Among bills California Governor Gavin Newsom signed into law earlier this month, as this year’s legislative season was ending, was a measure its author, state Senator Nancy Skinner, D-Berkeley, says will help to overcome the glaring racial and ethnic disparities in maternal and infant deaths in the state.
Senate Bill 65, the California Momnibus Act, will take effect Jan. 1. Among its provisions, the new law will expand the state’s Pregnancy-Associated Mortality Review Committee to investigate serious illnesses and deaths associated with pregnancy and childbirth and recommend best practices to reduce maternal and infant deaths. Under the new law, the committee, now made up mostly of physicians, will also include midwives, doulas, community advocates, and a tribal representative.
Although a report the California Department of Public Health issued last month shows that the state’s rate of pregnancy-related deaths remains low compared with the overall rate in the U.S., and stayed mostly stable between 2008 and 2016, racial and ethnic gaps widened. The pregnancy-related mortality ratio for Black women reached 56.2 deaths per 100,000 live births – four to six times greater than the mortality ratios for women of other racial and ethnic groups, including Asian-Pacific Islander (13.3), Hispanic (11.0), and white (9.4).
SB 65 also points out that California’s Native American infant mortality rate is 11.7 deaths per 1,000 live births, while the rate for Black infants is 8.7 deaths – far above the state average of 4.2 deaths per 1,000 live births.
The Momnibus Act will also clarify that pregnant people are exempt from CalWORKs welfare-to-work requirements. And it will establish a fund for midwife training programs that emphasizes underrepresented groups and underserved communities, as well as a stakeholder workgroup to help start the new doula benefit under Medi-Cal (California’s Medicare program).
The measure won nearly unanimous legislative approval, with final majorities of 31-5 in the Senate, and 77-0 in the Assembly.
Already included in the budget the legislature passed earlier this year were provisions to expand pregnant people’s eligibility for CalWORKs grants, expand basic needs payments, add doula care to Medi-Cal services, extend full Medi-Cal coverage to birthing parents for 12 months after giving birth, and include pregnant people in the state’s Guaranteed Income Pilot program.
As he signed the Momnibus Act, Gov. Newsom declared, “Every individual deserves to have a healthy pregnancy and birth, and this bill will help make this a reality for more California families.” He called it “unacceptable that the maternal and infant mortality rate among Black and Indigenous communities remains significantly higher than the state average,” adding that “with today’s signing, we’re doubling down on our commitment to both reproductive and racial justice.”
Skinner, who is vice-chair of the California Legislative Women’s Caucus, called the signing “a significant victory for Black maternal and infant health. Despite our medical advances,” she said, “more babies and mothers die during birth in the U.S. than in all other high-income countries, and these preventable deaths are disproportionately higher for Black families.” The bill’s enactment “will help close racial disparities in maternal and infant deaths and save lives.”
Among the California Momnibus Act’s dozen co-authors was Dr. Akilah Weber, D-San Diego, an obstetrician-gynecologist and a member of the Legislative Black Caucus, who said the new law affirms that such disparities in maternal and infant outcomes “will no longer be tolerated.”
The measure’s organizational sponsors included the Black Women for Wellness Action Project, California Nurse Midwife Association, March of Dimes, NARAL, National Health Law Program, Western Center on Law and Poverty, and the Women’s Foundation of California Solis Policy Institute.
Nourbese Flint, executive director of the Black Women for Wellness Action Project, said that while California “has led the charge” in tackling maternal deaths and severe injury in the U.S., “we know there is a long way to go, particularly when it comes to tackling the egregious death rates of Black mommas.” Flint called the governor’s signing of the Momnibus Act “a huge step in reimagining maternal care for our most vulnerable pregnant folks while setting the bar for the rest of the country.”
Jen Flory, policy advocate with the Western Center on Law & Poverty, thanked Newsom for “recognizing the need for California to face its Black maternal health crisis head-on.” By passing the bill, she said, “our state is making a down payment on the investment needed to correct the disparities Black and Indigenous birthing people have faced for too long.”
On the national level, last year Democratic legislators introduced a Momnibus Act in the House of Representatives, but it sank without a vote. In February 2021, U.S. Representative Lauren Underwood, D-IL, introduced H.R. 959, the Black Maternal Health Omnibus Act of 2021. The bill, which started with 82 co-sponsors and now has 163, including 23 Californians, is currently making the rounds of committees.
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