Martha Marx


Martha Marx



June 1, 2023


Today, the Connecticut State Senate passed legislation that will defend maternal health in Connecticut. One of Governor Ned Lamont’s priority bills for the 2023 legislative session, the legislation is intended to increase access to maternal health services for women around the state, specifically designed to improve problems with geographic and financial access to such services. The bill comes in response to several hospitals in the state having pending requests to close their labor and delivery facilities, reducing such services around the state overall and especially impacting residents of the state in areas with limited maternal health resources.

“In recent years, our state has seen the threat of reduced access to maternal health, which can impact the finances and health of expecting parents,” said State Senator Martha Marx (D-New London), Senate Vice Chair of the Public Health Committee, in approving the legislation. “This legislation will foster the use of birth centers, doulas and nurse home visits to support prenatal health care through all stages of pregnancy and birth, supporting families across our state.”

Senate Bill 986, “An Act Protecting Maternal Health,” would take actions upon becoming law including:

Officially recognizing birth centers as medical institutions; “birth centers” are freestanding facilities licensed to provide perinatal, labor, delivery and postpartum care during and after delivery and that are not licensed, attached to or located in hospitals. Beginning in 2024, these centers will require licensing for operation. Birth centers are intended for low-risk pregnancies which will have low risk of complication during labor and birth.
Biennial licensing and inspection of institutions by the Department of Public Health will include “birth centers,” with a cost of $940 per site and $7.50 per bed; birth centers will be required to report adverse events to the Department of Public Health similar to hospitals. The DPH will not grant or renew maternity hospital licenses after the end of 2023; birthing centers are exempt from requiring certificates of need, and the Office of Health Strategy will study whether the exemption should be extended beyond 2027; the DPH will establish an infant mortality review program to study medical records and data related to infant deaths; the DPH will also establish an infant mortality review committee to review infant deaths with the purpose of reducing disparities and making recommendations to reduce infant deaths; the DPH would establish a Doula Advisory Committee to study recommendations for requirements for certification and renewal for doulas and standards for training program curricula. The committee would also make recommendations on matters including access and promotion of education and resources for pregnancies, recommendations to improve access to doula care, and furthering efforts to counter maternal health disparities; A midwifery working group would also be established in the DPH, further studying ways to address racial disparities in maternal and infant health outcomes; state-wide program would be developed offering universal nurse home visiting services to all families with newborns in Connecticut, intended to improve child safety, health, development and parenting among many others.

Birth centers are a high-value alternative to hospitals for parents with low-risk pregnancies, saving more than $2,000 per infant and decreasing the rate of cesareans births among families. Birth centers also reduce pre-term births. According to the New York Times, from 2006 to 2016, there was an 83% increase in births at free-standing birth centers, and parents in birth center care see c-section rates of about 6%, compared to an overall rate of 26%.

Doulas serve valuable roles in supporting maternal childbirth. According to the American Pregnancy Association, doulas made parents less likely to have pain-relief medications and less likely to have cesarean births; some studies show that their presence can even decrease length of labor and requests for epidurals.

Universal home visiting, according to the Office of Early Childhood, can generate $3 in savings for every $1 spent on program costs. Nurse visits can provide responses to health impacts, reduce stigma for services and enhance referrals to needed resources for high-risk families.

Prior to its passage by the Senate today, this bill passed the Public Health Committee by a 26-11 tally in March.