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April 17, 2024

House Passes Legislation to Reduce Maternal Mortality, Address Disparity of Care for Black, Indigenous, and People of Color

DENVER, CO - The House today passed legislation sponsored by Representatives Lorena Garcia and Iman Jodeh to improve maternal health care in Colorado. HB24-1262 includes modifying the midwife licensure process and creating a new professional title, collecting more data on mistreatment during the perinatal period, and requiring advance notice to a patient when a facility reduces or ends maternal health care services. HB24-1262 passed the House by a vote of 48 to 12.

“Coloradans increasingly want expanded birth options, especially in Black and Latino communities, but existing barriers prevent community birth facilities from providing these services,” said Rep. Lorena Garcia, D-Unincorporated Adams County. “Increasing access to maternal care, including midwives, will allow Colorado parents to choose a birth plan that fits their needs. By giving Coloradans more options for maternal health care, we can reduce the impacts of the maternal mortality crisis and save lives.”

“The worsening maternal mortality crisis is a growing issue, especially for Black, Indigenous, and rural parents, and our bill seeks to address these preventable deaths,” said Rep. Iman Jodeh, D-Aurora. “Maternal health deserts and other barriers to maternal health care access prevent parents from receiving necessary, and sometimes life-saving care. By boosting health care provider options and perinatal resources, we can create a health care system that keeps our parents and newborns safe and healthy.”

Starting September 1, 2024, HB24-1262 would require any individual who practices certified professional midwifery to have a valid license. The bill would update the title of “direct-entry midwives” to “certified professional midwives” (CPMs) and change the regulation from registration to licensure. The licensure process includes passing an exam, graduating from an accredited midwifery education program, holding a CPM credential from the North American Registry of Midwives, being certified by the American Heart Association or the American Red Cross to perform adult and infant CPR, or having an equivalent education that is approved by the director of the Division of Professions and Occupations. 

The bill would also:

  • Direct the Civil Rights Commission to collect reports of mistreatment in maternity care to help identify ways to address prenatal mistreatment and discrimination,

  • Create an advisory panel to provide recommendations on disciplinary actions against CPMs,

  • Add a midwife who is practicing in a freestanding birth center, in a rural area, or as a home birth provider to the Environmental Justice Advisory Board,

  • Require a health care facility that provides maternal health care services to provide public notice at least 90 days before the discontinuation of these services,

  • Require the Colorado Maternal Mortality Prevention Program to study the availability of perinatal health care, facility and practice closures and the impacts on maternal and infant health, and provide recommendations to the General Assembly, and

  • Add pregnancy as a protected class for the purposes of discrimination in places of public accommodation.

The Colorado Maternal Mortality Review Committee made recommendations to combat the maternal mortality crisis, including increasing access to varied health care like midwifery, addressing maternal health workforce shortages, and studying the impact of facility shortages on Black, Indigenous, Latino, Asian, rural, and immigrant and refugee communities.

A 2022 report found that 38 percent of Colorado counties are a maternal health care desert, meaning they don’t have perinatal health care providers or birth centers. A 2023 report found that Black Coloradans are twice as likely to die during pregnancy or within one year postpartum, while Indigenous communities are three times as likely.

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