From the moment we discover a baby is on its way, a flood of thoughts rushes in.

Anticipation. Joy. Fear.

What will my baby be like?

What if I’m not good at this?

And the very real thought: What if something goes wrong?

All Michigan parents and babies deserve high-quality health care, and policymakers play a big role in removing the barriers to access that continue to plague our state’s maternal and perinatal health systems.

With precious lives at risk, we here at the Michigan League for Public Policy are proud to stand beside many partners and community members across the state in support of the Michigan Momnibus bill package (Senate Bills 818 through 827) and birth center bill (House Bill 5636) introduced earlier this year in the Michigan Legislature.

According to the Michigan Maternal Mortality Surveillance Program, approximately 80 to 90 maternal deaths occur in Michigan each year, and nearly 64% of pregnancy-related maternal deaths are preventable.

Sadly, stark racial disparities come to light when you look closer at the most recent state data, which shows that both American Indian/Alaska Native and Black pregnancy-associated maternal mortality rates were nearly two times higher than white pregnancy-associated maternal mortality rates from 2016 to 2020.

And, among all regions in the state, pregnancy-related maternal mortality was also shown to be highest in Michigan’s northeast region, which includes but is not limited to Alpena, Alcona, Montmorency, and Presque Isle counties.

Furthermore, while we recently reported that infant mortality has declined in Michigan, there are still a considerable number of infant deaths in our state. In fact, according to our latest Kids Count in Michigan statewide data, the most recent three-year average (2020 to 2022) of infant deaths in Michigan was 671.

Taken together, that data underscores why the Michigan Momnibus is so critically important.

The legislation aims to address systemic racism and other social determinants of health within Michigan’s maternal and perinatal health systems through a comprehensive, multifaceted approach.

Among the policy solutions included in the 10-bill package, the Michigan Momnibus would require the use of the Patient-reported Experience Measure of Obstetric Racism (PREM-OB) Scale or a similar tool to help measure the experiences of pregnant or postpartum individuals of color receiving care in our state and would identify instances of obstetrics violence or racism. It would also require state departments to regularly report on the best methods to address racial and ethnic disparities and improve patient care within the field, while also preventing discrimination based on pregnancy or lactating status.

Other key parts of the Michigan Momnibus and the associated birth center bill are the licensing of freestanding birth centers, an amendment to the Public Health Code to allow midwives to participate in our state’s health provider loan repayment program, and equitable reimbursement by insurance providers of licensed Michigan midwives in all settings (including birth centers and home births) — all of which would improve access to health care across our state.

Michigan is one of only nine states that does not license birth centers, which are facilities where midwives provide prenatal, birth, and postpartum care.

Birth centers serve as an alternative to giving birth in a hospital for low-risk pregnancies and they are often less expensive for families.

But, because they can’t currently get licensed in Michigan, the midwives working in those centers do not receive Medicaid reimbursement for the care they provide.

By removing the barriers currently preventing licensure for those centers, they could potentially be expanded to more rural areas with a shortage of nearby hospitals — like Northeast Michigan — where pregnant individuals may currently be driving long distances to receive the care they need.

In fact, part of the impetus for introducing the birth center bill was the fact that 30% of Michigan’s counties are rural and that maternity care deserts exist all over the state.

In addition to improving accessibility to care, birth centers are also known to help advance racial justice, as they often offer more culturally responsive care to communities of color.

Additionally, by better supporting midwifery and the recruitment of more midwives in the state, Michigan can help meet the growing demand for the valuable services they provide and help meet the needs of Michigan families with lower incomes who are more likely to rely on those services since they are more cost-effective. It’s also important to note that the World Health Organization has recognized midwifery as a solution for lowering maternal mortality rates across the globe.

Right now, the Michigan Legislature has an important opportunity to make meaningful changes in the way we care for mothers and babies in our state, especially mothers and babies of color.

The Momnibus offers long-overdue solutions to some of the most critical issues within Michigan’s maternal and perinatal health systems, and we know it will drastically improve health outcomes.

In my experience as a mom, the thoughts that rush into our heads as soon as we find out we are pregnant really never go away. We are always going to wonder about our child’s future, the part we play in it, and how we could be doing better.

But policies like those in the Momnibus package can go a long way toward making sure all babies and moms get the right start.

To learn more about the Michigan Momnibus, which includes several other care solutions not covered in this column, we encourage readers to visit mistatebirthjustice.com.

Monique Stanton is president and CEO of the Michigan League for Public Policy.