Perinatal Workforce Act
- Sponsor
- Sen. Baldwin, Tammy [D-WI]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Mar 25, 2026
Bottom line
The bill seeks to improve maternal health outcomes and reduce disparities by increasing the number of diverse, culturally competent perinatal health professionals, particularly in underserved communities.
What it actually does
This bill, the 'Perinatal Workforce Act,' aims to address disparities in maternal health outcomes by expanding and diversifying the perinatal workforce. It directs the Secretary of Health and Human Services to issue guidance to States on respectful maternal care and conduct a study on best practices. Crucially, it establishes two new grant programs: one for entities to create or expand accredited programs for physician assistants, perinatal health workers, and midwives, and another for nursing schools to provide scholarships for nurse practitioners, certified nurse-midwives, and clinical nurse specialists focusing on maternal and perinatal health. Both grant programs prioritize diversity and practice in underserved areas.
Proponents argue
Proponents argue that a diverse and well-trained perinatal workforce is essential to combat the high rates of maternal mortality and morbidity, especially among racial and ethnic minority groups. They contend that increasing the number of midwives, perinatal health workers, and specialized nurses, coupled with implicit bias training and culturally congruent care, will lead to better health outcomes and more respectful birthing experiences. The grant programs are seen as a direct investment in addressing workforce shortages and systemic inequities.
Opponents contend
Critics might argue that while the goals are laudable, the bill's approach might be overly prescriptive or create new bureaucratic hurdles for educational institutions. Some may question the effectiveness of grant programs alone to fundamentally shift workforce demographics or address deep-seated systemic issues in healthcare access and quality. Concerns could also be raised about the long-term sustainability of funding for these programs beyond the authorized appropriation period, or whether the definitions of 'culturally and linguistically congruent' care are sufficiently clear for consistent implementation across diverse settings.
The bill is concise and clearly structured, making it accessible for a quick read and easy to understand its core provisions.
Section 2
HHS Agency Directives on Perinatal Care
This section mandates the Department of Health and Human Services (HHS) to issue guidance to states within two years. This guidance will educate healthcare providers and insurers on the benefits and methods of delivering respectful maternal health care through diverse and multidisciplinary teams. It also requires HHS, through the NIH, to conduct a study on best practices for respectful, culturally, and linguistically congruent maternity care, with a report to Congress including examples and recommendations.
Supporters argue
Supporters argue that clear federal guidance and a comprehensive study are crucial first steps to standardize and promote respectful, culturally competent maternal care across the nation. They believe this will help reduce health disparities and improve patient experiences by encouraging diverse care teams and implicit bias training.
Critics contend
Some might argue that federal guidance, while well-intentioned, can be overly broad or difficult to implement uniformly across diverse state regulatory environments and healthcare systems. Critics may also contend that studies and reports, while informative, do not always translate quickly into tangible improvements in care delivery without stronger enforcement mechanisms or direct funding.
Tradeoffs
The tension lies between the desire for national consistency in maternal care standards and the need for flexibility to accommodate diverse local healthcare landscapes and patient populations. Balancing comprehensive guidance with practical, adaptable recommendations is key.
Section 3 (adding new Section 758 to the Public Health Service Act)
Grants to Establish or Expand Perinatal Workforce Programs
This section authorizes the Secretary of HHS to award grants to entities to create or expand accredited educational programs for physician assistants specializing in maternal and perinatal health, perinatal health workers (like doulas or community health workers), and midwives who meet international standards. The grants can also be used to increase enrollment in existing programs, including providing scholarships, with a strong emphasis on recruiting students from racially, ethnically, and linguistically diverse backgrounds and those who plan to practice in underserved areas. $15 million is authorized for each of fiscal years 2027 through 2031.
Section 4 (adding new Section 812 to the Public Health Service Act)
Grants for Perinatal Nursing Scholarships
This section authorizes grants specifically for schools of nursing to provide scholarships to students pursuing careers as nurse practitioners, certified nurse-midwives, or clinical nurse specialists with a focus on maternal and perinatal health. Similar to the other grant program, priority is given to schools that recruit diverse students, partner with health professional shortage areas for clinical placements, and include bias/racism training in their curriculum. $15 million is authorized for each of fiscal years 2027 through 2031.
Section 5
Government Accountability Office Study on Maternal Health Barriers
This section directs the Government Accountability Office (GAO) to submit a report to Congress every five years, starting two years after the bill's enactment. The report will assess barriers to entering and completing accredited education programs for midwives and other maternity care professionals, particularly for low-income women and women from racial and ethnic minority groups. It will also examine disparities in access to various maternal care providers, stratified by demographic factors and geographic location, and recommend ways to promote greater equity in access and compensation for perinatal health workers.
The term 'racial and ethnic minority group' is defined by reference to section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6(g)(1)).
Section 6(5)
Why it matters:This is standard legislative practice to avoid redundancy and ensure consistency with existing federal definitions. It is not intended to be evasive.
Case for: Proponents argue that using an existing, established definition ensures consistency across federal programs and avoids creating new, potentially conflicting definitions. It streamlines legislative language.
Case against: Critics might argue that relying on external definitions can make a bill less self-contained and harder for the average reader to fully comprehend without additional research, potentially obscuring the precise scope of who is targeted for benefits.
Estimated impact: This definition broadly impacts the eligibility criteria for students and faculty targeted by the grant programs, ensuring that the focus on diversity aligns with established federal categories.
The bill specifies that midwives included in maternity care teams or trained through grant programs must meet 'at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives'.
Section 2(a)(2)(B)(i) and Section 3(b)(1)(C)
Why it matters:This is a technical specification to ensure a high standard of midwifery practice and education, aligning with global best practices. It's a detail within the broader goals of workforce expansion.
Case for: Proponents argue that setting an international standard ensures that the midwives supported by this bill are highly qualified and adhere to globally recognized best practices, thereby enhancing the quality and safety of maternal care.
Case against: Some might argue that imposing international standards could create additional barriers for existing or aspiring midwives in the U.S. whose training pathways might not perfectly align with these specific global benchmarks, potentially limiting the pool of eligible professionals, especially in areas with existing shortages.
Estimated impact: This requirement could significantly influence curriculum development in midwifery education programs and the recognition of midwives within healthcare systems, potentially elevating the overall standard of midwifery care but also posing challenges for adaptation.