NYC tries remedy for grim inequity: Life-threatening birth complications in hospitals serving mostly black moms
Ultimately, racism sets stage: Maternal poor health, poverty & economic stress
If you’re black and plan to have a baby in Central Brooklyn, the odds are much higher than average that something will go terribly wrong.
Studies have shown that women who deliver at NYC hospitals that disproportionately serve black mothers — especially those in Central Brooklyn — are at a much higher risk of serious complications and death than those who serve mostly white women.
The city announced a plan on Monday to address this shocking statistic. The goal of the city’s five year $12.8 million plan, introduced by Mayor Bill de Blasio, first lady Chirlane McCray and a host of city officials, is to eliminate the disparities between black and white women and reduce by half the number of life-threatening complications in hospitals that serve a high number of black women.
Figures from the city’s Department of Health show the highest rate of maternal complications in the city are concentrated in Brownsville, East Flatbush, East New York, Bedford-Stuyvesant, Bushwick, Canarsie and Crown Heights.
Jamaica, St. Albans and Queens Village, East and Central Harlem and numerous neighborhoods in the South Bronx also suffer from high mortality and complication rates, though not as extreme as Central Brooklyn.
A ProPublica analysis found that SUNY Downstate Medical Center in Brooklyn, where 90 percent of the women who give birth are black, has one of the highest complication rates for hemorrhage in the state.
The hospital serves mothers with higher-than-average numbers of chronic health problems like diabetes, obesity and high blood pressure. In May, the Health Department announced Maternal Care Connection, a collaboration with Downstate to improve their obstetric care and chronic disease management.
While poor maternal health, poverty and life stresses are major factors, racism also plays a role in the discouraging statistics, Health Commissioner Dr. Mary Bassett said in a statement.
“We know one of the key drivers of racial disparities in maternal mortality is structural racism. Decades of inequitable distribution of resources across neighborhoods and unequal treatment within healthcare settings have resulted in racial differences in birth outcomes,” she said.
More than 3,000 women experience a life-threatening event during childbirth in New York City, and about 30 women die from a pregnancy-related cause each year. Black non-Hispanic women are eight times more likely to die of pregnancy-related complications than white women, much higher than the national average.
The city’s four-part plan includes engaging health care providers to adopt implicit bias training; improving data tracking and analysis at hospitals; enhancing maternal care at the city’s Health + Hospitals’ facilities; and expanding public health education.
The Health Department will create a Maternal Hospital Quality Improvement Network, targeting 23 of the 38 public and private maternity hospitals in NYC over a four year period, prioritizing providers in South Bronx, North and Central Brooklyn, East and Central Harlem, and Jamaica and St. Albans in Queens. Hospitals will collect data and incorporate best practices, and hospital staff will participate in practice drills.
The city’s public hospitals will start simulation training in obstetric units to focus on postpartum hemorrhage (bleeding) and thromboembolism (blood clots), two main causes of death. They will also hire maternal care coordinators, increase the number of women receiving pre- and postpartum care, and work to improve its data collection.
“We are losing far too many mothers –— especially women of color — to pregnancy-related complications,” said Mayor Bill de Blasio. “That is unacceptable. This new plan will put our hospitals and health care system on track to save the lives of mothers and make healthier the futures of their children.”
“New York City is making women’s health care priority number one,” said McCray. “No mother, in this great city of world class health providers, should ever worry about the quality of care she’ll receive when building her family, before, during or after childbirth.”
Council Speaker Corey Johnson called the problem, brought to the fore by Councilmember Helen Rosenthal, not just a health crisis, but a human rights issue.
“This investment is the city’s commitment to provide the best healthcare services to all New York women and the next step in ensuring the protection of all women, especially women of color,” he said in a statement.
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