low birth weight infants are exceedingly high
  • Declining rates of normal physiologic childbirth are alarmingly common
  • Cesarean section is the number one surgery performed in the United States, 1 in every 3 pregnant women will undergo surgical birth 
  • Health status and perinatal outcomes for women and infants of color are far worse than for their White counterparts
  • Hospital costs are without a doubt the largest sector of health care costs
  • Hospital costs for mother-baby care are considerable and are the highest of all hospital “profit centers”

Reviewing Healthy People 2020

To address the health of our nation, Healthy People 2010 objectives were established by the U.S. Department of Health and Human Services. A mid-course review found disturbing movement away from the maternal and child health targets to reduce: low birth weight, preterm births, maternal labor and birth complications, primary and repeat cesareans for low-risk women, and perinatal mortality. New 10-year national objectives have been established. Healthy People 2020 established benchmarks and will monitor progress over time with the goal of improving the nation's health.   

Because of the national attention to health care reform there is tremendous potential to redesign our ailing health care system into one that focuses on preventive and wellness care rather than sickness and emergency care.

Midwives As a Key Solution to Alarming Trends

The evidence is mounting that because midwives focus on normal physiologic childbirth and safe, personalized, cost-effective care, they offer a key solution to what ails our broken maternity care system.

Opportunities to support and promote maternal and child health care policies that:

  • Position exemplary maternity care models squarely within the U.S. health care system
  • Showcase evidenced-based choices in childbirth
  • Affect better outcomes for mothers and babies
  • Address disparities in health care status
  • Create greater access to midwives so they can play an integral part in a diverse, high quality, multidisciplinary maternity care workforce.

MANA and our partners are influencing and shaping maternal and child health policy by:

  • Working with congressional offices to ensure that midwives figure prominently in new legislation for maternal and child health care
  • Collaborating with other professional organization in the national alliance called Coalition for Quality Maternity Care
  • Supporting maternity care legislation that is introduced in the House and the Senate such as the MOMS21 legislation.

Supporting a CPM bill through the Midwives and Mothers in Action (MAMA) Campaign

  • MANA is a founding member of the MAMA Campaign and providing top leadership to the MAMA Campaign Steering Committee
  • Ensuring that we have an active lobbyist for midwives on Capitol Hill
  • Cultivating relationships with legislators for HR 1976, Access to Certified Professional Midwives Act of 2013
  • Organizing grassroots support for legislation that includes midwives, citizens and other health care professionals 

CPM bill reintroduced in May 2013

In the 2012 the MAMA Campaign had 25 co-sponsors for our CPM bill. On May 12, 2013 HR 1976 (formerly HR 1054), entitled Access to Certified Professional Midwives Act, was re-introduced by Congresswoman Chellie Pingree of Maine in the House of Representatives in the 113th Congress.  The Midwives and Mother’s in Action (MAMA) Campaign is excited to be back in business on the Hill this year for mothers, babies and midwives across the country. The passage of the bill will increase women's access to quality maternity care, particularly for the most vulnerable and marginalized women and infants in the U.S. by amending the Social Security Act to mandate Medicaid reimbursement for CPM services in all settings.

  • Become a supporter by bringing your Congress member on board as a co-sponsor of HR 1976
  • Become a supporter by contributing financially to the campaign and encouraging others to do the same at
  • Become a supporter by accompanying MAMA Campaign leaders when they visit Capital Hill to lobby for the bill's passage 

The Health Policy section of this website will supply you with the knowledge, inspiration and practical tools necessary to achieve policy goals in reforming the maternity care system in the United States.