NYC Initiative Set to Reduce Maternal Health Disparities

New York City Mayor Eric Adams announced new efforts to expand access to maternal health services, targeting care inequities that drive maternal health disparities for Black and Latino families.

The programs, Citywide Doula Initiative, The Midwifery Initiative, and the Maternity Hospital Quality Improvement Network (MHQIN), will specifically address care gaps in maternal deaths and infant mortality.

“The root causes of racial disparities in maternal health are real, so it’s time we do right by every mother and every baby, no matter the color of their skin or the language they speak,” Mayor Adams said in a press release. “Today, we are announcing a multifaceted initiative to help reduce the inequities that have allowed children and mothers to die at the exact time when we should be welcoming a life.”

“By expanding and investing in both doulas and midwives, we are taking the steps necessary to begin to address the disparities in maternal deaths, life-threatening complications from childbirth, and infant mortality,” Mayor Adams added.

Maternal and infant inequities result from structural racism, a lack of investment, and social drivers, the Mayor’s Office stated.

In New York, Black women are nine times more likely to die of a pregnancy-related complication than White women, the press release stated. The rate of infant mortality is three times higher for Black women and two times higher for Puerto Rican women than White women in New York.

The citywide expansion of the doula program will offer birthing families in 33 underserved neighborhoods free access to doulas. Several studies have proven that doulas effectively lower the risk of complications during childbirth.

Over the next three months, 500 families are expected to be offered a doula who will deliver emotional and physical support to birthing persons at home and in the clinic setting.

The initiative will also screen families for social determinants of health, such as food insecurity, to provide them with adequate resources.

To adhere to the demand for more doulas, the Citywide Doula Initiative will aim to train 50 community members as doulas. In addition, support will be offered to uncertified doulas, assisting them in receiving the proper certification.

“Uprooting the deeply entrenched maternal and infant health disparities that inflict exponentially higher mortality rates on Black and Latina women and children is essential to addressing a long legacy of health inequities,” said New York City Council Speaker Adrienne Adams. “Investments in these initiatives that provide free access to key services and other supports while expanding community-based infrastructure and coordination to ensure their success are an important step towards repairing the impacts of intergenerational disinvestment in the health of our families and communities.” 

The Midwifery Initiative will be expanded to all public and private birthing facilities, gathering research about existing midwifery care models across pregnancy, birth, and the postpartum period. The initiative will also help researchers identify models to enhance and expand midwifery training opportunities.

The new efforts also include the expansion of MHQIN, a community initiative that will be extended across all 38 birthing facilities in New York City. The MHQIN aims to address and reduce disparities in preventable maternal morbidity mortality.

These three initiatives are a part of a larger project to reduce health inequities among Black and Latino families in New York City.

These efforts by Mayor Adams come at a time when the country is confronting a maternal health crisis.

According to the most recent CDC data, the United States has the worst maternal mortality rates in the developed world.

The overall maternal mortality rate in 2020 was 23.8 deaths per 100,000 live births compared to 20.1 deaths per 100,000 live births in 2019. As maternal mortality worsened in 2020, maternal health disparities did as well.

The maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 births, which is 2.9 times the rate for non-Hispanic White women in 2020.

Data has shown that despite receiving adequate prenatal care access, disparities in pregnancy outcomes persisted.

A study found that although 97 percent of pregnant individuals accessed prenatal care, those with more significant social needs saw more adverse outcomes during pregnancy and postpartum. Even after adjusting for age, race, and body mass index, this trend persisted. 

Closing those maternal health disparities will require more than just connecting pregnant people to care, but also attention to the social determinants of health.