SB 65 Becomes Law, Requiring Investigation into Serious Illness and Deaths Associated with Pregnancy and Childbirth to Reduce Racial Disparities


By Hunter W. Collins

SB 65 (Skinner), the “California Momnibus Act,” as amended September 2, 2021, adds section 123660, adds Article 4.7 (commencing with section 123635), and adds Article 4 (commencing with section 128295) to the Health and Safety Code to establish the California Pregnancy-Associated Review Committee effective August 1, 2022. This bill requires the Committee to identify and review all pregnancy-related deaths and severe maternal morbidity and authorizes the Committee to request from any related state or local health department death records, medical records and autopsy reports to inform its review. The Committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee and will recommend best practices to reduce maternal and infant deaths.

The Committee, comprised of mostly physicians, will also include midwives, doulas, community advocates, and a tribal representative. All proceedings, activities, and opinions of the Committee will be kept confidential. SB 65’s legislative intent includes the statement that “[r]acism and racial bias in health care contribute to both the national maternal mortality and morbidity crisis and infant mortality and morbidity, in particular for pregnant and postpartum people and infants who are Black or Native American.” These minority groups face disproportionate levels of risk during childbirth as “California’s Native American infant mortality rate is 11.7 deaths per 1,000 live births, followed by Black infants at 8.7 deaths per 1,000 live births,” far above the “state’s average of 4.2 deaths per 1,000 live births.”

SB 65 builds upon SB 464 (Mitchell) (Chapter 533, Statutes of 2019), signed October 7, 2019, which works to reduce the black maternal mortality rate by requiring all perinatal health care providers to undergo implicit bias training, and the 2021–22 state budget’s investments to tackle racial and ethnic disparities in maternal health outcomes by including Medi-Cal coverage for doulas, extending Medi-Cal eligibility for postpartum people, providing easier access to CalWORKs for pregnant people, and establishing a guaranteed income pilot program that prioritizes pregnant Californians with low incomes.

SB 65 impacts consumers of the Department of Managed Healthcare (DMHC) by requiring additions to Medi-Cal Managed Care Plans, such as doula care, and extending full-scope Medi-Cal to a birthing parent for 12 months postpartum.

Governor Newsom signed SB 65 on October 4, 2021 (Chapter 449, Statutes of 2021). When signing the bill, the Governor stated that it is “unacceptable that the maternal and infant mortality rate among Black and Indigenous communities remains significantly higher than the state average” and that “California is committed to tackling discrimination and disparity” and “both reproductive and racial justice.”



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