Maternal health top budget priority for Pittsburgh Democrat La'Tasha Mayes

State budget hearings in Harrisburg aren’t just discussions of how tax dollars are being spent: Legislators often ask broader questions as well, of interest to themselves or their districts.

Pittsburgh House member La’Tasha D. Mayes sits on the House appropriations committee that plays a key role in allocating state dollars. And she’s used that position to focus on an issue that she says hasn’t gotten enough attention: the well-being of moms — Black moms in particular — in Pennsylvania.

Over the past few weeks, Mayes has asked the secretaries of the state Human Services and Health departments about their strategies to address maternal mortality, especially for low-income moms who rely on Medicaid and other benefits. She wondered what the state’s Drug and Alcohol Department was doing for moms in active addiction while suffering from postpartum depression. And she implored Auditor General Tim DeFoor to audit state prison spending for the health care of incarcerated women — a review that DeFoor said has yet to be done.

Mayes, a Democrat, has noted repeatedly that Black mothers are up to three times more likely to die during or shortly after pregnancy as white women. But in an interview, she said her efforts are “about all moms, because when we solve maternal mortality and morbidity … we solve this for every single mom in this Commonwealth.”

And Mayes said that Democrat and Republican House members have a stake in finding that solution.

“Moms who are living in rural counties that are maternal health deserts, they're suffering too,” she said. “This is probably one of the rare issues that we can work on in the House and Senate in a bipartisan way to save moms.”

Mayes is no stranger to taking on maternal health issues, having co-founded a reproductive justice organization more than 20 years ago. She’s also a new mother herself and a co-chair of the Black Maternal Health Caucus, established in 2023 and modeled after a Congressional Black Maternal Health caucus formed a few years earlier. Morgan Cephas of Philadelphia and Gina Curry of Delaware County also serve as co-chairs.

The caucus has crafted several bills — Mayes and others call it a “Momnibus” package — inspired by similar legislation offered in Congress. Two bills backed by the caucus have been signed by Gov. Josh Shapiro: One educates people on postpartum depression and mental-health screenings, while the other extends Medicaid to cover the cost of doulas, who provide physical and emotional support before, during, and after birth. (The caucus hopes to require private insurers to cover those services as well.)

Other legislative priorities include: blood-pressure monitoring at home post-birth (with separate bills last session for both Medicaid and private insurance to cover the cost); designating maternal health deserts across the state to provide additional support; supplying resource kits for moms and newborns; and requiring implicit bias training for health-related continuing education certifications through the Department of State.

Mayes said the caucus will bundle those initiatives together in a “Momnibus 2.0” package.

Amy Chen, who tracks states’ progress on securing Medicaid coverage for doula care, said national support is growing fast for such efforts.

“In 2017, we had two states that had Medicaid coverage for doula care,” said Chen, a senior attorney with the National Health Law Program, a nonprofit that works on health access for underserved communities. “By 2021, we had between half a dozen to ten, and now as of today, we have 23 states — close to half of states already … and a bunch more that are kind of in the process.”

Depending on the state and cost-of-living in the region, doula care can cost between $1,500 to $3,000 out of pocket, Chen added. And evidence suggests that, in some cases, these caregivers improve a mother’s well-being throughout the birthing process.

Advocates say that can be especially important for Black mothers.

“I can't tell you how many times I've come across moms who are telling me that … when they go home to their communities [after giving birth in a hospital], the organizations that are supporting them are not culturally competent,” said Muffy Mendoza, founder and executive director of Pittsburgh Brown Mamas, a support group for Black mothers. Sometimes, she said, Black moms “[are] just not comfortable being in those spaces.”

Mendoza’s group hosts a list of Black doctors and therapists in the Pittsburgh area, a request she said she hears frequently. She said her clients often feel better understood and cared for when their doctors resemble them, a phenomenon that has been studied by the American Association of Medical Colleges

And maternal health is more than just the care people get inside doctor’s offices and hospitals, Mendoza added: “We have to think about [healthcare] that is not just ‘making people feel well,’ but it's also just affirming who we are as a people, affirming that we deserve respect.”

It’s these potential implicit biases in health care that can play a role in the disproportionate Black maternal mortality rate, Mayes said. But it’s not always easy to get the word out:

Last session Mayes was among the sponsors of a bill that would require training about such bias to be included in continuing-education programs for a broad range of caregivers. It idled in a House committee. Mayes said that while legislators lacked the “appetite” for such a reform, “We have to be honest about the biases that our healthcare system has.”

Even if that measure doesn’t make progress this session, Mayes said, she hopes to educate people in Western Pennsylvania next month. This year, she and her colleagues will celebrate Black Maternal Health week in Pittsburgh, April 14 through April 16.

“We can solve the issue of Black maternal mortality and morbidity if we want to,” Mayes said. On the other hand, she added, “If we can’t figure out how to save moms, we can’t figure out anything in the state.”