Just a few months ago, Rebecca Brouillette of Biddeford experienced the joy of having a new baby. However, all was not perfect. Not only did Brouillette suffer from postpartum depression after giving birth, she said, but also she experienced pelvic floor dysfunction and anxiety.

That’s why on May 5, Brouillette testified before the Legislature’s Health Coverage, Insurance and Financial Services Committee in favor of LD 1357, “An Act To Require Private Insurance Coverage for Postpartum Care.” The bill, introduced by State Sen. Anne Carey, D-Cape Elizabeth, whose district includes part of Scarborough along with Cape Elizabeth and South Portland, requires insurers, in individual policies that cover maternity benefits, to provide coverage for postpartum care that meets the recommendations of the American College of Obstetricians and Gynecologists.

Recommendations from a May 2018 report by an American College of Obstetricians and Gynecologists committee states, “The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs. It is recommended that all women have contact with their obstetrician–gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth.”

Most insurance policies provide coverage for postpartum care involving just one office visit at six weeks postpartum, according to a press release from the Maine Legislature Senate Majority Office.

Complications following childbirth can include pain and bleeding, high blood pressure, lactation difficulties, and pelvic floor dysfunction, according to the release. More than one-quarter of U.S. women have pelvic floor disorder with symptoms such as long-term urinary incontinence, but treatment like physical therapy that can strengthen the pelvic floor muscles and improve quality of life isn’t covered by private insurance for postpartum care.

Based on her own experience, Brouillette said, “I firmly believe that birth givers need additional support after childbirth and this bill would have an enormous impact on Maine families. One single 6 week checkup post delivery is not enough.”


Paying out-of-pocket for the health issues she has faced postpartum “is a large financial burden,” she said, especially when coupled with the additional expenses associated with  having a new baby.

“With this bill,” Brouillette said, “birth givers can have access to the specific care they need to thrive and flourish after the birth of a baby, I know I would have personally benefited greatly from LD 1357.”

Carney said she introduced the bill because, “the three months following the birth of a child are wonderful and challenging. New moms are recovering from childbirth, caring for an infant, sometimes navigating preexisting medical conditions while simultaneously preparing to return to work at the end of 12 weeks of family medical leave. Insurance coverage that supports the ‘fourth trimester’ care model will allow Maine women to successfully transition to parenthood, stable health conditions and return to work.”

Executive Director of the Maine Women’s Lobby, Destie Hohman Sprague also testified in support of this bill. “Maternal health and mortality in Maine, and the United States, is among the worst in the developed world,” she said. “As one of the only countries in the world without paid family leave and the only developed country without universal health care, we experience significantly higher rates of maternal mortality and decreased maternal and postpartum health. The burden of this poor health infrastructure falls disproportionately on women of color, Black and Indigenous women, and low-income and rurally located women. Investing in the health and wellness of people who give birth — not only before birth but through the postpartum period — supports babies, parents, our workforce, and our healthcare system (by allowing people to access the care they need when they need it, instead of during emergencies).”

A work session on the bill had been scheduled for May 11 — which is after the Leader went to press.

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