AB 2258
Dignity in Pregnancy and Childbirth Act — Implementation and Expansion
Also known as: "CA AB 2258"
Sponsored by Assemblymember Ash Kalra (D) · 7 cosponsors
Legislative timeline
Introduced
Signed into law
Signed into law by Governor Newsom; effective January 1, 2026
Last reviewed by our editors: Apr 22, 2026
What this bill does
AB 2258 is a follow-on bill expanding California's landmark SB 464 (2019), which was the first state law to mandate implicit bias training for perinatal clinicians. The original SB 464 applied to hospitals receiving Medi-Cal funding. AB 2258 expands the mandate to birthing centers, licensed midwife practices, and ambulatory surgical centers performing obstetric procedures.
The bill strengthens enforcement: facilities must submit completion records to CDPH annually (replacing honor-system self-attestation under SB 464), and noncompliance can result in Medi-Cal decertification. Signed by Governor Newsom on October 1, 2025, effective January 1, 2026.
Who benefits
Black birthing people in California, who die in childbirth at 3.1 times the rate of white women even in the most progressive state. Midwife practices and birthing centers previously lacking a state-mandated training framework. CDPH, which gains an enforcement mechanism that SB 464 lacked.
Who loses / who opposes
Birthing centers and midwife practices that previously operated without implicit bias training requirements face new administrative burden and risk of Medi-Cal decertification for noncompliance. Some provider organizations argue training mandates are insufficient without broader systemic health reform.
Impact on Black communities
This bill is a resolved success case demonstrating the model for state-level implicit bias mandates. Black women in California die in childbirth at 3.1 times the rate of white women, a disparity that persists after controlling for income and education — implicating implicit clinical bias. Studies of SB 464 implementation found most clinicians who completed training changed at least one practice behavior. AB 2258 closes the gap by covering non-hospital birth settings. California's model is being watched by 12 other states that have introduced similar bills since 2019.
What you can do
This bill is now law in California. For advocates, the action is to support similar legislation in other states. The National Birth Equity Collaborative has a state-by-state toolkit at birthequity.org/policy.
California perinatal providers: CDPH begins accepting training completion records January 1, 2026. Contact your facility compliance officer to ensure training is scheduled before the deadline.