H. Res. 1120 is a House of Representatives resolution that designates March 14, 2026, as “Black Midwives Day,” recognizes the historical and ongoing contributions of Black midwives, and urges government action to address racial disparities in maternal and infant health.
The resolution is declarative rather than legislative: it does not create new law but signals congressional support for a set of policy priorities aimed at expanding access to culturally congruent midwifery care.
Its preamble catalogues the problem—maternity care deserts, high maternal mortality among Black women, and the historical suppression of Black midwifery—and the operative clauses encourage a suite of responses from federal, state, and local actors. Those requests range from workforce and training investments to calls for broader recognition of diverse midwifery training pathways, support for Medicaid and TRICARE coverage of midwife care, and steps to destigmatize and decriminalize midwifery practice.
At a Glance
What It Does
The resolution formally recognizes March 14, 2026, as Black Midwives Day and urges federal, state, and local governments to take measures to reduce racial disparities in maternal health. It enumerates specific policy objectives—workforce diversification, barriers to training/preceptorships, accreditation recognition, autonomous practice authorization, and expanded payer coverage—while remaining non‑binding.
Who It Affects
The text addresses Black midwives and Black birthing people directly, but it also implicates federal agencies (HHS, CMS, DoD/TRICARE), state licensing boards, Medicaid programs, midwifery training programs and preceptors, and health systems operating in maternity care deserts.
Why It Matters
As a statement of congressional intent, the resolution elevates midwifery—and specifically Black midwifery—within the maternal health policy conversation, creating a policy frame that advocates and agencies can cite when seeking funding, regulatory change, or state action on licensure and coverage.
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What This Bill Actually Does
The resolution begins with an extended preamble that lays out the policy problem: the United States faces significant racial disparities in maternal mortality and morbidity, Black communities have experienced systematic suppression of traditional midwifery, and many areas are ‘maternity care deserts’ with no local obstetric services. The sponsors anchor their case in recent data and international human‑rights observations to argue that increasing Black midwifery is a practical and equity‑focused response.
Operationally, the 'Resolved' clauses do not impose new regulatory duties. Instead, the House expresses support for the designated day and encourages government actors to pursue a menu of reforms: diversify the perinatal workforce, invest in education and preceptorships for Black midwives, reduce accreditation and training barriers, permit midwives to practice to the full extent of their training, pursue Medicaid and TRICARE coverage for midwife‑provided maternity care, and remove criminal penalties that disproportionately affect midwifery pathways.
Those requests are framed as invitations to action rather than mandatory legal changes.If agencies or states act on the resolution’s suggestions, implementation will proceed through familiar levers: federal agencies could propose rule changes, issue guidance, or fund demonstration grants; Congress or state legislatures could change statutes governing scope of practice or Medicaid coverage; and licensing bodies could adjust accreditation recognition and preceptor rules. Practically speaking, the resolution creates no deadlines, no appropriation of funds, and no enforcement mechanism—it is a policy signal that can be used by advocates to press for concrete steps.
The Five Things You Need to Know
The resolution cites a maternity care desert statistic: more than 2,300,000 women of childbearing age live in areas without a hospital offering obstetric care, a birth center, or an obstetric clinic.
It quotes CDC figures showing a 2024 maternal mortality rate for Black women of 44.8 deaths per 100,000 live births versus 14.2 for White women, using those data to justify targeted workforce and access interventions.
The text explicitly calls for increased funding for education, training, and access to Black preceptors and for financial pathways to support students and preceptors.
It urges federal and state governments to authorize the autonomous practice of all midwives to the full extent of their training and to recognize midwives across all training pathways by removing accreditation barriers.
The resolution promotes TRICARE and Medicaid coverage (authorization or reauthorization) of maternity care provided by midwives from any training pathway, and it urges decriminalization and destigmatization of midwifery practice in the setting chosen by the pregnant person.
Section-by-Section Breakdown
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Problem statement: disparities, deserts, and history
The preamble aggregates epidemiological and historical points the sponsors use to justify policy attention. It cites the rise in infant mortality, the high maternal mortality rate among Black women, the existence of maternity care deserts, and the historical decline and suppression of Black midwifery. For practitioners and policy shops, the preamble functions as a compact bibliography of arguments for expanding culturally congruent midwifery and for treating midwifery as a racial‑equity issue.
Symbolic designation of Black Midwives Day
This clause formally supports recognizing March 14, 2026, as Black Midwives Day. The designation is declaratory; it creates no statutory obligations but serves as a congressional expression of support that advocates can cite in funding requests, public awareness campaigns, and agency commentary.
Calls for proactive governmental measures and stakeholder collaboration
These clauses urge federal, state, and local governments to take proactive steps on workforce diversity and culturally congruent care and commit the House to collaborate with stakeholders on policy solutions. The language contemplates cross‑sector engagement—public agencies, community organizations, and professional bodies—but stops short of prescribing specific legislative or regulatory tools.
Targeted workforce and accreditation requests
Subparts A–E enumerate concrete workforce items: increased funding for education, training, and access to Black preceptors; removing barriers to preceptors; creating financial pathways for students/preceptors; mentorship programs focused on sustaining Black midwifery; and removing accreditation barriers by recognizing all training pathways. These are actionable asks that would require appropriation or regulatory changes to implement—e.g., grant programs, changes to accreditor recognition rules, or state education incentives.
Authorization of autonomous practice
The resolution encourages federal and state governments to authorize midwives to practice autonomously to the full extent of their training. Because scope‑of‑practice rules are primarily state law, meaningful change on this point would require state legislative action or regulatory reforms by state boards; at the federal level, the influence is limited to convening, guidance, or funding incentives.
Coverage by TRICARE and Medicaid
The resolution promotes authorizing or reauthorizing TRICARE and Medicaid coverage of maternity care provided by midwives across all training pathways. Realizing this objective would typically require statutory language or regulatory action at CMS and the Department of Defense and could carry fiscal implications for federal and state budgets tied to Medicaid eligibility and benefit design.
Decriminalization, destigmatization, and final recognition
The closing clauses urge steps to destigmatize and decriminalize midwifery in chosen birth settings and reaffirm support for the contributions of Black midwives. These calls intersect with state criminal statutes and licensing enforcement practices, and they aim to reduce legal risks that have disproportionately affected community and direct‑entry midwives.
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Who Benefits
- Black birthing people and their families — increased attention to culturally congruent care and targeted workforce investments aim to improve access, trust, and outcomes for Black mothers and infants.
- Black midwives and aspiring midwives — the resolution’s calls for preceptor funding, mentorship, accreditation recognition, and destigmatization are specifically designed to lower structural barriers to training, practice, and retention.
- Medicaid enrollees and military families (TRICARE beneficiaries) — the resolution encourages coverage expansion that, if implemented, would expand payer access to midwife‑provided maternity services.
- Rural and underserved communities in maternity care deserts — by highlighting deserts and advocating for midwife integration, the resolution supports strategies that can increase local options where obstetric services are absent.
- Community health organizations and maternal health advocates — the congressional statement provides political cover and a policy frame to support grant applications, pilot programs, and state advocacy campaigns.
Who Bears the Cost
- State governments and licensing boards — changes to scope‑of‑practice, accreditation recognition, or decriminalization would typically require state legislative or regulatory work, administrative capacity, and possible fiscal adjustments.
- Federal agencies (CMS, HHS, DoD) — acting on coverage or programmatic recommendations would require regulatory drafting, possible rulemaking processes, and budgetary commitments or reallocation of funds.
- Insurers and Medicaid programs — expanding coverage for midwife services across training pathways may change utilization patterns and require actuarial assessment, claims processing updates, and negotiated reimbursement rates.
- Hospitals and obstetric practices — integrating expanded midwifery services or adjusting referral patterns could necessitate workflow, credentialing, and collaboration changes, with potential financial and operational implications.
- Midwifery education programs — scaling up to meet any workforce expansion will require instructors, clinical preceptors, facilities, and potentially increased accreditation oversight, all of which carry costs.
Key Issues
The Core Tension
The central dilemma is between expanding access and cultural congruence—by recognizing diverse midwifery pathways and promoting autonomous practice—to reduce racial disparities, and the simultaneous need for standardized training, regulatory oversight, and payer confidence to ensure safety, liability coverage, and quality of care; the resolution favors expansion and recognition but does not resolve how to balance open access with rigorous, uniform safeguards.
H. Res. 1120 is influential as a policy signal but legally non‑binding.
That limits immediate effect: none of the resolution’s calls creates statutory entitlement, appropriates funds, or overrides state licensing systems. Real‑world change would require follow‑on actions—appropriations for education and preceptor grants, state law or board rule changes on scope‑of‑practice and accreditation, CMS or congressional action to expand Medicaid coverage, and DoD policy shifts for TRICARE.
Advocates can use the resolution as leverage, but implementation timelines and fiscal tradeoffs remain unresolved.
Several operational tensions are under‑addressed. First, the resolution urges recognition of “all training pathways” and autonomous practice while not specifying minimum competency, credentialing standards, or liability and malpractice frameworks; states and payers will demand those details before changing licensure or coverage rules.
Second, proposals to decriminalize direct‑entry midwifery may clash with public‑safety concerns in jurisdictions that link criminal sanctions to unlicensed practice; removing criminal penalties without parallel quality‑assurance mechanisms could provoke political pushback. Finally, the resolution calls for funding and coverage changes without identifying revenue sources, meaning advocates will need to map specific federal appropriations or state budget offsets to operationalize the sponsors’ goals.
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