Promises in Practice: The Momnibus Bill, One Year In
November 6, 2025
On Thursday, November 6, advocates and leaders gathered at the Boston Foundation to celebrate one year since the passing of the “momnibus bill,” officially known as H.4999, An Act promoting access to midwifery care and out-of-hospital birth options. The forum, Promises in Practice: The Momnibus Bill, One Year In, highlighted the progress the Commonwealth has made in addressing maternal health inequity since the Act expanded access to midwifery care, birth centers, home births, doulas, postpartum depression support, and other services.
Orlando Watkins, Vice President and Chief Program Officer at the Boston Foundation, opened the event by stressing the Act’s importance. “This is about more than health metrics,” he said. “It ensures that every birthing person has agency, dignity and a respectful care experience.” He noted that maternal health is central to the Foundation’s child well-being work, saying that when birthing people thrive, families and communities thrive.
Senator Liz Miranda, a key driver of the Act’s passage, spoke about learning the truth behind Massachusetts’ maternal health crisis. Once confident in the state’s health-care system, it took time for her to fully grasp the inequities birthing people were facing. She recalled how many negative and dangerous birth experiences friends and family had faced. These stories, she said, revealed “structural and systemic racism in our hospitals,” which strips autonomy from birthing people of color. She praised the Healey-Driscoll Administration for passing the most comprehensive maternal health bill in the country, noting that birth outcomes improve when midwives, doulas, and alternative birth options are available.
Dr. Elaine Fitzgerald Lewis, Director of the Bureau of Family Health and Nutrition at the Massachusetts Department of Public Health, who spoke next, acknowledge that there is still more to be done, but highlighted the achievements made possible by the Act, including:
Certified Professional Midwife Integration: establishing regulation and licensure pathways, building a governing board, strengthening workforce capacity, and formalizing protocols.
Birth Center Expansion and Funding: allocating $2.8 million in state funding, releasing new RFPs, and supporting community-based birth options.
Pregnancy Loss Awareness: developing culturally sensitive campaigns, online resources, and stillbirth prevention.
Maternal Mortality Review: enhancing the representation and consistency of the review committee, increasing the timeliness of case reviews and practice changes such as remote blood pressure monitoring, standardized care levels, and expanded doula access.
Universal Home Visiting: expanding the “Welcome Family” program with the goal of reaching new families with equitable postpartum support.
Orlando Watkins, Vice President and Chief Program Officer at the Boston Foundation, opened the event by stressing the Act’s importance. “This is about more than health metrics,” he said. “It ensures that every birthing person has agency, dignity and a respectful care experience.” He noted that maternal health is central to the Foundation’s child well-being work, saying that when birthing people thrive, families and communities thrive.
Senator Liz Miranda, a key driver of the Act’s passage, spoke about learning the truth behind Massachusetts’ maternal health crisis. Once confident in the state’s health-care system, it took time for her to fully grasp the inequities birthing people were facing. She recalled how many negative and dangerous birth experiences friends and family had faced. These stories, she said, revealed “structural and systemic racism in our hospitals,” which strips autonomy from birthing people of color. She praised the Healey-Driscoll Administration for passing the most comprehensive maternal health bill in the country, noting that birth outcomes improve when midwives, doulas, and alternative birth options are available.
Dr. Elaine Fitzgerald Lewis, Director of the Bureau of Family Health and Nutrition at the Massachusetts Department of Public Health, who spoke next, acknowledge that there is still more to be done, but highlighted the achievements made possible by the Act, including:
Certified Professional Midwife Integration: establishing regulation and licensure pathways, building a governing board, strengthening workforce capacity, and formalizing protocols.
Birth Center Expansion and Funding: allocating $2.8 million in state funding, releasing new RFPs, and supporting community-based birth options.
Pregnancy Loss Awareness: developing culturally sensitive campaigns, online resources, and stillbirth prevention.
Maternal Mortality Review: enhancing the representation and consistency of the review committee, increasing the timeliness of case reviews and practice changes such as remote blood pressure monitoring, standardized care levels, and expanded doula access.
Universal Home Visiting: expanding the “Welcome Family” program with the goal of reaching new families with equitable postpartum support.
AGENDA
Welcome
Orlando Watkins, Vice President and Chief Program Officer, The Boston Foundation
Opening Remarks
Liz Miranda, Senator, Commonwealth of Massachusetts
Progress Report: The Momnibus Bill
Elaine Fitzgerald Lewis, Director, Bureau of Family Health and Nutrition, Massachusetts Department of Public Health
Panel Discussion and Audience Q&A
Awara Mendy Adeagbo, Doula; Nonprofit Strategy Consultant & Funder; Servant Leader, Greater Boston Birth Equity Coalition
Emily Anesta, President, Bay State Birth Coalition
Ginny Miller, CNM, Owner, Seven Sisters Midwifery
Reena E. Singh, Senior Program Officer, Blue Cross Blue Shield of Massachusetts Foundation
Moderator: Danubia Camargos Silva, Senior Program Officer, Child Well-Being, The Boston Foundation
The panel discussion, moderated by Danubia Camargos Silva, Senior Program Officer for Child Well-Being at the Boston Foundation, built on that presentation, highlighting both progress and pain points in the state’s maternal health sector.
Ginny Miller, CNM, Owner of Seven Sisters Midwifery, described the challenges birth centers continue to face. While the bill has created new opportunities for her birth center, reimbursement is still a major issue, with complex insurance billing and low payment rates. “Midwives are not paid the same as physicians for the same exact procedures and codes,” she said. She shared that while state grants help, long-term reimbursement parity is crucial.
Emily Anesta, President of the Bay State Birth Coalition, praised the bill for prioritizing respectful, relationship-based care, but noted that advocacy must continue. Improvements in maternal and infant health will not come, she argued, “until the care is respectful and people are treated well and not experiencing racism or coercion.”
Awara Mendy Adeagbo, Servant Leader at the Greater Boston Birth Equity Coalition and a doula, celebrated expanded access to doula care but emphasized that implementation is where equity is or is not achieved. “A legislative win is not liberation,” she said. “Implementation really matters, and there are still many gaps.”
Reena Singh, Senior Program Officer at the Blue Cross Blue Shield of Massachusetts Foundation, highlighted the importance of community engagement and collaboration in sustaining progress. Philanthropy, she said, must offer both financial and strategic support, whether through community organizing, policy and research, communication strategies, or coalition-building.
Singh spoke about the Commonwealth Funders for Birth Equity as an example of community organizing. "This is a collaboration of philanthropic funders and donors improving perinatal health outcomes and advancing birth equity in Massachusetts,” Singh explained. "We started to come together informally, to share what folks had been funding, what they were interested in funding.” Singh further explained that this collaboration is modeled after existing funder collaboratives. The goals of the Commonwealth Funders for Birth Equity are to “build, activate, and sustain a values-aligned philanthropic collaborative” and to “bring greater visibility, access, and influence on perinatal and birth equity.” Singh shared that members convene to share information, learn from one another, figure out how to maximize impact, and support local leadership and community solutions.
Camargos Silva concluded the meeting by acknowledging the balance between celebrating the progress made but identifying the challenges that remain. She emphasized that the true measure of success is whether those being served actually experience transformative, equitable care. She stressed the importance of continually listening to feedback from the community, even when it is difficult, and using it to improve cultural sensitivity and the quality of services provided. She closed the forum by encouraging the audience to always approach the work with kindness and to go above and beyond to ensure that every person feels valued and transformed by their experience.
Ginny Miller, CNM, Owner of Seven Sisters Midwifery, described the challenges birth centers continue to face. While the bill has created new opportunities for her birth center, reimbursement is still a major issue, with complex insurance billing and low payment rates. “Midwives are not paid the same as physicians for the same exact procedures and codes,” she said. She shared that while state grants help, long-term reimbursement parity is crucial.
Emily Anesta, President of the Bay State Birth Coalition, praised the bill for prioritizing respectful, relationship-based care, but noted that advocacy must continue. Improvements in maternal and infant health will not come, she argued, “until the care is respectful and people are treated well and not experiencing racism or coercion.”
Awara Mendy Adeagbo, Servant Leader at the Greater Boston Birth Equity Coalition and a doula, celebrated expanded access to doula care but emphasized that implementation is where equity is or is not achieved. “A legislative win is not liberation,” she said. “Implementation really matters, and there are still many gaps.”
Reena Singh, Senior Program Officer at the Blue Cross Blue Shield of Massachusetts Foundation, highlighted the importance of community engagement and collaboration in sustaining progress. Philanthropy, she said, must offer both financial and strategic support, whether through community organizing, policy and research, communication strategies, or coalition-building.
Singh spoke about the Commonwealth Funders for Birth Equity as an example of community organizing. "This is a collaboration of philanthropic funders and donors improving perinatal health outcomes and advancing birth equity in Massachusetts,” Singh explained. "We started to come together informally, to share what folks had been funding, what they were interested in funding.” Singh further explained that this collaboration is modeled after existing funder collaboratives. The goals of the Commonwealth Funders for Birth Equity are to “build, activate, and sustain a values-aligned philanthropic collaborative” and to “bring greater visibility, access, and influence on perinatal and birth equity.” Singh shared that members convene to share information, learn from one another, figure out how to maximize impact, and support local leadership and community solutions.
Camargos Silva concluded the meeting by acknowledging the balance between celebrating the progress made but identifying the challenges that remain. She emphasized that the true measure of success is whether those being served actually experience transformative, equitable care. She stressed the importance of continually listening to feedback from the community, even when it is difficult, and using it to improve cultural sensitivity and the quality of services provided. She closed the forum by encouraging the audience to always approach the work with kindness and to go above and beyond to ensure that every person feels valued and transformed by their experience.