The BABIES Act (S. 5262)
Better Availability of Birth Centers Improves outcomes and Expands Savings
The BABIES Act (S. 5262) was re-introduced in the 118th Congress in the Senate with an addition that would expand access to birth centers by providing grants administered by HRSA for start-up funding for birth centers. This funding could be used toward costs related to renovation or construction of buildings, equipment purchase, or costs related to accreditation or licensure.
The bill would also establish a Medicaid demonstration program to develop and advance innovative payment models for freestanding birth center services for women with a low-risk pregnancy. The BABIES Act would set up demonstration model Birth and Health Centers in 6 states. The demonstration would consist of implementing prospective payment systems for care provided in these facilities. The demonstration also will include in-depth evaluation of the centers, their outcomes, and realized savings to the Medicaid program. The goal will be to provide access to high quality midwifery-led care to more women who currently lack this care.
Why this legislation is needed
The U.S. is experiencing a crisis in maternal health care. Maternal mortality rates in the U.S. are higher than any other developed nation and are not improving. Each year, more than 815 women die due to pregnancy complications, and for every maternal death, another 70 experience a life threatening condition (Hoyert, National Center for Health Statistics, 2024). Preterm birth rates, now 10.4% of all births, have continued to increase each year (CDC, 2024). Preterm birth is one of the leading causes of infant mortality in the U.S (March of Dimes, 2024).
Childbearing people of color, particularly African Americans, Native Americans, and vulnerable populations, including those living in rural and inner-city areas, experience disparities during and after childbirth with higher rates of poor outcomes for both mothers and infants. Rates for maternal mortality for African American women are 3 times the national rate. Infant mortality, preterm, and low birth weight births are all significantly higher among vulnerable populations.
Over 35% of all US counties are considered Maternity Care Deserts, defined as counties that lack perinatal care providers (March of Dimes, 2024). When people are forced to travel further for care, the risk of poor outcomes increases. According to the March of Dimes, birth centers can help to alleviate this shortage of access to care (MOD, 2024).
The birth center model of midwifery-led care has been shown through the Strong Start for Mothers and Newborns evaluation and multiple other studies to improve outcomes for mothers and infants, lowering preterm birth, low birth weight, and cesarean births. Evaluations conducted by the Urban Institute showed a $2000 savings for each pregnancy where care was provided in the birth center due to better outcomes, fewer NICU admissions and fewer cesarean births (DuBay et al., 2020; Alliman et al., 2019).
Increasing access for more women and families to the birth center model of care will lead to better health for all our mothers and newborns.