Taskforce Established to Provide Policy Advice and Community Outreach Holds First Public Meeting
Meeting Provides Update on Progress of State Response and Advances Additional Recommendations Following Statewide Listening Sessions in High Risk Communities
Statewide Listening Sessions Gives Voice to Women in High Risk Communities
Governor Andrew M. Cuomo today announced progress on a comprehensive initiative announced earlier this year to target maternal mortality and reduce racial disparities in health outcomes. The State on Tuesday held its first public meeting since the taskforce was created in June - a critical step to assess the progress of the Governor's initiative, discuss the findings of statewide listening sessions in high risk communities and advance further recommendations.
"New York is committed to ensuring every woman in the state has equal access to high quality healthcare, and this initiative will help break down unnecessary barriers to care," Governor Cuomo said. "These listening sessions and task force meetings are critical steps in addressing unacceptable racial disparities in our health care system and creating a stronger, healthier New York for all."
"We have made progress to ensure women have access to quality, affordable healthcare to prevent maternal mortality, but a vast racial disparity still exists that requires creative solutions and bold action," said Lieutenant Governor Kathy Hochul. "It is a grave injustice that black women in New York are four times more likely to die during childbirth than white women, with even larger disparities in other states. As part of the maternal mortality taskforce, we are making sure that all women have a voice in addressing this serious issue to help save lives. We are committed to expanding access to maternal care so all New York mothers, regardless of race, have the same opportunities to live long and healthy lives."
As discussed in Tuesday's meeting, the taskforce will continue to provide expert policy advice on improving maternal outcomes, addressing racial and economic disparities and reducing the frequency of maternal mortality and morbidity in New York State. The taskforce is comprised of leading healthcare professionals, Secretary to the Governor and Chair of the New York State Council on Women and Girls Melissa DeRosa, Lieutenant Governor Kathy Hochul, New York City Public Advocate Letitia James and appointees from Senate Democratic Leader Andrea Stewart-Cousins, Assembly Speaker Carl Heastie, Senate Majority Leader John Flanagan and Assembly Minority Leader Brian Kolb, as well as other stakeholders and members of the community. The taskforce is led by:
- Howard Zucker, MD, JD, Commissioner of the New York State Department of Health
- Sascha James-Conterelli, DNP, CNM, LM, President of the New York Association of Licensed Midwives
- Danielle Laraque-Arena, MD, FAAP- President of SUNY Upstate
- Wendy Wilcox, MD, MPH, Chairman, Department of Obstetrics and Gynecology, NYC Health and Hospitals, Kings County
While New York State has made improvements in reducing maternal mortality rates since 2010, when it was ranked 46th in the nation for the lowest mortality rate, the state still ranks 30th in the nation. Moreover, racial disparities persist, as black women are almost four times more likely nationally to die in childbirth than white women and three times more likely in New York. Research shows that in New York City, highly educated black women still fare significantly worse than white women with less than a high school degree.
At the direction of Governor Cuomo, Department of Health Commissioner Dr. Howard Zucker led a series of statewide listening sessions in high risk communities. Meetings in the Bronx, Brooklyn, Queens, Harlem, Albany, Syracuse and Buffalo provided an opportunity to listen to local stakeholders, including pregnant women, explore the barriers that women face in obtaining routine prenatal care and discuss strategies to better increase awareness of the signs and symptoms of pre-eclampsia and other causes of maternal mortality and morbidity.
Additional initiatives discussed at Tuesday's meeting include:
Establishing the Maternal Mortality Review Board -- At the recommendation of the Governor's Council on Women and Girls, DOH established the Maternal Mortality Review Board, composed of health professionals from a cross-section of stakeholders around the state who serve and/or are representative of the diversity of women statewide, to work in collaboration with the American College of Obstetricians and Gynecologists and the City of New York to review each maternal death in New York State. The Board, which will convene in early 2019, is tasked with making policy recommendations to DOH to improve maternal outcomes by reducing maternal mortalities and morbidities, and recommendations would specifically contemplate racial and economic disparities.
Launching the Best Practice Summit with Hospitals and OB-GYNs -- The Governor, in partnership with the Greater New York Hospital Association, Healthcare Association of New York State, ACOG, and other stakeholders, will launch a summit this year to discuss the issue of maternal mortality and morbidity, including racial disparities. The Summit will address statistics, best practices, community awareness, medical school curricula, graduate medical education, and practicing physician training, with the goal of implementing immediate measures and identifying future action items to improve maternal care and management.
Piloting the Expansion of Medicaid Coverage for Doulas -- DOH will pilot the expansion of Medicaid coverage for doulas in early 2019. Doulas are non-medical birth coaches who assist a woman before, during, or after childbirth if needed. Certified doulas have been shown to increase positive health outcomes, including reducing birth complications for the mother and the baby.
Supporting Centering Pregnancy Demonstrations -- New York will increase support for a program included in the Governor's State of the State First 1,000 Days of Life initiative, known as Centering Pregnancy. The program is designed to enhance pregnancy outcomes through a combination of prenatal education and social support and has been associated with reduced incidence of preterm birth and low birth weight, lower incidence of gestational diabetes and postnatal depression, higher breastfeeding rates and better inter-pregnancy spacing. Centering Pregnancy has also been shown to narrow the disparity in preterm birth rates between black women and white women.
Requiring Continuing Medical Education and Curriculum Development -- The Governor calls on the State Board for Medicine to require appropriate practitioners to participate in continuing medical education on maternal mortalities/morbidities and disparate racial outcomes. Additionally, DOH will work with medical schools, including SUNY's four medical schools, to build materials on maternal mortality/morbidity and disparate racial outcomes into their medical school curriculum, graduate medical education and training for practicing physicians. SUNY has established a statewide working group to coordinate efforts across middle schools and they have identified key experts who will advise on various aspects of the curriculum and training programs.
Expanding the New York State Perinatal Quality Collaborative -- The State has expanded its collaboration with hospitals across New York State to review best practices to address hemorrhaging and implement new clinical guidelines to reduce maternal mortality. Over 80 hospitals are engaged voluntarily in this effort, led and coordinated by the Department of Health. This collaborative has identified key metrics for measuring success in reducing maternal hemorrhage, as well as drafted clinical guidelines which will ultimately be used across the state to improve quality care.
Department of Health Commissioner Dr. Howard Zucker said, "I am honored to be leading the Taskforce on Maternal Mortality and Disparate Racial Outcomes, an essential and worthwhile initiative that will improve health outcomes for women across the state. The Governor's commitment to ensuring all women have access to the care they need is making New York a healthier state for all."
Assembly Health Committee Chair Richard N. Gottfried said, "Every new mother and newborn should have a right to quality health care without financial obstacles. New York's maternal mortality rates are still far higher than they should be, particularly the racial and community disparities, and I look forward to working with public health experts and policymakers to continue addressing this critical issue."
Assemblywoman Latoya Joyner said, "Every woman deserves the best possible care for themselves and their newborn, and achieving that goal requires culturally competent medical professionals to be at the forefront of improving healthcare outcomes and reducing maternal mortality rates. The taskforce's focus on the long overlooked women's health issue of maternal mortality gives us a unique opportunity to explore the initiatives needed to save lives and I appreciate the support that Governor Cuomo and the state Department of Health have shown for the taskforce's work."