Briana Perry (left) and Sen. London Lamar, April 15, 2024
Sen. London Lamar’s pattern of introducing legislation aimed at improving maternal mortality rates is personal. In 2019, her freshman year as a legislator, she experienced a stillbirth and nearly died from complications. Eight months ago, she became the first Tennessee state senator to give birth while in office, and her son, Nylinn, accompanies her to session periodically.
A bill Lamar introduced this year would create an 11-member maternal health equity advisory committee within the Tennessee Department of Health, with an emphasis on appointing members with experience working with grassroots or community organizations. The bill passed the Senate in March with bipartisan support and is set to be heard on the House floor session Tuesday.
Lamar held a press conference Monday along with reproductive rights advocacy group Healthy and Free Tennessee in honor of Black Maternal Health Week, a national observance created by the Black Mamas Matter Alliance.
The maternal-health- and doula-related legislation is entwined with Tennessee’s strict abortion laws, Lamar said.
“If we truly want to be a pro-life state, a state that values the lives of all babies before they actually make it to this earth, we need to do more as a state to provide more resources and services to Black mothers and mothers across this state,” she said.
The 2023 maternal mortality report produced by the Tennessee Department of Health and the state’s Maternal Mortality Review Committee found non-Hispanic Black women were 2.3 times as likely to die from pregnancy-related causes as white women, and women on TennCare were 1.8 times as likely to die from pregnancy-related causes as those with private insurance. (Earlier in the session, Lamar introduced legislation that would have automatically enrolled minors in TennCare coverage, but it was shot down.) The committee also determined that discrimination was a contributing factor in 22 percent of the 2021 deaths.
Tennessee has the third-highest maternal mortality rate in the country, according to KFF.
As reflected in Lamar’s legislation, community-based doulas are an important player in mitigating maternal mortality disparities, said Briana Perry, interim executive director of Healthy and Free Tennessee.
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“We know that doulas, especially community-based doulas who come from or currently live in the communities that they serve, and provide care and support available and appropriate for those communities disproportionately impacted by maternal and infant mortality, should be centered in these policies and conversations around reimbursement,” Perry said.
Lamar has been making incremental change in her time as a legislator, but still wants to see doula care covered by TennCare. In order to qualify, doulas, who are not medical providers, will need to be certified as a “licensed provider.” The state’s Doula Services Advisory Committee, created through a 2023 law introduced by Lamar, will discuss the matter at its April meeting.
Healthy and Free Tennessee would like the list of approved avenues to aid those wanting to become a certified doula to include places like Homeland Hearts, a local community-based doula organization that focuses on cultural competency.
At the Monday press conference, Lamar called Gov. Bill Lee’s inclusion of $1 million in the 2023-24 budget to create a pilot program to try out TennCare doula payment “a show of good faith.” The program is still underway.
Lamar said she is grateful for the support of her legislation to introduce committees around maternal mortality and doula care, but there’s a sense of urgency.
“My issue is — while I know people care — the lack of urgency and intentionality around directly funding what needs to be done to help lower this problem,” she said. “I do also believe the laws are restricting women's health care choices [and] have played a direct impact on why we have high rates of maternal and infant mortality and morbidity in the state.”
This article was first published by our sister publication, the Nashville Post.
