‘Not doing enough’: NY maternal mortality reforms haven’t closed racial gap

Eight years after New York State launched a high-profile task force to confront maternal deaths and racial disparities in childbirth outcomes, state auditors say health officials are only now making “significant” progress implementing reforms — even as Black women continue dying at disproportionately high rates.

For Bruce McIntyre, whose longtime partner Amber Isaac died during childbirth at a Bronx hospital in 2020, the findings underscore how slowly the state moved after years of warnings.

“They are not doing enough,” McIntyre told The City Reporter.

A follow-up audit released May 26 by the state comptroller found the Department of Health had expanded maternal health initiatives, increased data analysis and launched new postpartum support programs.

Still, the state’s review of maternal deaths found that pregnancy-related mortality remains stubbornly high and marked by stark racial disparities.

Between 2018 and 2022 — the most recent year for which numbers were available — New York City had 52.3 pregnancy-associated deaths and 27.1 pregnancy-related deaths for every 100,000 live births, according to the latest city Health Department data.

Black women faced the greatest risk by far.

The city Health Department found that Black non-Hispanic women were about five times more likely than white women to die during pregnancy or within a year after pregnancy, a disparity that has widened slightly in recent years.

The comptroller’s report attributed the gap to longstanding inequities, including chronic underinvestment in predominantly Black neighborhoods, unequal access to quality health care and the cumulative physical and psychological toll of racism.

The five-year period also encompasses the COVID-19 pandemic, which worsened existing health disparities.

City officials have vowed to decrease the number of maternal deaths as part of the HealthyNYC initiative, which more broadly aims to boost life expectancy for all New Yorkers. The city has set a goal of cutting maternal deaths by 10% by 2030.

Maternal deaths in New York State have varied, but the latest figures show an upward trend, according to city data that hasn’t been publicly updated since 2021.

Data from the city’s Department of Health shows an uptick from 2016, when 36 deaths were recorded, to 58 in 2021. Roughly 30 of the deaths in 2021 were classified as pregnancy-related deaths, meaning mothers died from cardiovascular conditions, hemorrhaging, infections such as sepsis and mental health conditions. The city data defines pregnancy-related deaths as a person dying during pregnancy or within one year from the end of a pregnancy.

Throughout the years and among all categories, Black women outranked every other demographic in the number of pregnancy-related deaths, with Black mothers in Brooklyn suffering the most overall.

According to the Centers for Disease Control and Prevention, the United States recorded 18.6 maternal deaths per 100,000 births in 2023. Black women nationally died from pregnancy-related causes at roughly three times the rate of white and Hispanic women, disparities that worsened during the COVID-19 pandemic.

New York has improved its standing compared with other states, climbing from 46th in the nation for maternal mortality in 2010 to 17th for the period from 2018 through 2022, according to the audit.

But that progress has not been shared equally.

During that period, the maternal mortality rate for Black women in New York mirrored national trends, with death rates more than three times higher than white women.

Auditors also pointed to warning signs beyond maternal deaths.

Severe maternal morbidity — life-threatening complications related to pregnancy and childbirth — has been increasing nationally.

Federal data cited in the report showed such cases rose 22% between 2008 and 2021, from 146.8 cases per 10,000 hospital discharges to 179.8 per 10,000. The state audit also noted that New York’s cesarean section rate remains above the national average. Researchers have linked that to higher risks of maternal complications and death.

The state has spent nearly a decade trying to address the high-profile problem.

In April 2018, former Gov. Andrew Cuomo created an $8 million task force on maternal mortality.

The task force of medical experts produced ten recommendations including  the establishment of a maternal mortality review board to analyze the causes of the fatalities.

But the death rate and racial disparity actually worsened, according to the initial state audit in July 2024.

As for the new “progress,” auditors lauded a virtual home visiting pilot launched in 2024 that pairs hospitals with community organizations to provide remote check-ins, education and support to women after childbirth.

The state also increased its analysis of hospital discharge data to study severe maternal morbidity, the audit said.

Auditors further noted the state Health Department has launched at least 14 maternal health-related initiatives in recent years, including various training programs and expanded collaboration with hospitals and community organizations.

In February, Mayor Zohran Mamdani announced that the city Health Department would receive $20 million over three years for the Strong Foundations initiative to boost training for nurses and distribute supplies to new parents such as pack and plays, diapers and developmental toys.

“All parents deserve access to high-quality prenatal and perinatal care, and today’s announcement will ensure that all New Yorkers, and particularly those who face structural barriers to care, are provided with the resources they need at the very beginning of their child’s life,” Mamdani said at the time.

City health officials also pointed to the Nurse-Family Partnership, which connects registered nurses with expecting parents to help them successfully navigate the childbirth transition. The city recently expanded eligibility for the program, which served more than 2,100 expecting parents in 2025. Health officials say participants have shown high rates of breastfeeding and childhood immunization, along with improved education and employment outcomes for parents.

The city has also invested in perinatal and early childhood mental health services, expanding clinic capacity across the five boroughs and supporting training for new mental health professionals. Since 2016, the clinics have provided treatment or family peer support to more than 7,000 people, according to the Health Department.

Still, for families who lost loved ones during childbirth, the reforms remain overshadowed by the years it took the state to act.

Amber Isaac died in April 2020 shortly after delivering her son Elias through an emergency cesarean section at Montefiore Medical Center. Days before her death, she had posted on social media that she was dealing with “incompetent doctors” while struggling to get treatment for severe swelling and other symptoms.