New York City Public Advocate Jumaane D. Williams today released a report on maternal health inequities, analyzing systemic issues and outlining potential policy solutions. It details issues of maternal morbidity and the pervasive but underdiscussed healthcare disparities that contribute to the problem both nationally and locally.
The report, Equitable Pregnancy Outcomes for Black and Brown New Yorkers, comes as the Public Advocate has been advancing city legislation on maternal health outcomes, and after he and his family shared their personal story and struggles with maternal healthcare inadequacies and inequities.
"When I first began working on issues of Black and Brown maternal health, and on these bills, I had no idea how personally it would affect my family– but I knew, I had met and spoken with, the families of so many who had experienced inequity and tragic loss.” said Public Advocate Jumaane D. Williams on the release of the report. “This report details the causes of maternal morbidity, the deep disparities in who receives adequate care and who faces greatest pain and tragedy. It tells the stories behind the statistics, and highlights solutions that can save lives. It is critical, it is urgent, that we pass these bills in the City Council, and continue the work on a state and federal level, to help promote health and prevent tragedy from pre to post-pregnancy."
Maternal health inequities are a national issue, and that disparity is magnified and exacerbated in New York. Nationally, Black and Native American women are three times more likely than white women to die from a pregnancy related case – while in New York City, Black women are 8 times more likely than white women to die from a pregnancy-related cause, and nearly 3 times more likely to experience severe maternal morbidity than white women. In 2017, Black women gave birth to 23% of New York City babies, yet accounted for 55% of maternal deaths. Black women continue to have worse outcomes than their white counterparts regardless of insurance or socio-economic status.
These inequities, and the tragic losses they represent, stem from a number of factors detailed in the report. Causes identified include access to care, quality of care, prevalence of chronic illness, structural racism, socioeconomic inequities, and implicit biases within the healthcare system.
To begin to address these inequities, the report includes the following recommendations:
- The New York City Council needs to pass the Public Advocate’s maternal health legislative package, including bills to establish a maternal health bill of rights and require employers to hold an onboarding meeting to discuss an employee's reintegration back into the workplace after parental leave, as well as a resolution calling for passage of the federal Black Maternal Health Momnibus Act of 2021.
- New York City needs to expand its comprehensive plan to reduce maternal death from 5 years to 10 years.
- New York City’s Health + Hospitals Corporation needs to incorporate the World Health Organization’s recommendations for improving outcomes of preterm births.
- New York City Health + Hospitals needs to include information on maternal mortality rates and the number of severe maternal morbidity cases in its annual Community Health Needs Assessment report.
- New York State must enact legislation to require public and private health care facilities to incorporate a biannual anti bias training for women and birthing people of more color, as well as a training focused on creating trans-inclusive, gender affirming environments for TGNC patients.
- The state must also enact legislation that would require health insurance plans to provide free coverage of midwifery and doula services to expectant persons at a liveable wage.
- The U.S. Congress needs to pass and the President needs to sign the Black Maternal Health Momnibus Act.
After having worked on addressing Black maternal health throughout his first two years in office, and introducing legislation on the issue this summer, the Public Advocate and his wife, India Sneed-Williams, publicly shared their personal experiences with health inequities earlier this week. After struggles with fertility, miscarriage, cancer diagnosis, and healthcare providers who failed to listen to or provide crucial options for the couple, they announced Monday that they are expecting a ‘miracle baby.’ Learn more about their journey here.
They hope that by sharing their story, they can help empower individuals to self-advocate for and receive more culturally responsive, equitable reproductive healthcare, and help to advance systemic change to confront ongoing inequities in New York City and beyond through solutions detailed in this report.
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