S. 4986 — Mamas First Act

This section finds that maternal mortality rates vary by race and ethnicity, at 13.6 deaths per 100,000 live births for White women, 45 for Black women, 13.9 for Hispanic women, and 54.6 for American Indian and Alaska Native women; that U.S. rates are the highest among similarly situated countries and four out of five deaths are preventable; and that doula support and midwifery-led care reduce low-birth-weight births, complications, cesarean rates, and preterm births while improving breastfeeding initiation.

This section requires states to cover prenatal, labor, and postpartum services provided by doulas, midwives, tribal midwives, and lactation support providers under Medicaid, including in homes, birth centers, clinics, hospitals, or via telehealth. It defines the providers by certification, training, client recommendations, or state authorization standards; prohibits cost sharing; and applies the mandate beginning January 1, 2027.