New York State Health Department Releases Maternal Mortality Reports Detailing Stark Racial, Ethnic Disparities

New Reports Show Pregnancy-Related Deaths Five Times Higher Among Black, Non-Hispanic Pregnant Persons Than White, Non-Hispanic

State Health Department Leads Several Initiatives to Reduce Pregnancy-Related Deaths and Improve Health Outcomes

ALBANY, N.Y. (March 14, 2024) – The New York State Department of Health today released two new separate reports that show, despite continued efforts to reduce maternal mortality especially among racial and ethnic minorities, the rate of pregnancy-related deaths is still far too high in New York State, especially among Black pregnant persons. The reports recommend additional support before and after pregnancy to help reduce these inequities.

"The number of Black people who die of causes related to pregnancy is indicative of long-standing health disparities resulting from inequitable care and systemic racism," New York State Health Commissioner Dr. James McDonald said, "These inequities are unacceptable. Governor Hochul and I will continue to fight for the elimination of health disparities and so all birthing people have healthy births no matter their race or ethnicity."

The State Health Department released New York State Report on Pregnancy-Associated Deaths in 2018-2020 which summarizes findings and recommendations from the comprehensive reviews of pregnancy-associated deaths statewide. The report describes the work that is underway in the Department to address this public health issue and highlights key findings in pregnancy-related deaths that include:

• A total of 121 pregnancy-related deaths occurred from 2018-2020, which included 41 pregnancy-related deaths in 2018, 42 in 2019, and 38 in 2020.
• The overall pregnancy-related mortality ratio in New York State was 18.5 deaths per 100,000 live births from 2018 to 2020.
• Black, non-Hispanic women had a pregnancy-related mortality ratio five times higher than White, non-Hispanic women (54.7 versus 11.2 deaths per 100,000 live births).
• White, non-Hispanic women comprised 29.8 percent of pregnancy-related deaths while accounting for 49.1 percent of all live births.
• The pregnancy-related mortality ratio for cesarean delivery was 3.1 times that of vaginal delivery (23.8 versus 7.6 deaths per 100,000 live births).
• It was determined that 73.6 percent of pregnancy-related deaths had at least some chance of being prevented.

According to New York State Maternal Mortality and Morbidity Advisory Council Report 2023, racial and geographic disparities reflect U.S. trends—with Black people four times more likely to die in pregnancy or childbirth than White people. To address this, the State Department of Health created the Maternal Mortality and Morbidity Advisory Council (MMMAC) to review the findings and recommendations of the Maternal Mortality Review Board to identify social determinants and other issues known to impact maternal health outcomes. The MMMAC develops its recommendations on policies, best practices, and strategies to prevent maternal mortality and morbidity.

The Council report highlights racial and ethnic disparities in maternal mortality in New York State and recognizes that to make a sustainable impact on maternal mortality and morbidity and reduce racial and ethnic disparities in New York State, further actions are needed by a wide range of partners working together at the system, facility, provider, community, and individual levels. The Council report calls these partners to action for several critical issues, including recognizing and reducing racism and discrimination, addressing the impacts of social determinants of health, supporting mental health, and more.

In addition, Governor Kathy Hochul signed a law creating a state doula directory and allocated $4.5 million to support the state's Regional Perinatal Centers, to provide high-level perinatal and infant care where needed throughout our state. Doula services are fully covered by Medicaid as of January 1, 2024.

State Department of Health Medical Director for the Division of Family Health Dr. Marilyn Kacica said, "I thank Governor Hochul, Dr. McDonald and the New York State Maternal Mortality and Morbidity Advisory Council for their unwavering commitment to this critical issue. We will continue to address how maternal mortality affects the Black community as well as the racism and discrimination that drive these racial disparities."

State Maternal Mortality and Morbidity Advisory Council Chair Cheryl Hunter-Grant said, "Today's newly released reports by the New York State Department of Health provide insights and counsel to address systemic racism and its devastating impacts on Black maternal health. The Department of Health's State Maternal Mortality and Morbidity Advisory Council will continue to put forth recommendations and devise solutions that will ensure safer birthing experiences among Black people who give birth and improve health outcomes."

In collaboration with partners, the State Health Department is involved in a statewide effort to reduce the instances of maternal mortality and eliminate health disparities, while implementing several initiatives to reduce pregnancy-related deaths and improve health outcomes.

Maternal Mortality Review Board (MMRB) was established in 2019 to examine information related to pregnancy-associated deaths and to issue findings and recommendations to advance the prevention of maternal mortality.

Maternal Mortality and Morbidity Advisory Council was established in 2019 to review the findings and recommendations of the Maternal Mortality Review Board to identify social determinants and other issues known to impact maternal health outcomes. The MMMAC develops its recommendations on policies, best practices, and strategies to prevent maternal mortality and morbidity.

The New York State Perinatal Quality Collaborative (NYSPQC) was initiated in 2010 and is led by the Department's Division of Family Health. The NYSPQC engages a statewide network of birthing hospitals and centers that seek to provide the best, safest, and most equitable care for birthing people and infants in New York State.

New York State Birth Equity Improvement Project is a learning collaborative that has engaged New York State birthing hospitals and centers to support the development of anti-racist policies and practices at the facility level and improve the experience of care and obstetric outcomes for Black women/birthing people in New York State.

New York State Opioid Use Disorder in Pregnancy & Neonatal Abstinence Syndrome Project aimed to improve the identification and care of people with Opioid Use Disorder during pregnancy, as well as improve the identification, standardization of therapy, and coordination of aftercare of infants with Neonatal Abstinence Syndrome.

New York State Obstetric Hemorrhage Project reduced maternal morbidity and mortality statewide by translating evidence-based guidelines into clinical practice to improve the assessment, identification, and management of obstetric hemorrhage.

The Perinatal Infant and Community Health Collaborative (PICHC) is a community health worker/paraprofessional-based home visiting program. PICHC programs implement strategies to improve the health and well-being of individuals of reproductive age, and their families, with a focus on individuals in the prenatal, postpartum, and interconception periods.

Nurse-Family Partnership and Healthy Families New York programs provide education, screening, and referrals to those who are pregnant or parents of young children.

More information on Maternal Mortality can be found here.