The legislative package, passed by the Council in August, addresses racial disparities, most severely affecting Black women and birthing people

City Hall, NY – Speaker Adrienne E. Adams and the New York City Council celebrated the maternal health legislative package, which addresses significant disparities in maternal health, mortality, and morbidity for the first time in the City’s history, being signed into law today.

“Maternal health is a social justice issue that is a matter of life or death for many women and birthing people in our city and country, especially in Black communities,” said Speaker Adrienne Adams. “This historically diverse and women-majority Council prioritized addressing this issue to reduce the severe inequities faced by Black, Latino, and indigenous people in receiving equitable care. The horrifying lived experiences that have endangered too many lives are finally being acknowledged with concrete policy actions, and the enactment of these laws is a major step forward for our city. This progress would not have been possible without the leadership of women in the Council, and it shows the impact on policy when women are accurately represented in lawmaking.”

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. In an effort to address this national maternal health crisis that impacts New York City, the Council crafted a 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.

The legislative package is a demonstration of the agenda advanced by the City’s first-ever women majority Council, distinguishing how women lead differently in prioritizing solutions for persistent issues that have disproportionately affected women and communities of color. In July, the Council passed a groundbreaking abortion rights package, which was signed into law last month. The Council will continue to take on the longstanding challenges facing women in this city, who are the majority, as well as the millions of families across communities.

The legislative package contains the following:

Introduction 86-A, sponsored by Public Advocate Jumaane Williams by request of the Bronx Borough President, requires the City to conduct public education on standards for respectful care at birth, as well as 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.

Introduction 409-A, sponsored by Council Member Farah Louis, requires the Department of Health to post the annual Maternal Mortality and Morbidity report on its website. The annual Maternal Mortality and Morbidity 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.  

Introduction 482-A, also sponsored by Council Member Louis, requires the Department of Health 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.

Polycystic ovary syndrome and endometriosis are known to impact Black women and women of color more severely, due to a range of health access inequities that lead to misdiagnosis, underdiagnosis, and mistreatment. This legislation would expand public awareness about these conditions to ensure New Yorkers impacted by them, especially in communities of color, are more likely to receive appropriate treatment by helping them and their loved ones identify the signs.

Introduction 472-A, sponsored by Council Member Jennifer Gutiérrez, requires the Department of Health 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.   Doulas provide a humanizing approach to childbirth, giving families physical, emotional and practical support. Providing free doula care would empower birthing people who systemically face maternal mortality – particularly Black New Yorkers. With longstanding inequities and disrespect faced by Black and people of color in the healthcare system, doulas are a comforting and trustworthy alternative.

Introduction 478-A, sponsored by Council Member Crystal Hudson, requires the City 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.

Introduction 490-A, sponsored by Council Member Julie Menin, requires the Department of Health 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.

Introduction 509-A, sponsored by Council Member Althea Stevens, requires the City 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. While C-sections can be lifesaving, they may also produce long-term and short-term effects like infection and immune development.  This legislation would ensure New Yorkers will receive important information on maternal health and C-sections so they can make proper decisions on their healthcare. Research shows that Black women are more likely to be subjected to cesarean sections than white women, even in low-risk situations. The use of unnecessary cesarean deliveries poses health risks to the mother and child, due to potential complications.

Also included in this package are several resolutions.

Resolution 95, sponsored by Council Member Carlina Rivera, calls 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 Council Member Rivera, calls on the New York State Legislature to pass legislation making doula care more accessible to individuals with Medicaid and those without health insurance.

Resolution 92, sponsored by Public Advocate Williams, calls on Congress to pass and the President to sign the Black Maternal Health Momnibus Act of 2021, to make critical investments in and advance policies that would help end preventable maternal mortality and close the racial and ethnic disparities in maternal healthcare.

Resolution 244, also sponsored by Public Advocate Williams, calls on the Centers for Disease Control and Prevention to expand funding for the Healthy Start Brooklyn doula program, known as By My Side, in order to provide free doula services to low-income birthing parents in Brooklyn who disproportionately face the risks of infant mortality, low birthweight, preterm birth and other challenges.

“Birth equity is a social justice issue — and it’s one that’s especially urgent and deadly in New York City. It’s one that has become personal to my family, and so many families across our city,” said Public Advocate Jumaane D. Williams. “This public health crisis is both under-acknowledged and under-addressed, but today, we’re taking invaluable and concrete steps to protect pregnant people in the five boroughs. 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. Thank you to Borough President Gibson for your partnership on both this bill and this issue, to the speaker and City Council for taking up these bills, and to the mayor for signing this historic legislation into law today.”

“The empowerment that doulas offer throughout pregnancy and birth has meaningful effects on health outcomes, but also reaches far beyond, strengthening women’s voices and aiding them to advocate for better conditions in their communities,” said Council Member Jennifer Gutiérrez, one of the sponsors of the legislative package. “Doulas, who are largely women of color, have offered meaningful, life-saving support to moms and birthing people for thousands of years. This package of bills will work towards reducing maternal mortality, deepen our understanding of the issue, and expand the ways we approach care in our city. This is a clear signal that this majority-female City Council cares deeply about women, especially women of color, and that we are going to do everything we can to keep them alive.” 

“Despite the Supreme Court’s decision to take away our daughters rights all across this nation, NYC will never sit idle,” said Council Member Julie Menin, one of the sponsors of the legislative package. “My bill, which the Mayor is signing today, will codify and expand New York City’s health services, thereby protecting and increasing access to safe abortion care. Enacting this legislation will expand protections for New Yorkers who need access to services such as contraception, abortion, and screenings for cancer and sexually transmitted infections. Today, we lead this fight as we prepare New York City for the next wave of individuals needing reproductive and sexual health services.”

“As a woman, a daughter, a mother, and a member of the first majority women council, it is an honor as we officially establish a law that will save the lives of Black women across the city,” said Council Member Althea Stevens, one of the sponsors of the legislative package.“Maternal health accessibility is essential, especially in the current state of the negligence of women and birthing human rights around the country. This will not just work for the benefit of now but will be in honor of all our loved ones we lost while giving birth. We will continue to stand as a united front, as this law is just a message to let the country know that we are just getting started.”

“As a proud co-sponsor of this groundbreaking maternal health legislative package, I know these policies will create safer birth options for New Yorkers and their families,” said Council Member Carlina Rivera, sponsor of several of the corresponding resolutions. “We cannot accept disproportionately high rates of maternal death among communities of color as inevitable. This package is a result of close partnership with birth workers, health care providers and parents across New York to use every tool at our disposal to shape a city and state where birth is not a potential death sentence.”

“The ability to protect the health of mothers, birthing people, and babies in childbirth is a basic measure of a society’s development, said Council Member Lynn Schulman, Chair of the Council’s Health Committee. “This legislative package will enable women to have more bodily autonomy, especially with the unfortunate reversal of Roe v. Wade. Thank you to Mayor Eric Adams and Speaker Adrienne Adams for your leadership in making maternal health a priority.”

“Today’s signing of the Council’s landmark maternal health package into law by Mayor Adams is a significant victory for those of us who have championed the movement to close the glaring and deadly inequities faced by women and birthing people of color in our city daily,” said Council Member Mercedes Narcisse, Chair of the Council’s Hospitals Committee. “These bills will surely help close the racial disparities in maternal and infant deaths and save precious lives. I look forward to our continued efforts to fight to address all healthcare inequities across the board.”