Amid The National Maternal Mortality Crisis, Washington State Passes Essential Legislation

April 7, 2022 9:33 am Published by

Newly signed laws show promise to address gaps in reproductive and perinatal health, access to doula services, and public support for low-income families with young children.


Media Contact: Elena M. Teare,

SEATTLE, WA (April 7, 2022) – On March 30, Governor Inslee signed a slew of bills that will expand access to community-based doula services and donor breast milk insurance coverage, introduce a diaper subsidy for households enrolled in Temporary Assistance for Needy Families (TANF), and allow licensed midwives to seek prescriptive license extensions to prescribe contraceptives for postpartum patients and treat common conditions of a healthy pregnancy.

This legislation comes as the maternal mortality crisis worsens across the nation amid the COVID-19 pandemic’s continued straining of the medical system. Data released by the National Center for Health Statistics reported that maternal deaths in the United States rose 14 percent in 2020, up from 20.1 deaths per 100,000 live births in 2019 to 23.8 deaths in 2020. The report revealed the disproportionate burden on birthing people of color, especially Black women, as they consisted of one-third of all maternal deaths in 2020. The data cements the United States’ maternal health outcomes as the poorest among similarly developed countries.

HB 1881, also signed into law, will create a new health profession within the state’s Department of Health for birth doulas. Doulas are nonmedical persons that provide emotional, physical, and informational support for pregnant people before, during, and after labor, often coaching clients to self-advocate in medical settings. Research has shown that doulas improve birth outcomes and one-on-one continuous doula support for low-risk patients in spontaneous labor is endorsed by the American College of Obstetricians and Gynecologists (ACOG).

Dila Perera, Executive Director of Open Arms Perinatal Services, commented, “HB 1881 lays the groundwork to expand access to community-based doulas by publicly and directly reimbursing their work. Research has already shown the promise doulas have to address maternal health disparities. It’s time to strive to pay them what they are worth.”

Washington State is in many ways a leader for maternal and infant health in the country, but inequities for Black, Indigenous, and other people of color persist. A study released in 2018 showed higher rates of incomplete prenatal care for Black birthing people compared to the White population in the state. King County reports the preterm birth rates from 2015-19 for American Indian Alaskan Native (AIAN), Native Hawaiian Pacific Islander, and Black populations to be 17.4 percent, 17.3 percent, and 11.9 percent, respectively, compared to the White population at 7.8 percent.

“Open Arms has always advocated for the priorities of our communities, birth workers, and families. We are so happy that so many partners and allies met with such tremendous success this year. When more community-based doulas reach more families and clients have support with everything from diapers to helplines, our whole state benefits. We are just getting started,” continued Perera.


Founded in 1997, Open Arms is the first independent, community-based program in Washington State to provide comprehensive perinatal services to over four thousand economically marginalized families. We are a predominantly BIPOC organization that provides free support during pregnancy, birth, and early childhood with birth and community-based outreach doula services, lactation counseling, and social service referrals to over 500 families annually throughout the Puget Sound region.