Dignity in Pregnancy and Childbirth Act

Available Now: Anti-Racism and Implicit Bias Curriculum

The Minnesota Department of Health (MDH) has partnered with the University of Minnesota Center for Antiracism Research for Health Equity (CARHE) who developed interactive and engaging eLearning courses to meet the criteria listed in the Dignity in Pregnancy and Childbirth Act (MN § 144.1461), that went into effect in January 2023.

The new curriculum was designed for healthcare professionals to deepen their understanding of the impact of structural racism on the health and healthcare of Black and Indigenous birthing people. The first course focused on Black birthing people was released earlier this year, and the new module focusing on Indigenous birthing people is now available. The curriculum is divided into three segments for ease of completion. These courses are available at the Minnesota Dignity in Pregnancy and Childbirth Project on the Diversity Science website.

The Dignity in Pregnancy and Childbirth Act (MN § 144.1461), passed by the Minnesota State in 2021, addresses inequities in maternal health care. This legislation includes a requirement for hospitals with obstetric care and birth centers to develop or access a continuing education curriculum and must make available a continuing education course on anti-racism training and implicit bias.

Informational Presentation and Recording Available

MDH hosted an informational presentation on the Dignity in Pregnancy and Childbirth Act: Anti-Racism and Implicit Bias Curriculum designed for hospitals with obstetric care and birth centers. 

Presentation and recording with transcription:

• Dignity in Pregnancy and Childbirth Act Presentation Slides (PDF)
• Dignity in Pregnancy and Childbirth Act Presentation (Video)

This informational presentation highlighted how participants can:

• Access a newly available course developed by CARHE tailored for Minnesota providers to specifically meet the training requirements outlined in the Dignity in Pregnancy and Childbirth Act.
• Submit alternative course curriculum on anti-racism training for review to meet the requirements of the Dignity in Pregnancy and Childbirth Act.
• Meet compliance of the statute.

Audience:

• Administrators at hospitals and birth centers

Questions:

MDH Maternal and Child Health Section
health.mch@state.mn.us

Monitoring Implementation​

The Commissioner of Health, in coordination with the Minnesota Hospital Association, will monitor the implementation of the statute and may inspect course records or require reports. MDH’s Health Regulation Division will lead the monitoring component​:

• Hospitals and birth centers may be asked to attest to their compliance with this statute during the Hospital and Critical Access Hospital Licensing Renewal, beginning in October 2023​.
• MDH may review facility records as part of recertification survey or during a compliant investigation, if relevant​.
• Not seeking paperwork for each provider be submitted to MDH​.

Alternative Course Curriculum

Organizations can submit their anti-racism training curriculum for review. If the curriculum is determined to meet legislative all criteria the curriculum can be used by organizations to meet requirements of MN § 144.1461.

Submit your organization's curriculum

The following components are not required or reviewed by MDH but are included in statute and should be considered by the submitting organization:

• Hospitals and birth centers must make an annual refresher curriculum available, that reflects current trends on race, culture, identity, and anti-racism principles and institutional implicit bias.
• A certificate of course completion to another facility or to a course attendee upon request.

Minnesota Department of Health review

• Submitted curriculum will be reviewed by a multi-disciplinary group of State staff. Review criteria can be found in Dignity in Pregnancy and Childbirth Training Criteria (PDF). Curriculum must meet all criteria to be posted by MDH and fulfill the legislative requirement.
• Organizations will be notified in writing if their curriculum meets the criteria or not. Any criteria that are not met will include notes for improvement.
• Organizations can re-submit curriculum for review.

Frequently Asked Questions

• Do I need to complete the course by December 31, 2022?
  • No, the legislation requires that initial continuing education courses under this subdivision must be made available by December 31, 2022. Hospitals, birth centers and health care providers do not have a deadline for completing the continuing education.
• Is the compliance for this education due to be completed in October 2023, or released to all staff who provided care to pregnant or postpartum patients? Is there a deadline for completion? 
  • There is no deadline at this time for completion, health regulation will be releasing additional guidance in the coming months. There is no deadline for a timeline to complete, at this time.
• Who is defined as routine direct care staff required to complete the course?
  • It required of hospital systems and birth centers to ensure that their staff that fall under this statute to complete this training. As noted within the statute, employees and contractors that routinely provide direct care for pregnant/postpartum patients. Hospitals and birth centers must determine who within their employees and contractors meets the criteria.
• Is the training required of clinic staff who do not perform deliveries, but provide care to pregnant patients? 
  • Yes, the curriculum does apply for staff providing direct care to pregnant patients, regardless of their role in deliveries. 
• How often are we required to provide education to the staff? The statute states “ongoing continuing education” but is there a minimum frequency we should ensure we are hitting (yearly, every 2 years, etc.)
  • In addition to the initial continuing education course made available under the legislative requirement in paragraph (a), hospitals with obstetric care and birth centers must make available an annual refresher course that reflects current trends on race, culture, identity, and anti-racism principles and institutional implicit bias.
• Can I use curriculum developed by other organizations?
  • Yes, MDH is in the process of developing criteria and a review process for curriculum to ensure it meets the legislative requirements. Please check back here for more information soon.
  • The education on the website discusses having any home-grown curriculum approved to ensure it meets criteria- does this need to be done before we launch any education or do we just need to keep records of our objectives in case we are “audited”? In compliance to statute requirements, an organization needs to submit curriculum to be approved by MDH, if an organization is not using the state recommended training.

Increasing Access to Midwife and Doula Care

The Dignity in Pregnancy and Childbirth Act, Sub. 3 outlines requirements to identify barriers to obtaining midwife and doula services for groups with the most significant disparities in maternal and infant mortality and morbidity, and develop procedures and services designed to increase the availability of midwife and doula services for these groups.

More information about this work can be found on the Maternal Care Access: Doula and Midwifery Services webpage.