Systemic patterns of oppression have ensured that Black people, people of color, Indigenous people, people with low incomes, young people, people in rural areas and gender-expansive people have less access to, and lower quality of, health care in the U.S. This reality is starkly illustrated by the ongoing maternal mortality and morbidity crisis, particularly for Black and Indigenous birthing people. Workforce shortages and hospital closures further limit access to maternal health care at the same time as restrictions on reproductive health increase risks to pregnant people. Birth centers, midwives, and doulas have proven solutions to respond to the needs of pregnant people in their communities—both rural and urban—to improve quality of care and outcomes, but often face barriers at the state level to implementing them. Panelists will provide key insights on the historical and current landscape of maternal health, case studies from a regionally diverse set of states, and concrete strategies for state legislators to meet this moment.