Across the country, states are stepping up to address the maternal health crisis through comprehensive “Momnibus” packages, a set of bills designed to move maternal health systems toward stronger and more holistic outcomes. The recent National Partnership for Women & Families State Momnibus Scan found that thirteen states have partially or fully passed Momnibus legislation, and four more introduced packages this year.
To bring the report’s findings to life, NPWF hosted a two-part Instagram Live series featuring advocates from Virginia, Delaware, Kentucky, and Michigan. The first Instagram live brought together two powerhouse leaders, Kenda Denia, founder and executive director of Birth in Color in Virginia, and Shané Darby, founder and executive director of Black Mothers in Power in Delaware and a Wilmington City Council member. The second Instagram live featured seasoned advocates Tamarra Wieder, the Kentucky State Director for Planned Parenthood Alliance Advocates, and Nicole White, the Co-founder of Birth Detroit and MI State of Birth Justice. Virginia, Delaware, and Kentucky successfully signed their Momnibus packages into law, whereas Michigan’s Momnibus passed the Senate this year. Together, the conversations spotlighted strategies for achieving each state’s maternal health policy priorities and signaled what is needed for the work ahead.
Lived Experiences Shape Stronger Maternal Health Policy
Across the four featured states, the advocates emphasized the need to elevate the lived expertise of those directly impacted by gaps in pregnancy and postpartum care when creating a responsive and accountable policy agenda. For example, Birth in Color hosted Black maternal health listening sessions with birthworkers, families, and community members in 2019, far before Virginia’s Momnibus was conceived. Those conversations shaped the development of nearly 10 maternal health bills, some of which became part of the Momnibus, while others were separate. Nonetheless, the maternal health legislation generated from the community listening sessions increased recognition of the need and political mobilization to improve Black maternal health, so that when the state obtained its first Black Speaker of the House, a policy window opened, ushering in the first Momnibus package in Virginia.
In Delaware, Black Mothers in Power also began their work by hosting community listening sessions. To reduce barriers to engagement, Black Mothers in Power provided meals and covered childcare expenses for participating families. Expanding access to doula training, Medicaid doula reimbursement, and the need for greater support to families that center their intersectional experiences and identities emerged as top priorities and were incorporated into the development of the Delaware Momnibus.
Nicole reflected on the importance of partnerships with birthworkers in Michigan’s Upper Peninsula, noting that the same forces that create maternity health deserts in rural counties also hinder access in urban cities like Detroit. She pointed out that, “even though we were always centered and rooted in racial justice and gender justice, for us that does include rural communities… we started off recognizing that we needed each other and that perinatal health is essential to our state’s health.” The collaborative efforts between rural and urban partners have been fundamental to achieving bipartisan support for Michigan’s Momnibus.
Momnibus Work Demands No Compromises on Equity or Access to Full-Spectrum Reproductive Care
Early engagement with families and birthworkers in the policy process gave advocates a clear understanding of the community’s non-negotiables. For Delaware, this meant explicitly centering ‘Black maternal health’ in their Momnibus bill text. As Kenda from Virginia put it, she was not going to “negotiate with someone’s life”, making clear that maternal health policy must confront the disparities driving the crisis and prioritize Black birthing people who are most at risk. For this reason, advocates in Virginia and Delaware did not entertain attempts to water down the equity focus or decenter ‘Black maternal health’ in their Momnibus packages.
In other states, advocates carefully crafted legislation to protect people’s bodily autonomy and defended against harmful amendments that would have compromised people’s access to abortion care. For example, Kentucky advocates successfully blocked a proposed amendment to their Momnibus that would have required hospitals and midwives to refer patients with nonviable pregnancies to perinatal palliative care services, partly to deter them from seeking an abortion. This effort was a huge win in Kentucky, where over half of the counties already lack a single reproductive healthcare provider.
Implementation Challenges Threatening Momnibus Progress
Implementation challenges of state Momnibus packages are intensifying as federal threats unfold. The Republican budget bill, signed into law in July 2025, significantly cuts and erodes the federal Medicaid program and is putting pressure on state budgets. All state maternal health infrastructures, state Momnibus packages, and state budgets rely on Medicaid. Compounding this, recent federal proposals to defund critical maternal and child health programs are a direct attack on state Momnibus momentum. The state advocates emphasized that successful implementation of the laws depends on sufficient funding. As Nicole shared, “we can have five Momnibuses and still have work to do”, reminding us that without stable federal funding, even the strongest legislation cannot deliver the care they promised. State advocates are bracing for the budget fallout ahead and mapping alternative funding pathways with philanthropists to safeguard and advance access to midwifery and doula care.
Removing administrative barriers for patients and providers in the Medicaid program is also a focus for states. Black Mothers in Power shared that although the Delaware Momnibus established Medicaid doula reimbursement, doulas face administrative challenges, including navigating multiple Medicaid managed care organization portals, duplicative applications, and inconsistent eligibility requirements, which prohibit them from receiving reimbursement. Advocates are applying pressure against these obstacles, asserting that access to doula care is unattainable if reimbursement is blocked by administrative red tape.
The Way Forward
When community members help shape policy, state Momnibus packages respond to the challenges families face and offer a blueprint for moving the maternal mortality and morbidity crisis toward lasting change. As new legislative sessions begin, our advocates’ assertions are clear: organize strategically and inclusively, treat community expertise as non-negotiable, and apply sustained pressure to show the value of maternal health policy even amid budget constraints.
