The "Mamas First Act" proposes to amend Title XIX of the Social Security Act, making services from doulas, midwives, tribal midwives, and lactation support providers a mandatory covered benefit under the Medicaid program. This initiative directly responds to alarming maternal mortality rates in the United States, particularly among Black and Indigenous women, and the finding that a significant portion of these deaths are preventable. The bill emphasizes providing culturally congruent care across various settings, including home, community, and hospital, or via telehealth, encompassing prenatal, labor, and postpartum support. Key provisions include detailed definitions for each provider type, outlining specific criteria for certification, experience, or state authorization to ensure quality of care. For instance, doulas must be certified or have client/provider recommendations, while midwives must be state-authorized or meet international standards. Importantly, the bill explicitly prohibits cost-sharing for these services, aiming to remove financial barriers to access for beneficiaries. The legislation is slated to take effect on January 1, 2027, with allowances for states needing additional legislative time to implement the changes.