California Gov. Gavin Newsom signed the "Momnibus Act" into law on Monday to address racial disparities in maternal and infant health, a victory especially for families of color.
The law will create a fund to grow and diversify the midwifery workforce, extend California's Medicaid coverage for doulas -- trained professionals who support mothers through pregnancies -- and extend Medicaid eligibility for mothers experiencing postpartum depression from two to 12 months.
The law is part of a sweeping effort to change stark numbers in the state.
Black women in California are four to six times more likely to die within a year of pregnancy than white women, according to data from 2014 to 2016 compiled by the California Department of Public Health. Nationally, Black and American Indian women are two to three more likely to die from pregnancy-related causes compared with white women, according to a 2019 Centers for Disease Control and Prevention report.
In California, even though the state's infant mortality is lower than the national average, Black babies still die at more than double the statewide average, lawmakers said in the bill.
Mashariki Kudumu, director of maternal and infant health initiatives for the March of Dimes in Los Angeles, helped work on "Momnibus."
"We know in California, there's about nine counties that don't have an obstetric provider, areas known as maternity deserts. Especially during COVID, we're seeing hospitals shut down their maternity units. Getting care has been a barrier for a lot of people during this time. And so being able to have more midwives that can provide prenatal care throughout the state, especially in these maternity deserts, will be a great benefit," Kudumu said.
"Everyone deserves a healthy and joyous and dignified pregnancy birth. And this bill really does help do that," she added.
The bill was authored by Democratic Sen. Nancy Skinner with support from statewide maternal health and racial justice groups.
A major part of the "Momnibus Act" is to have a committee improve data collection and reviews of maternal deaths in the state, including interviews of affected family members affected, to better study what contributes to maternal and infant mortality rates. The committee plans to publish findings and recommendations every three years.
Some of the bill's provisions already had been included in the 2021-22 state budget, including the establishment of a guaranteed income pilot program for pregnant low-income Californians and extensions of Medicaid coverage.
The legislation applies to all women who need but can't afford the services, regardless of immigration status.
Tiffany Sagote, an obstetric medical assistant in San Francisco who's pregnant with her third child, told ABC News the law is "super special for women of color who have often been overlooked in health care, professionally and emotionally, during such a beautiful milestone in our life."
"The most exciting thing," she added, "is receiving an extension of postpartum management with Medi-Cal, like mental health services, which at times are often cut short for women of color ... there is an idea in the Black community where, like, needing help is kind of taboo or a sign of failure. But in reality, it is the best thing to help us maintain a solid foundation and give our children the best version of ourselves."
She said having diverse doulas and midwives will help expectant mothers be able to advocate for themselves, especially when they aren't listened to.
"I have unfortunately experienced it myself, seen and dealt with racism and mistreatment in the health care field that leads to the statistics among black mothers and infants," Sagote continued. "Having more access to Black and Indigenous doulas will help mothers not feel intimidated to stand up for themselves in a medical setting."
Kudumu said the bill's services will lessen stress among mothers of color or those who come from low-income backgrounds.
"We know Black women have a preterm birth rate that's higher than other women in California. Adjusting some of the reasons behind that -- in terms of stress, in terms of racism, economic opportunities -- is important," she said.
Nourbese Flint, executive director of the Black Women for Wellness Action Project, joined the signing ceremony with her 7-week-old baby and called the bill signed on Monday her "second baby."
While she called the law "a win," she said that "there's still more work to do."
Stacey Stewart, president and CEO of March of Dimes, said the organization is pushing for a federal version of California's "Momnibus," a version of which was reintroduced this session with the support of Senate Majority Leader Chuck Schumer, D-N.Y.
"California passing its 'Momnibus' is also a model for what other states can do as well. And we hope we hope other states will look to California for that leadership," Stewart said. "If fully implemented, and fully funded [on a federal level], we should have every expectation that there should be a significant increase in health outcomes for moms and babies of color."