Massachusetts health officials are pledging to invest in new programs and rewrite regulations to expand access to maternal health care.
These steps are among dozens of recommendations in a pair of Department of Public Health reports released Wednesday. Gov. Maura Healey ordered her top health officials to review maternal health care access across the state, as well as medical services in northern Worcester County, following the controversial decision to close a Leominster hospital maternity unit in September.
Several community hospitals have shuttered or reduced labor and delivery services in recent years — including in Beverly, Falmouth and Wareham — often citing staffing challenges and declining patient numbers.
State officials found Massachusetts does not have any maternity care “deserts,” or counties lacking obstetric services. But the state must work to increase access to services and make care more equitable, said Dr. Robbie Goldstein, commissioner of public health.
“We are, overall, a very healthy state,” Goldstein told WBUR. “We are a state with a lot of great health care resources. But we are a state that wants to and will hold ourselves accountable to a much higher level.
"And I think these reports allowed us to articulate that goal, that we don't want to just be at the national average. We want to make sure that everyone in Massachusetts has access to high-quality care.”
The reports did not say the Leominster maternity unit, or other units that have closed, should have remained open. But Goldstein said the state can take other actions, and some of the recommendations can begin right away. For example, he said the Department of Public Health will update its regulations to make it easier for birth centers to open in the state and for nurse midwives to work here. The department also will create a certification process for doulas, which could help more people access doula support.
State officials also said they will work with insurers and health care providers to expand home visiting programs for postpartum patients.
In their review of essential health care services in northern Worcester County, officials found transportation challenges, workforce shortages and a dearth of mental health and addiction treatment facilities.
That report calls on Worcester County’s biggest health care provider, UMass Memorial Health, to provide greater access to specialists in the Leominster area. It also recommends improvements to public transportation to help patients travel to medical appointments.
Goldstein said state laws and regulations should be updated, so public health officials can play a stronger role when hospitals decide to close essential services.
“We, as a department, have a role to play here — more than just a regulatory role of collecting paper and processing legal documents around essential closures," he said. “We have a role to engage with the community.”
Leaders of the Massachusetts Nurses Association, who opposed the maternity unit closure in Leominster, said the reports are "a positive step" in what should be a concerted effort to improve care for people of color and people from low-income communities.
"In the longer term, the Commonwealth must look to overhaul the existing essential services closure process to give the DPH more authority and the power to enforce their rulings," union leaders said in a statement.
UMass Memorial officials said they’re working to increase access to specialists, including at a clinic that recently opened in Leominster.
“We will soon be investing an additional $1 million in programs to support the broader health care needs of the local community, including women and birthing people,” spokesperson Shelly Hazlett said, adding UMass Memorial “looks forward to continuing our efforts to preserve access to care for patients across Massachusetts in collaboration with the Healey administration.”
This article was originally published on November 15, 2023.