Thursday, October 10, 2024

NYC Council Speaker Adams Calls Pregnancy-Associated Deaths a Public Health Crisis, Announces Plan to Convene Stakeholders to Confront Maternal Mortality with Coordinated Action

 

Despite recent interventions, over 20 New Yorkers still die from preventable pregnancy-related causes each year, with Black women and low-income communities disproportionately impacted

New York City Council Speaker Adrienne Adams called for all of New York City’s stakeholders to prioritize confronting maternal mortality as an urgent public health crisis. Speaker Adams declared that these preventable pregnancy-associated deaths with severe racial disparities must not be normalized, just days after it was revealed that 24-year-old Bevorlin Garcia Barrios died at Woodhull Medical Center last month. As part of her clarion call, she announced an intention to convene of city, state, and federal government officials, public health leaders, unions, advocates, and other city stakeholders in ongoing coordinated efforts to address the crisis of maternal mortality in New York City.

Speaker Adams’ livestreamed speech can be found here, and the text of the speech can be found here.

In New York City, over 20 women die each year from pregnancy or childbirth-related causes. Black New Yorkers are six times more likely to die of pregnancy-related causes compared to white New Yorkers. These disparities are a product of medical and structural racism that leave Black women, communities of color and low-income New Yorkers without access to adequate health care and medical treatment, while experiencing stressors that perpetuate severe disparities in health outcomes. 

Addressing the racial disparities in maternal health, mortality, and morbidity has been a top priority for the Council, yet Speaker Adams’ speech noted the limitations of lawmaking in successfully confronting the crisis.

In 2022, the Council passed a package of 11 bills to expand maternal health services, including doula care, and address systemic inequities that affect women and birthing people, particularly those that disproportionately harm Black, Latino, and indigenous people. Earlier this year, Speaker Adams outlined several initiatives in her 2024 State of the City address to confront the maternal mental health challenges facing New Yorkers during and post-pregnancy. According to the Department of Health and Mental Hygiene, in 2021, the leading cause of pregnancy-associated deaths in New York City was attributed to mental health conditions, and two-thirds of the total 58 deaths occurred within a year of postpartum. Last month, as part of the third stop of the Council’s Mental Health Roadmap, the Council passed a package of bills aimed at improving maternal mental health support. The legislation includes efforts to create a pilot program establishing postpartum support groups in each borough.  

The full speech as prepared for delivery is below.

Good afternoon.

Thank you for joining us today at City Hall. We are joined by Deputy Speaker Diana Ayala, Majority Leader Amanda Farias, Council Member Carlina Rivera, Hospitals Chair Mercedes Narcisse, Health Chair Lynn Schulman, and BLAC Co-Chair Crystal Hudson.

I also want to acknowledge Patricia Loftman, a decades-long leader in midwifery services.

We are gathered here to address the critical state of maternal health in our city.

We are failing women during one of the most vulnerable periods of their lives.

As a society, we accept maternal mortality as an unfortunate casualty, when in fact a majority of deaths could have been prevented with appropriate care and attention.

When you look at the severe racial disparities in the cases of maternal mortality, it becomes clear that this is an unsung public health emergency. These deaths are not accidents; they are a disturbing pattern of injustice.

Just last week, we learned of the tragic death of Bevorlin Garcia Barrios, who went to one of our city’s public hospitals in search of care. Despite alerting medical staff of her serious pain and symptoms, she was sent home.

When she returned to the hospital just days later with an increased severity of symptoms, she was finally admitted, but her case was not treated as an emergency. Why?

The very next day, she died from complications of an emergency C-section.

Bevorlin was the third woman to die during childbirth at Woodhull Medical Center since 2020. In New York City, an average of 20 women die each year from pregnancy or childbirth-related causes.

A common thread in these tragedies is often a lack of clear communication among some hospital staff, and between provider and patient, leading to serious patient concerns being ignored. These communication issues are further complicated when there are language barriers, and hospitals lack qualified interpreters.

My heart goes out to Bevorlin’s family and friends, and to people across our city who have also experienced the unimaginable grief of losing a loved one to pregnancy-related causes.

Across the nation, far too many Black women and others who can become pregnant suffer preventable, life-threatening complications during pregnancy and childbirth that too often cost them their lives.

Here in New York City, Black women are six times more likely to die of pregnancy-related causes compared to our white counterparts.

These disparities are a product of medical and structural racism that make access to adequate health care and treatment out of reach for low-income, immigrant, and Black women.

Every death is a tragedy, but make no mistake about it  every preventable death is a tragic failure. As a government, we must bear responsibility for the loss of each precious life, and the reality is that most of these deaths are preventable.

In the wealthiest city in the world, with some of the greatest medical institutions, this is completely unacceptable. We must act with far greater urgency to prevent these deadly outcomes.

While we have made progress in recent years through an increased focus, we must treat this crisis as the emergency it is and do more. 

Despite ongoing interventions from the Council, the City, and the State, from providing free doula care in underserved communities to investing in mental health support, maternal mortality continues to devastate our communities.

Today, I am raising the alarm. Ending maternal mortality must be our urgent focus. This issue is solvable. All levels of government and all stakeholders that possess the resources must come together to help end this public health and safety crisis.

Too often, Black women, and other people of color, have their pain and symptoms dismissed by medical professionals, leading to delayed diagnoses and insufficient care.

My own mother was one of these women.

She experienced several false alarms while preparing to give birth to me. On her fourth visit to Elmhurst General Hospital, the nurses dismissed her symptoms as just another false alarm.

Despite her insistence that this time was different, she was ignored. And so, she gave birth to me alone, on a gurney in a corner of the hospital. It is a miracle that we both survived.

For years, stories like my mother’s were completely ignored and it is clear that her experience still occurs. The devastating impact of pregnancy-related complications, especially in communities of color, has been overlooked for too long.

It is no coincidence, then, that with more representative and diverse leadership  particularly women-led leadership  maternal health has garnered renewed scrutiny and attention.

As a women-majority City Council and the most diverse in our city’s history, our legislative body is made up of mothers, grandmothers, expectant mothers, and those supporting their partners through pregnancy.

This is personal for us as leaders of communities who intimately know these experiences firsthand.

New Yorkers are looking to all of us for leadership, and it requires approaching this crisis with humility and clarity. While recognizing some progress, we must be honest that there are limitations to the solutions we’ve advanced and what we can achieve through lawmaking alone.

We need comprehensive solutions that require the coordination, collaboration, and sustained investments of all stakeholders: the city, state, and federal government, brilliant minds in our public and private hospital systems, university medical schools, community-based organizations, healthcare providers, advocates, and survivors.

The problems are well-known, in large part because of the strong voices of advocates who have worked tirelessly to put solutions in front of us.

We must all move as one, harnessing shared political will to fix the patchwork of challenges that allow so many to fall through the cracks.

That is why today, I am announcing that my office and the Council will convene stakeholders to leverage our collective power and resources to confront these longstanding inequities that lead to the horror of maternal mortality. We will keep this issue at the top of our priority lists.

Our intent is to create ongoing collaboration focused on consistent and coordinated action.

There are many notorious issues that deserve our focus, and this work must be guided by experts who can lead us to take concrete actions to achieve maternal health equity.

Culturally competent care has lifesaving implications. Language access, which has been a barrier, ensures providers can communicate clearly with patients.

Discrimination is another problem. It’s well documented that providers are less likely to believe Black women and other women of color about their pain and symptoms. These biases can have devastating consequences, from patients not receiving proper pain management to loss of life.

We can support New Yorkers by also investing in our public hospitals and safety net hospitals that care for those most impacted by maternal mortality.

These hospitals overwhelmingly serve low-income and immigrant populations, as well as communities of color. Many patients arrive needing serious medical care and are underinsured or uninsured. Staff are often overworked, understaffed, and under-resourced.

The combination of these structural inequities makes it challenging for public and safety net hospitals to meet the quality of care New Yorkers deserve.

Our hospitals must be better resourced and prepared to serve their patient populations with pre-existing disparities.

Maternal health requires that we not only address physical care, but also the broader determinants of health  accessible mental health services, safety, nutrition, and housing  all of this directly impacts maternal outcomes.

In New York City, the leading cause of pregnancy-associated deaths was mental health conditions, with 20 deaths due to overdoses in 2021.

This is an alarming statistic that makes clear the City must do more to focus on postpartum care.

We must also consider the comprehensive health and safety of all women before they decide to become mothers.

Stressors like poverty, lack of access to health care, including prenatal care, and unstable living conditions can lead to negative health outcomes with long-term implications that contribute to issues during pregnancy.

Finally, we need to strengthen the continuum of care, because those who are at greatest risk of maternal mortality don’t have consistent access to health care in the first place.

This requires us to invest more in community-based interventions for low-income women that improve their overall health.

Continuity in care can help mothers and providers build trusting relationships, while ensuring providers are more attuned to changing health patterns or behaviors that can occur over time.

Addressing these longstanding inequities will require sustained focus and ongoing action.

The maternal health crisis is a public health emergency, and New Yorkers are counting on us to treat it with the urgency and dignity that our mothers deserve.

I will consistently use my voice as Speaker to keep it at the forefront of the agenda for our city and bring powerful stakeholders together.

We have the talent, resources, and tools to change the trajectory of maternal mortality in our city.

No one should die from preventable causes, and we owe it to our mothers  without whom there is no life  to work together and get this right.

Thank you.

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