The Perinatal Workforce Act amends the Public Health Service Act to push federal resources toward growing and diversifying the workforce that provides care around pregnancy and the first year postpartum. It directs HHS to issue guidance to states about multidisciplinary, culturally and linguistically congruent care teams; tasks NIH with a study on respectful maternity care; creates two grant programs to expand training pipelines for perinatal professionals and perinatal-focused nurses; and orders recurring GAO reports on barriers to maternal health education and access.
Why it matters: the bill targets the education and hiring pipeline—scholarships, new or expanded accredited programs, and curricular expectations (including bias and racism training)—rather than only delivery or payment reforms. Compliance officers at grant-funded schools, hospital workforce planners, and state health agencies should expect new reporting obligations, technical-assistance offers from HHS, and guidance that centers international midwifery education standards and culturally congruent team models.
At a Glance
What It Does
Requires HHS to issue state-targeted guidance on building diverse, multidisciplinary maternity care teams and funds two new federal grant programs (one for perinatal workforce programs, one for perinatal nursing scholarships). It also directs NIH to study respectful, culturally and linguistically congruent maternity care and requires recurring GAO assessments of education and access barriers.
Who It Affects
Accredited and prospective midwifery and nursing programs, schools seeking to add or expand perinatal-focused curricula, hospitals and health systems that integrate midwives and perinatal teams, managed care entities and state Medicaid programs asked to consider recruitment incentives, and HHS agencies that will administer guidance, grants, technical assistance, and reporting.
Why It Matters
The bill channels federal dollars into training and recruitment, sets curricular expectations (implicit bias/racism training and International Confederation of Midwives standards), and builds federal monitoring of access and education barriers—potentially reshaping workforce composition and where new clinicians practice.
More articles like this one.
A weekly email with all the latest developments on this topic.
What This Bill Actually Does
The Act uses four levers to expand and diversify perinatal care: guidance, research, targeted grants, and oversight. First, HHS must produce and distribute guidance to states within two years describing how to recruit and retain diverse maternity clinicians and how to incorporate multidisciplinary teams—explicitly naming midwives meeting International Confederation of Midwives (ICM) standards, perinatal health workers, physician assistants, advanced practice nurses, and certified lactation consultants.
The guidance also encourages job-shadowing placements for students in accredited midwifery programs to strengthen clinical pipelines.
Second, NIH must complete a study on respectful and culturally and linguistically congruent maternity care and deliver a public report within two years. That report must include compendia of existing programs delivering such care, examples of systems that reduced racial and ethnic disparities in maternal outcomes, and practical recommendations clinicians and payers can follow.Third, the bill inserts two new grant authorities into the Public Health Service Act.
One (new section 758) funds entities that establish or expand accredited education programs to train physician assistants (with maternal/perinatal clinical training), perinatal health workers, and midwives who meet ICM standards; it permits scholarships and capacity expansion and gives priority to programs recruiting students from racial and ethnic minority groups, those who plan to practice in Health Professional Shortage Areas (HPSAs) or disparity-affected regions, and programs that include bias/racism training. The other (new section 812) awards grants to nursing schools for scholarships for nurse practitioners, certified nurse‑midwives, and clinical nurse specialists with maternal/perinatal emphasis and uses similar prioritization and reporting rules.
Grants run up to five years, grantees must submit annual reports on participant demographics and practice plans, and HHS must provide technical assistance and publish outcome reports evaluating effectiveness.Finally, the Comptroller General must produce a GAO report within two years—and every five years thereafter—assessing barriers to entering accredited midwifery and related programs, disparities in access to maternity clinicians and perinatal health workers, and compensation equity under public and private payers. The statute also defines key terms (e.g., culturally and linguistically congruent, perinatal health worker, postpartum as one year) to align programmatic activity and reporting.
The Five Things You Need to Know
HHS must issue and disseminate guidance to states within two years on recruiting diverse maternity clinicians and incorporating multidisciplinary, culturally and linguistically congruent teams, including job-shadowing for midwifery students.
NIH must complete a study and publicly report within two years on best practices in respectful and culturally and linguistically congruent maternity care, including compendia of programs that reduced disparities.
Section 758 creates a grant program to establish or expand accredited programs educating physician assistants (with maternal/perinatal clinical training), perinatal health workers, and ICM-standard midwives; grants may fund scholarships and capacity expansion and run up to five years.
Section 812 establishes perinatal nursing workforce grants to nursing schools to provide scholarships for NPs, certified nurse‑midwives, and clinical nurse specialists with a maternal/perinatal focus, with prioritization for programs that recruit diverse students and place students in HPSAs.
The Act authorizes GAO to report within two years and every five years on barriers to maternal health education and access, including recommendations on training barriers, access disparities, and compensation equity for perinatal workers.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Short title
Names the bill the 'Perinatal Workforce Act.' This is a housekeeping provision but signals the statute’s focus on workforce development across the perinatal period (pregnancy through one year postpartum).
HHS guidance to states on building diverse, multidisciplinary teams
Directs the HHS Secretary to issue guidance within two years advising states, hospitals, insurers, and managed care entities on recruiting and retaining maternity clinicians from racially, ethnically and linguistically diverse backgrounds; on integrating midwives (meeting ICM standards), perinatal health workers, PAs, APRNs, and IBCLC-certified lactation consultants into teams; and on offering job-shadowing for accredited midwifery students. Practically, this guidance is persuasive rather than prescriptive—but it creates expectations that state Medicaid programs and payers will be educated about workforce models that emphasize cultural congruence and nonphysician providers.
NIH study on respectful and culturally and linguistically congruent maternity care
Requires NIH to study best practices and produce a public report within two years that includes: compendia of institutions delivering culturally congruent care, examples of systems that reduced maternal disparities, and actionable recommendations. The report will serve as a federal catalogue of models that states and health systems can emulate and will inform federal grant priorities and technical assistance.
Perinatal workforce grants: eligible uses, prioritization, reporting, and funding
Adds an authority to award grants to entities establishing or expanding accredited education programs for physician assistants (with perinatal clinical training), perinatal health workers, and midwives who meet ICM standards. Grants may fund creation of accredited programs, expansions, and scholarships (explicitly to increase enrollment of students from diverse backgrounds). The Secretary must prioritize programs that recruit students from racial and ethnic minority groups, target HPSAs or areas with maternal disparities, and include bias/racism training in core curricula. Grants last up to five years; recipients submit annual reports on participant demographics and practice intentions. The section also requires HHS to provide technical assistance and mandates a Secretary-level report evaluating effectiveness four years after enactment. The statute authorizes $15 million per fiscal year for 2027–2031 for this program.
Perinatal nursing workforce grants: scholarships and priorities
Creates a parallel grant program administered to schools of nursing to provide scholarships for nurse practitioners, certified nurse‑midwives, and clinical nurse specialists with maternal/perinatal training. Priority and reporting criteria mirror the general perinatal grants—focus on diversity, placements in HPSAs, bias/racism training, and reporting on student demographics and practice plans. Grants run up to five years; HHS must offer technical support, and a Secretary report is due four years after enactment assessing recruitment and deployment outcomes. Congress authorized $15 million per fiscal year for 2027–2031 for this program.
GAO recurring report on education and access barriers
Directs the Comptroller General to report to Congress within two years and every five years thereafter on barriers to entering and completing accredited midwifery and related maternity-care programs, disparities in access to clinicians and perinatal workers (stratified by race, ethnicity, language, geography, insurance), and compensation equity recommendations. The GAO work is intended to surface system-level constraints that grant funding alone may not overcome and will feed into subsequent program design and oversight.
Definitions
Defines pivotal terms used throughout the Act—'culturally and linguistically congruent,' 'maternity care provider' (enumerating clinicians and ICM-standard midwives), 'perinatal health worker' (a broad nonclinical category including doulas and community health workers), 'postpartum' (one year), and 'racial and ethnic minority group' (by reference). These definitions narrow statutory scope in important ways (for example, explicit acceptance of ICM standards for midwives) and shape grant eligibility and reporting.
This bill is one of many.
Codify tracks hundreds of bills on Healthcare across all five countries.
Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Pregnant and postpartum individuals in communities of color and limited-English proficiency: the bill promotes more culturally and linguistically congruent teams and expands pipelines for clinicians who reflect community demographics, which may improve access and patient experience.
- Accredited midwifery and nursing programs, and students from underrepresented groups: grants and scholarships reduce financial barriers and expand classroom/clinical capacity, particularly benefiting students from racial and ethnic minority groups and low‑income backgrounds.
- Community-based perinatal workers (doulas, community health workers, lactation counselors): the statute recognizes and funds training pathways for nonclinical perinatal roles and elevates their role within care teams, potentially increasing employment and reimbursement opportunities.
- Hospitals, health systems, and rural or HPSA clinics seeking workforce pipelines: prioritized grants and technical assistance aim to grow clinicians who are likely to practice in shortage or disparity-affected areas, assisting local recruitment and retention efforts.
Who Bears the Cost
- Federal agencies (HHS, NIH, HRSA, GAO): agencies must administer grant competitions, produce guidance and studies, provide technical assistance, and compile performance reports—requiring staff time and administration outside the direct appropriation for grants.
- Grantee educational institutions: to qualify for priority and meet reporting expectations, schools may need to redesign curricula (to meet ICM standards or add bias/racism training), create or expand clinical placements, and absorb administrative reporting burdens.
- States and payers encouraged to adopt guidance: although guidance is not a mandate, states, Medicaid programs, and managed care entities will face pressure to adapt policies to support team-based models and placements, potentially requiring statutory or budget changes at the state level.
- Congressional appropriations: the bill authorizes discretionary funding streams (two $15M-per-year authorizations); if appropriations are limited, agencies must balance administrative overhead with funding awards.
Key Issues
The Core Tension
The central dilemma is targeted supply-side investment versus systemic constraints: the Act funds education and recruitment to increase diversity and numbers, but without complementary changes to licensure, hospital privileging, and reimbursement structures, additional clinicians may not be deployable or retained in the communities that need them most.
The bill is deliberately pipeline-focused: scholarships, accredited program expansion, and curricular requirements are useful levers, but they do not directly change licensure regimes, hospital privileging, or payment for services—factors that materially affect whether newly trained clinicians can practice where needed. The Act leans on guidance and prioritization rather than mandatory payment reforms, so uptake by payers and hospitals will depend on parallel state and private sector decisions.
Similarly, the statute adopts the International Confederation of Midwives’ education standard as a benchmark. That creates clear program goals but may clash with existing U.S. midwifery credentialing pathways and state licensure laws, requiring schools to invest to meet international standards or risk being less competitive for grants.
Data and measurement issues are another pain point. Several reporting and evaluation provisions hinge on availability of granular outcomes data (maternal mortality, severe morbidity, workforce location, and student demographics).
Federal and state gaps in consistent data collection—on where graduates practice, their patient panels, and outcomes stratified by race/ethnicity and language—will complicate the Secretary’s and GAO’s ability to demonstrate program impact. Finally, grants are time-limited (up to five years) and relatively small compared with the scale of workforce shortfalls; without explicit sustainability funding or follow-on reimbursement changes, expanded class sizes and new graduates may disperse to higher‑paying settings rather than remain in HPSAs or disparity-affected communities.
Try it yourself.
Ask a question in plain English, or pick a topic below. Results in seconds.