You may have read the New York Times articles, seen the USA Today pieces or listened to the NPR stories on how the maternity care system in this country is failing mothers and families, especially women of color. Every year in the United States, about 700 women lose their lives and more than 50,000 women have a maternal near-miss (nearly die) due to severe complications from labor and childbirth.
In 2016, the state of New York ranked 30th in the nation for its maternal mortality rate. Similar to trends we see across the nation, black women in New York are disproportionately affected by maternal mortality, with a rate of 51.6 deaths per 100,000 live births compared to 15.9 among white women in 2014-16.
Have you ever wondered what happens when news stories like these hit the airways? What do state agencies, policymakers and organizations do in response?
In April 2018, following the NY Times article Why America’s black mothers and babies are in a life-or-death crisis, New York Governor Andrew Cuomo announced a comprehensive plan to reduce the number of maternal deaths in the state and address racial disparities in health outcomes. The initiative included:
- Establishing a maternal mortality review board to review each maternal death in New York State and identify opportunities for improvement
- Piloting the expansion of Medicaid coverage for doulas
- Coordinating statewide listening sessions for women of color to share their birth stories
- Launching a NY State Taskforce on Maternal Mortality and Disparate Racial Outcomes to provide expert policy advice on improving maternal outcomes, addressing racial and economic disparities and reducing the number of maternal deaths in the state.
Listening to moms
In the summer of 2018, March of Dimes was invited to serve on the NY State Taskforce. Experts met three times to share and discuss important data on the causes on maternal deaths and to determine next steps. At the same time, the State Department of Health launched listening sessions across New York to hear from women of color about their birth experiences. I had the privilege of leading a discussion group at one of the sessions and was moved by the women’s honest and powerful stories of pain and triumph.
Women shared stories of feeling disrespected and dismissed by providers, facing challenges trying to navigate a complex health care system and feeling judged based on the color of their skin. But there were also stories that gave me hope; stories of compassionate providers who took their time to listen, of strong women who essentially became their own care managers, and of the invaluable role of support individuals such as community health workers or doulas.
The stories from the listening sessions were not simply filed away on a shelf somewhere. Instead, they were shared widely with Taskforce members, policy leaders and health care providers.
Moving in the right direction
In March of 2019, the Taskforce delivered a report to the Governor with ten recommendations to improve maternal outcomes, address racial and economic disparities and reduce the frequency of maternal mortality and morbidity in New York State. March of Dimes was heavily involved in each stage of the process and co-authored some of the chosen recommendations.
In his 2019 State of the State address, Governor Cuomo committed to:
- Immediately implementing the top recommendations of the Taskforce, including launching a Maternal Mortality Review Board
- Creating an implicit racial bias training and education program for hospitals with the aim of reducing unequal treatment of individuals based on the color of their skin. Implicit racial bias happens when we put labels or make judgment of people without being aware of it. Implicit racial bias can make us act or think in an unfair way towards people or social groups.
- Investing in community health worker programs
- Creating a database for maternal health outcomes
- Spending $8 million over 2 years to fund these important initiatives
I am thrilled by the state’s commitment to improving maternal health, and I look forward to continuing my involvement in the implementation of the Taskforce recommendations. March of Dimes is committed to reducing maternal mortality and racial disparities not only in New York, but across the country. We won’t stop fighting to level the playing field so that all moms and babies are healthy. Because when a society supports every family, the future is brighter for us all.
Kathryn Mitchell, MPH
Kathryn Mitchell joined March of Dimes New York in 2016 as a Maternal & Child Health Director. In this position, she plans and implements maternal and child health programming in New York State. She received her Masters of Public Health with a concentration in Maternal & Child Health from the University of North Carolina at Chapel Hill in 2015.