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  • Emily Glazier

A Band-Aid Solution: New York's Proposal to Address the Maternal Health Crisis

A pregnancy-related death is a death “that occur[s] within one year of pregnancy.”[1] In the United States, approximately 700 women die each year as a result of pregnancy or pregnancy-related complications.[2] Notably, pregnancy-related mortality rates are significantly higher for Black and American Indian and Alaska Native (AIAN) women.[3] Even in the face of high income levels, Black women in America face a disproportionately higher risk of pregnancy-related death.[4] In New York, such disparities are even more prominent: Black women are “over four times more likely to die from childbirth-related complications.”[5] In New York City, Black women are “nine times more likely to die from pregnancy or childbirth.”[6]

Structural racism leads to disparities in health outcomes, especially concerning maternal health.[7] First, Black women are more likely to give birth at poor quality hospitals as a result of residential segregation.[8] The difference in delivery location is critical because it “may contribute as much as 47.7% of the racial disparity in severe maternal morbidity rates in New York City.”[9] Further, racial segregation is linked to the placement of environmental hazards.[10] Minority communities are disproportionately exposed to air pollution, and such exposure negatively impacts the health of Black mothers and babies.[11] In addition, diabetes and hypertension “are more prevalent in Black and Hispanic” New York City residents.[12] Such chronic diseases can increase risks associated with pregnancy.[13] Racial disparities at birth are also exacerbated by inequitable access to paid parental leave.[14] Finally, Black mothers often face discrimination within the healthcare system such as experiencing verbal abuse or being denied medication.[15]

Attempts to fix the maternal health crisis often ignore its root causes. For example, in 2022, New York City Mayor Eric Adams signed seven maternal health bills, marking the city’s first attempt at addressing the issue.[16] The initiative invested and expanded doula and midwife programs.[17] More recently, on January 4, 2024, New York Governor Kathy Hochul announced a proposal to tackle the maternal and infant mortality crisis.[18] Hochul's proposed solution will expand New York’s Family Leave policy “to include 40 hours of paid leave to attend prenatal medical appointments.”[19] Under New York’s current law, short-term disability is available during the final weeks of pregnancy; however, this is only available after a seven-day waiting period.[20] Under federal law, leave is unpaid.[21] Hochul’s statewide paid prenatal leave proposal is a step in the right direction, as pregnancy-related mortality is reduced if mothers have access to regular prenatal medical visits.[22]

Hochul also plans to expand access to doula services, eliminate co-pays and other out-of-pocket costs for pregnancy-related benefits, and implement new oversight mechanisms to avoid unnecessary C-sections.[23] Such incremental progress is important in addressing the racial gap in pregnancy-related mortality. However, Hochul’s proposal fails to address key factors that contribute to stark racial disparities, such as hospital quality, exposure to air pollution, and discrimination.[24] Addressing the maternal health crisis is not a quick fix and New York must take a more comprehensive approach in order to reduce maternal mortality rates disproportionately affecting Black and AIAN women.



[1] Latoya Hill, Samantha Artiga & Usha Ranji, Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them, KKF (Nov. 1, 2022), https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/.

[2] Id.

[3] Id.

[4] Claire Cain Miller, Sarah Kliff & Larry Buchanan, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, N.Y. Tɪᴍᴇs (Feb. 12, 2023), https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html.

[5] Grace Ashford & Joseph Goldstein, New York Could Become First State to Offer Paid Leave for Prenatal Care, N.Y. Tɪᴍᴇs (Jan 4. 2024), https://www.nytimes.com/2024/01/04/nyregion/hochul-prenatal-care-maternal-mortality.html.

[6] Id.

[7] Irene E. Headen, Michal A. Elovitz, Ashley N. Battarbee, Jamie O. Lo & Michelle P. Debbink, Racism and perinatal health inequities research: where he have been and where should we go, 227 Aᴍ. J. ᴏғ Oʙsᴛᴇᴛʀɪᴄs & Gʏɴᴇᴄᴏʟᴏɢʏ 560, 560 (2022); Racism and Health, CDC (Sept. 18, 2023), https://www.cdc.gov/minorityhealth/racism-disparities/index.html.

[8] Julia M. Goodman, Connor Williams & William H. Dow, Racial/Ethnic Inequities in Paid Parental Leave Access, Hᴇᴀʟᴛʜ Eᴏ̨ᴜɪᴛʏ (2021), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665807.

[9] Elizabeth A. Howell, Natalia N Egorova, Amy Balbierz & Jennifer Zeitlin, Site of delivery contribution to black-white severe maternal morbidity disparity, 215 Aᴍ. J. ᴏғ Oʙsᴛᴇᴛʀɪᴄs & Gʏɴᴇᴄᴏʟᴏɢʏ (2016).

[10] Julia Mizutani, In the Backyard of Segregated Neighborhoods: An Environmental Justice Case Study of Louisiana 31 Gᴇᴏ. Eɴᴠ’ᴛ L. Rᴇᴠ. 363, 365 (2019).

[11] Christopher Flavelle, Climate Change Tied to Pregnancy Risks, Affecting Black Mothers Most, N.Y. Tɪᴍᴇs (Jun. 18, 2020), https://www.nytimes.com/2020/06/18/climate/climate-change-pregnancy-study.html.

[12] Joseph Goldstein, Why New York Has Faltered in Making Childbirth Safer for Black Mothers, N.Y. Tɪᴍᴇs (Jan. 10, 2024), https://www.nytimes.com/2024/01/07/nyregion/childbirth-maternal-mortality-black-women.html.

[13] Id. 

[14] Goodman, Williams & Dow, supra note 8.

[15] Goldstein, supra note 12.

[16] Id.

[17] Press Release, Office of the Mayor, Mayor Adams Takes Action to Reduce Maternal and Infant Health Inequities by Expanding Access to Doulas and Midwives (Mar. 23, 2022), https://www.nyc.gov/office-of-the-mayor/news/149-22/mayor-adams-takes-action-reduce-maternal-infant-health-inequities-expanding-access-to#/0 (“Doulas provide physical and emotional support during pregnancy and childbirth, which helps lower the risk of complications during childbirth for the parent and the infant . . . Midwives are clinicians who receive formal education, training, and licensure to provide a full range of highly personalized maternal and primary health care to meet their clients’ unique physical, mental, emotional, and cultural needs.”).

[18] Governor Hochul Unveils Third Proposal of 2024 State of the State: Taking on the Maternal and Infant Mortality Crisis, N.Y. Sᴛᴀᴛᴇ (Jan. 4. 2024), https://www.governor.ny.gov/news/governor-hochul-unveils-third-proposal-2024-state-state-taking-maternal-and-infant-mortality.

[19] Id.  

[20] Id.

[21] Ashford & Goldstein, supra note 5.

[22] Governor Hochul Unveils Third Proposal of 2024 State of the State, supra note 18.

[23] Id.

[24] Ashford & Goldstein, supra note 5.

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