H. Res. 231 is a nonbinding House resolution that formally recognizes the historical and contemporary contributions of Black midwives and designates March 14, 2025 as “Black Midwives Day.” The resolution compiles epidemiological and historical findings—including maternity care deserts and sharply elevated Black maternal mortality—and uses those findings to press federal, state, and local governments to act.
Rather than creating new statutory authority, the resolution urges a package of policy priorities: diversify and expand the perinatal workforce, increase funding for midwifery education and preceptorships, remove accreditation and licensure barriers, authorize autonomous midwifery practice consistent with training, promote Medicaid and TRICARE coverage of midwife-provided maternity care across training pathways, and encourage destigmatization and decriminalization of community-based midwifery. For compliance officers, payers, and health system leaders, the text flags likely policy directions and constituencies that could press for regulatory or statutory follow-through if the hortatory language gains traction.
At a Glance
What It Does
The resolution designates March 14, 2025 as Black Midwives Day and collects factual findings about maternal health disparities and midwifery outcomes. It asks federal, state, and local governments to pursue workforce diversification, funding for training and preceptors, authorization of autonomous midwifery practice, and expanded payer coverage for midwife services.
Who It Affects
The measures cited would directly concern Black midwives and midwifery training programs, Black birthing people (particularly those in maternity care deserts), state licensing boards, Medicaid and TRICARE administrators, and health systems that contract with midwives or operate birth centers.
Why It Matters
Although nonbinding, the resolution consolidates data and international recommendations to create a policy framework that advocates and agencies can point to when seeking statutory changes, regulatory waivers, or funding. It signals congressional attention to credentialing, payer coverage, and criminalization issues that could translate into future legislative or administrative action.
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What This Bill Actually Does
H. Res. 231 is structured like many commemorative resolutions: it opens with a long preamble of “whereas” clauses and ends with a set of seven resolve clauses that urge action.
The preamble gathers recent data (for example, the text cites maternity care deserts and rising Black maternal mortality), historical context on the suppression of Black midwifery, and international human-rights recommendations calling for removal of legal barriers to midwifery. Those factual citations frame the policy asks that follow.
The operative portion does not change statute or appropriate funds. Instead it urges governments at all levels to take a series of steps: first, proactively diversify the perinatal workforce and increase access to culturally congruent care; second, collaborate with stakeholders to develop policies that confront systemic racism in maternal health; third, boost education and training pipelines by expanding funding, preceptor access, and recognition of multiple midwifery training pathways; fourth, authorize midwives to practice autonomously to the full extent of their training; fifth, promote TRICARE and Medicaid coverage for midwifery services across training backgrounds; and sixth, encourage efforts to destigmatize or decriminalize midwifery practiced in homes, birth centers, and community settings.Practically speaking, the resolution functions as a policy roadmap rather than an implementable statute.
If stakeholders treat it as a rallying document, expect pressure on state legislatures and federal agencies (Centers for Medicare & Medicaid Services for Medicaid policy and DoD/TRICARE for military family coverage) to consider rulemaking, demonstration projects, or statutory initiatives aligning with the resolution’s priorities. Because the text explicitly calls out accreditation, preceptors, and payer coverage, institutions that train midwives and payers that reimburse maternal services are likely to see advocacy focused on those discrete levers.Finally, the resolution elevates cultural and historical arguments alongside clinical and economic ones—linking the case for midwifery expansion to trust, cultural competence, and reparative justice for communities whose traditional care systems were eroded.
That combination can broaden the coalition pushing for practical reforms but also creates implementation complexity, as technical regulatory and payer questions will sit beside community-driven demands for autonomy and access.
The Five Things You Need to Know
The resolution designates March 14, 2025 as “Black Midwives Day” and frames it as a day for awareness, education, and community building.
The bill cites that approximately 2,200,000 women of childbearing age live in maternity care deserts—areas without hospitals, birth centers, or obstetric providers.
It highlights a 2023 CDC figure that the maternal mortality rate for Black women was cited at 50.3 deaths per 100,000 live births, markedly higher than other groups.
One operative ask is that federal and state governments authorize autonomous practice for ‘‘all midwives to the full extent of their training,’’ encompassing multiple training pathways.
The resolution calls for promoting TRICARE and Medicaid coverage of maternity care provided by midwives regardless of training pathway and urges funding for education, preceptors, mentorships, and pathways to accreditation.
Section-by-Section Breakdown
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Data, history, and international recommendations that justify action
The preamble compiles epidemiological data (maternity care deserts, rising infant and maternal mortality, race-disaggregated mortality rates), historical notes about the suppression of Black midwifery in the 20th century, and citations to United Nations committee recommendations. Practically, these findings create the factual predicate advocates will use when asking agencies or legislatures to change rules or fund programs.
Urge governments to diversify perinatal workforce and expand culturally congruent care
This clause asks federal, state, and local governments to take proactive measures to reduce racial disparities by diversifying the perinatal workforce and increasing access to culturally aligned maternal health services. For implementation, that language points to grant programs, targeted pipeline investments, and recruitment strategies but does not itself appropriate funds or create mandates.
Call for funding and training supports, preceptor access, and accreditation flexibility
Clause 3 asks for increased funding for education and training, more access to Black preceptors, removal of barriers to preceptors, financial pathways to support students and preceptors, and mentorship programs, and asks that midwives across training pathways be recognized for accreditation purposes. Translating this into policy would require grants, scholarship authority, or regulatory changes around clinical placement and accreditation standards.
Authorize autonomous practice and expand payer coverage
Clause 4 encourages governments to authorize midwives to practice autonomously consistent with their training; clause 5 promotes TRICARE and Medicaid coverage for maternity care provided by midwives from all training backgrounds. Those asks engage state scope-of-practice laws and federal payer rules: states control licensure and scope, while CMS and DoD set Medicaid and TRICARE coverage policies, respectively.
Destigmatize and decriminalize community-based midwifery
Clause 6 urges active steps to remove stigma and criminal penalties that affect direct-entry and community midwives and to protect birth-site choice (home, birth center, clinic). This invites legislative review of criminal statutes and disciplinary rules in states where prosecutions or sanctions against midwives persist, and it highlights the legal patchwork that currently governs community births.
Recognition and symbolic support
The final clause expresses support and recognition for the historical and ongoing role of Black midwives. As a symbolic element, it is designed to elevate the profile of midwifery within broader maternal-health advocacy and to legitimize other concrete asks in the resolution.
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Who Benefits
- Black midwives and midwifery students — the resolution explicitly calls for funding for education, access to Black preceptors, mentorships, and recognition across training pathways, which would expand training and career support.
- Black birthing people and families — by emphasizing culturally congruent care, expanded midwife access, and destigmatization of community birth settings, the resolution aims to improve trust, continuity, and health outcomes for Black mothers and infants.
- Rural and underserved communities living in maternity care deserts — the push to integrate midwives more fully and to authorize autonomous practice could increase local access to prenatal, birth, and postpartum care where obstetric providers are scarce.
- Midwifery training programs and community-based birth centers — calls for funding and payer coverage create potential revenue and enrollment pathways that could stabilize and scale these programs.
Who Bears the Cost
- State governments and licensing boards — authorizing broader autonomous practice and decriminalizing certain pathways may require legislative or regulatory overhaul, legal review, and new oversight capacity.
- Federal payers (Medicaid programs and TRICARE) — expanding coverage to midwives across all training backgrounds could increase utilization and program costs, and may require changes to provider enrollment, credentialing, and reimbursement systems.
- Hospitals and health systems — integrating a larger midwifery workforce and honoring autonomous practice may require adjustments to privileging policies, transfer protocols, and collaborative agreements.
- Professional credentialing bodies and accreditors — the resolution’s call to recognize multiple pathways could force revisitation of education standards and certification reciprocity, with administrative and substantive workload for accreditation entities.
Key Issues
The Core Tension
The bill’s central dilemma is whether to prioritize rapid expansion of culturally congruent access—by recognizing multiple training pathways and granting broad autonomy—or to prioritize standardized credentialing and payer controls that ensure consistent clinical safeguards; achieving both goals requires reconciling competing demands for access, quality assurance, and fiscal accountability.
Two implementation realities complicate the resolution’s impact. First, H.
Res. 231 is hortatory: it urges action but does not create enforceable rights, appropriate funds, or change statutory coverage rules. Real-world effects therefore depend on follow-on legislative bills, administrative rulemaking at CMS and DoD, and state-level reforms to scope-of-practice and criminal-law statutes.
Advocacy groups can use the resolution as leverage, but the text itself imposes no obligations.
Second, the specific policy asks raise technical trade-offs. Authorizing ‘‘autonomous practice’’ for diverse midwifery training pathways prompts immediate questions about uniform competency standards, mechanisms for emergency transfer and collaboration with obstetric care, malpractice liability frameworks, and how payers will credential and reimburse nonstandard pathways.
Similarly, calls to expand Medicaid and TRICARE coverage intersect with federal/state financing rules, provider enrollment systems, and budget constraints—so coverage expansion may require careful statutory or waiver-based design. Finally, the push to decriminalize community midwifery will encounter a patchwork of state laws and possibly opposition from licensure boards or medical associations, meaning legal exposure and enforcement variability will persist absent coordinated statutory reform.
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