Photo courtesy of New York City Council via Flickr
For the first time in the history of the City Council, on Thursday, Aug. 11, the legislative body passed a package of legislation addressing significant disparities in maternal health, mortality, and morbidity. City Council representatives said that while about 30 birthing people in New York City die each year of a pregnancy-related cause, statistics indicate that approximately 3,000 women “almost die,” or experience morbidity, during childbirth, with the majority of cases being people of color.
In New York City, Black women are eight times more likely than white women to die from a pregnancy-related cause, and nearly three times more likely to experience severe maternal morbidity than white women, city officials said in the context of the announcement.
In an effort to address what they said is a national maternal health crisis that impacts New York City, the Council passed the new package of bills to expand maternal health services and address systemic inequities that affect women and birthing people, particularly those that disproportionately harm Black, Latino and indigenous people.
“Even prior to the pandemic, Black women and birthing people have faced a maternal health, mortality, and morbidity crisis,” said Speaker of the City Council, Adrienne Adams. “The lived experiences that far too many people have endured are striking, and the disparities for Black, Latino, and indigenous people are horrifying. This package of legislation is an important step to eliminate the inequities so that all women and birthing people are safe and protected. I am proud of this women-majority Council for prioritizing solutions to this dire crisis. When women are in leadership and the majority to make our laws, we lead on longstanding issues of significance that are critical to equitable access to health and safety.”
Introduction 86, sponsored by Public Advocate Jumaane Williams by request of the Bronx Borough President Vanessa Gibson, would require an agency designated by the mayor to administer public education on the city’s standards for respectful care at birth. As reported, Gibson had long called for policy changes to improve Black maternal mortality rates, most recently during Black Maternal Mortality Awareness Week in May.
It would also provide information regarding the right to be free from discrimination in relation to pregnancy, childbirth or a related medical condition, reasonable workplace accommodations for persons who are pregnant or were recently pregnant and caregivers; rights for a person who is pregnant or was recently pregnant under the disability benefits law and paid family leave benefits law, earned safe and sick time act, and temporary schedule change law; and how to access information on appointing a health care proxy.
In the context of the announcement, Williams said birth equity was a social justice issue and one that was especially urgent and deadly in New York City. “This public health crisis is both under-acknowledged and under-addressed, but today, City Council will take invaluable and concrete steps to protect pregnant people in New York City,” he said.
“Through the creation of a maternal health bill of rights with dedicated and sustained outreach to inform people of those rights, we are ensuring that these rights are upheld and New Yorkers are empowered to demand what they deserve,” Williams added. “New York City cannot end the maternal mortality divide alone, so we are also calling on the federal government to pass and enact the Momnibus Act to save lives across the country. Thank you to Bronx Borough President Vanessa Gibson for your partnership on both this bill and this issue, and to the City Council for taking up these bills.”
For her part, Gibson said the country was in a state of emergency when Black women are still three times more likely to die during childbirth, with the mortality rate even higher than the national average for Black women living in New York City. Black birthing individuals in our city and across the United States, deserve to receive culturally sensitive, patient-centered care that is attuned to their unique needs free of bias and racism that has resulted in the deaths of too many pregnant people,” she said.
Gibson added, “With today`s legislation, we are saying enough is enough, and that New York City will take action to ensure birthing persons are aware of their rights and are protected under the law. Thank you to Public Advocate Jumaane Williams for his partnership in pushing Intro 86-A forward, Speaker Adrienne Adams, the Women`s Caucus, and our doulas, midwives, and birth workers for their advocacy in ensuring all birthing individuals in our city receive the unbiased maternal care that they deserve before, during, and after childbirth.”
The bill was sponsored by Brooklyn Council Member Farah Louis and requires NYC Department of Health & Mental Hygiene (DOHMH) to post the annual Maternal Mortality and Morbidity report on its website. The annual report is mandated per Local Law 188 of 2018. However, there was no requirement for the data to be posted on the department’s website until now.
A second bill, also sponsored by Louis, would require DOHMH to provide education on polycystic ovary syndrome and endometriosis, by posting information on its website. DOHMH will also be required to submit a report regarding education efforts on both conditions to the mayor and speaker of the council no later than March 1, 2023.
A separate bill, sponsored by Brooklyn/Queens Council Member Jennifer Gutiérrez, would require DOHMH to establish a program to train doulas and provide doula services to residents of marginalized neighborhoods in all five boroughs at no cost to the resident. Doulas will be trained in birth equity, trauma-informed care, perinatal mood and anxiety disorders, navigating the hospital environment, and support services available to low-income birthing people and their families. DOHMH will also be required to submit a report to the mayor and speaker of the council on the merits of the program.
“Doula care is a humanity-driven approach that centers on the individual needs of each birthing person, rather than a systematized process of medical care, which leads far too often to bad outcomes and racialized bias,” said Gutiérrez. “The empowerment that doulas offer in the birthing process has meaningful effects on people’s pregnancy outcomes but reaches far beyond, strengthening their voices and aiding them to advocate for better conditions in their communities. As a new mother, I’m deeply proud that this is the first bill of mine to become law and to be creating a pipeline of new, and meaningful jobs for New Yorkers across the city.”
Yet another bill, sponsored by Brooklyn Council Member Crystal Hudson, would require an agency designated by the Mayor to provide education and information regarding services offered by doulas and midwives, the evidence-based benefits of such services, and free and low-cost resources related to such services in the city. The administering agency would also be required to submit to the mayor and speaker of the council, and post online, a report describing the methods of targeted outreach used.
“Black women are eight times more likely to die during pregnancy than their white counterparts, which is the direct result of an institution whose history is marred with gross racism and misogyny,” said Hudson. “Black maternal mortality is as much an issue of racial justice and economic liberation as it is an issue of health equity and justice. Our City’s vast disparities in health outcomes can be directly attributed to a lack of quality, affordable care and the City’s failure to inform our communities of the resources available to them.”
Hudson added, “Int. 478 seeks to bridge this divide in maternal health care by mandating DOHMH better fulfill its duty to New Yorkers by providing relevant information about the services, care, and benefits offered by doulas and midwives, which will allow us to take a critical step toward guaranteeing the health and wellbeing of our City’s Black and brown, poor and working class women and birthing folks.”
Introduction 490, sponsored by Manhattan Council Member Julie Menin, who previously led the City’s 2020 census efforts, would require DOHMH to conduct research on sexual and reproductive health disparities within the city and provide sexual and reproductive health services. In providing these services, DOHMH will have the duty to provide outreach, education, and support to individuals, especially low-income individuals and those without health insurance, regarding issues related to sexual and reproductive health.
DOHMH would also make referrals to affordable and accessible services related to contraception, abortion, family planning, breast and cervical cancer screenings, and counseling, testing, and treatment for HIV and sexually transmitted infections.
“Today we lead the fight to protect reproductive rights as our City Council led by Speaker Adams is preparing New York City for the next wave of individuals needing sexual health services,” said Menin. “This legislation, along with the package the Council is voting on today, will expand protections for New Yorkers needing access to services such as contraception, abortion, and screenings for cancer and sexually transmitted infections.”
She added, “By codifying and expanding New York City’s health services, we are protecting our existing rights and increasing access to safe abortion care. Income, race, ethnicity, or immigration status should never impact a person’s access to sexual and reproductive services.”
Introduction 509, sponsored by Bronx City Council Member Althea Stevens, who represents the District 16 neighborhoods of Morrisania, Concourse, Highbridge, and Morris Heights, would require an agency designated by the mayor to administer a public education program that informs the public regarding maternal mortality and severe maternal morbidity.
DOHMH would also be required to report on the total births in the city, disaggregated by vaginal and cesarean sections, and whether the pregnancy was considered low risk. DOHMH would also be required to issue recommendations to reduce maternal mortality and severe maternal morbidity, including efforts to reduce the risks associated with unplanned cesarean delivery, and efforts to address inequities across patient demographics.
Also included in this package are several resolutions.
Resolution 95, sponsored by Manhattan City Council Member Carlina Rivera who is one of the current frontrunners in the congressional race for NY-10, would call on the New York State Legislature to pass legislation that would require maternal health providers to supply individuals with a planned c-section and those who undergo an unplanned c-section with a standardized written communication about the procedure, to ensure universal dissemination of information to improve health outcomes for birthing parents and newborns.
Resolution 205, also sponsored by Rivera would call on the New York State legislature to pass legislation making doula care more accessible to individuals with Medicaid and those without health insurance.
“I am proud to join my colleagues in passing this package of key maternal health legislation, which will ensure every person’s essential human right to quality, equitable, and respectful care in childbirth,” said Rivera. “My bills, Res. 95 and Res. 205, call on New York State to invest in providing critical resources to birth workers and expand patient-centered care. We have the power to end the Black maternal mortality and morbidity crisis, both at home in New York and across the United States.”
Resolution 92, sponsored by Williams, would call on Congress to pass and President Joe Biden to sign the Black Maternal Health Momnibus Act of 2021, to make critical investments in and advance policies that he said would help end preventable maternal mortality and close the racial and ethnic disparities in maternal healthcare.
In other City Council related news, another bill, introduction 600, sponsored by Adams, will implement a State-authorizing law allowing the City to provide a rebate of real property taxes for eligible properties on fiscal year 2022 property taxes. The rebate would be the lesser of $150 or the property’s annual real estate tax liability. To be eligible for the rebate: (1) the property must be a one, two or three family residence or a dwelling unit in a cooperative or condominium; and (2) the property must be the primary residence of the owner. In addition, the income of all of the owners for whom the property serves as their primary residence cannot exceed $250,000.
A transparency resolution approving changes in the designation of certain organizations receiving funding in the expense budget was also introduced.
In other maternal related news, District 14 City Councilwoman Pierina Sanchez has given birth to her baby after a busy few months in her first year in office, while our latest health check provides tips on breastfeeding as August celebrates National Breastfeeding Awareness month. You can check it out here.
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