Black parents across the U.S. continue to face stark racial disparities when it comes to maternal health. In an effort to raise awareness, the heads of the city and state’s health departments and public hospitals hosted a panel of experts at a local doula headquarters during Black Maternal Health Week.

“I want to thank every doula in this space, every health advocate, every nurse, every doctor, midwife, who has pushed to get us to the space. Because we know that for too many years there was no recognition of the disparities,” said Assemblymember Stefani Zinerman at the event. “And you guys did the work, and you hit the streets, and you expanded each circle across the state to make sure that there was recognition of the inequities in the system, and you declared that we were not gonna take it anymore.”

For the last 24 years, the overall rate of maternal mortality has remained steadily high in New York City, and extreme disparities between racial groups persist, according to Department of Health (DOH) data.

From 2011 to 2020, there was an increase in maternal deaths among Black women. They are still about five times as likely to experience a pregnancy-associated death than whites, based on a DOH report from 2018 to 2022. Hispanic women were about two times as likely to have a maternal death from 2016 to 2020. These staggering disparities are due to structural racism, implicit bias, and sexism more than anything, said NYS Department of Health Commissioner Dr. James McDonald.

Dr. Wendy Wilcox is the Chief Women’s Health Officer for NYC Health + Hospitals and Chief of Obstetrics and Gynecology at Woodhull Hospital. Based on recent research, many of the pregnancy-related deaths occurring among Black moms are in the two-year post-partum period after giving birth and not necessarily in a hospital, said Wilcox. This could be from a variety of issues, such as late-stage pre-eclampsia or a hemorrhage from a C-section, mental health struggles and suicide, or domestic partner and gun violence, said Wilcox.

“We are living in unprecedented times,” said Ancient Song Doula Services Founder Chanel Porchia-Albert. “The ways in which structurally, we currently have an administration saying, ‘have more babies, have more babies,’ but we don’t have the necessary support in place to really support someone who is pregnant and parenting. Like, why would I want to bring my child into this world without the necessary support in place?”

Standards of care are expected to be impacted by President Donald Trump’s big tax bill, which gutted about $1 trillion from Medicaid and the Affordable Care Act. Nearly a third of all people of color, and women make up the majority of adults nationwide, are covered by Medicaid.

McDonald added that the state has had to reexamine certain programs, like the Birth Equity Improvement Project (Respectable Care), and change their names to ensure they aren’t targeted by the federal government’s anti-DEI cuts. Words like ‘Black,’ ‘health equity,’ ‘accountability,’ ‘indigenous,’ or even ‘low-income’ are now an issue.

“What are the better paths forward? Because the status quo isn’t working,” said New York City Department of Health and Mental Hygiene Commissioner Dr. Alister Martin.

However, multiple elected officials and advocates are working to make sure Black mothers have what they need.

“We understand that we need to decenter the hospital system in birthing,” said Assemblymember Michaelle C. Solages, who chairs the Black, Hispanic, Puerto Rican, and Asian Caucus. She is also a mother of three. “And we need to make sure that we’re listening to midwives, and doulas, and other caretakers, and healthcare professionals, about how we can bring more to the conversation. And we’re moving that conversation in Albany.”

At the state level, Solages has fought to expand doula coverage, improving access to donor breast milk, changing the maternal screening programs, fighting for home visiting, Medicaid coverage for lactation consultants, and for temporary disability insurance for alternative pregnancy outcomes. McDonald said one of the other things the state health department has done is financially incentivize hospitals to lower the scheduling of unnecessary C-section rates by at least 1%.

At the city level, the mayor and city council have been working to expand proven solutions, including providing free baby baskets to new parents, integrating midwifery models into hospital settings, delivering on universal childcare programs, and expanding the city’s newborn home visit programs.

Martin said that he wholly believes in the city’s By My Side Doula program. Over the last three years, the program has served over 3,900 mothers. He has seen the results work for women in real time on his spot visits as doulas are adept at navigating the healthcare system for their patients. “And not only that, it’s not just the direct service. It’s also the policy work that they do, the advocacy work that they do to make sure the structures and the systems are different and better for our patients,” said Martin.

Longtime midwife Trinisha Williams focuses on advocating on the ground for an increase in access to midwives and doulas, birth options, and education. “One of the things that I would love to have more access to is preconception care. People need to know about birth options, menstruation, and all the rest of it before they become pregnant,” said Williams, “So this way they can be able to then have that conversation clearly with either their OB or their midwife about how they can have a healthy pregnancy.”

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