New York City Launches Initiative to Eliminate Racial Disparities in Maternal Death

A Central Brooklyn hospital featured in ProPublica and NPR’s “Lost Mothers” series for its high hemorrhage rate will serve as a pilot for quality reforms.

In response to alarming racial disparities, New York City announced a new initiative last week to reduce maternal deaths and complications among women of color. Under the new plan, the city will improve the data collection on maternal deaths and complications, fund implicit bias training for medical staff at private and public hospitals, and launch a public awareness campaign.

Over the next three years, the city will spend $12.8 million on the initiative, with the goal of eliminating the black-white racial disparity in deaths related to pregnancy and childbirth and cutting the number of complications in half within five years.

“We recognize these are ambitious goals, but they are not unrealistic,” said Dr. Herminia Palacio, New York City’s deputy mayor for health and human services. “It’s an explicit recognition of the urgency of this issue and puts the goal posts in front of us.”

The city’s health department is targeting nearly two dozen public and private hospitals over four years, focusing on neighborhoods with the highest complication rates, including the South Bronx, North and Central Brooklyn, and East and Central Harlem. Hospital officials will study data from cases that led to bad outcomes, and staff will participate in drills aimed at helping them recognize and treat those complications.

Health department officials approached SUNY Downstate Medical Center in May to serve as a pilot site for many of the new measures.

 

The Central Brooklyn hospital was featured in the “Lost Mothers” series published by ProPublica and NPR last year as one of the starkest examples of racial disparities among hospitals in three states, according to our analysis of over 1 million births in Florida, Illinois and New York. In the second half of last year, two women, both black, died shortly after delivering at SUNY Downstate from causes that experts have said are preventable. The public, state-run hospital has one of the highest complication rates for hemorrhage in the city.

“We look forward to working with all of our partners to provide quality maternal health care for expectant mothers,” said hospital spokesperson Dawn Skeete-Walker.

“SUNY Downstate serves a unique and diverse population in Brooklyn where many of our expectant mothers are from a variety of different backgrounds, beliefs, and cultures.”

The city will also specifically target its own public hospitals, which are run by NYC Health + Hospitals, training staff on how to better identify and treat hemorrhage and blood clots, two leading causes of maternal death.

The initiative is “aimed at using an approach that encourages folks to have a sense of accountability without finger pointing or blame, and that encourages hospitals to be active participants to identify practices that would benefit from improvement,” said Palacio.

In addition to training, the city’s public hospitals will hire maternal care coordinators who will assist high-risk pregnant women with their appointments, prescriptions and public health benefits. Public hospitals will also work to strengthen prenatal and postpartum care, including conducting hemorrhage assessments, establishing care plans, and providing contraceptive counselling, breastfeeding support and screening for maternal depression.

Starting in 2019, the health department plans to launch a maternal safety public awareness campaign in partnership with grassroots organizations.

“This is a positive first step in really being able to address the concerns of women of color and pregnant women,” said Chanel Porchia-Albert, founder and executive director of Ancient Song Doula Services, which is based in New York City. “There need to be accountability measures that are put in place that stress the community as an active participant and stakeholder.”

The city’s initiative is the latest in a wave of maternal health reforms following the “Lost Mothers” series. Over the past few months, the U.S. Senate has proposed $50 million in funding to reduce maternal deaths, and several states have launched review committees to examine birth outcomes.

As ProPublica and NPR reported, between 700 and 900 women die from causes related to pregnancy and childbirth in the United States every year, and tens of thousands more experience severe complications. The rate of maternal death is substantially higher in the United States than in other affluent nations, and has climbed over the past decade, mostly driven by the outcomes of women of color.

While poverty and inadequate access to health care explain part of the racial disparity in maternal deaths, research has shown that the quality of care at hospitals where black women deliver plays a significant role as well. ProPublica added to research that has found that women who deliver at disproportionately “black-serving” hospitals are more likely to experience serious complications — from emergency hysterectomies to birth-related blood clots — than mothers who deliver at institutions that serve fewer black women.

 

In New York City, the racial disparity in maternal outcomes is among the largest in the nation, and it’s growing. According to a recent report from New York City’s Department of Health and Mental Hygiene, even as the overall maternal mortality rate across the city has decreased, the gap between black and white mothers has widened.

Regardless of their education, obesity or poverty level, black mothers in New York City are at a higher risk of harm than their white counterparts. Black mothers with a college education fare worse than women of all other races who dropped out of high school. Black women of normal weight have higher rates of harm than obese women of all other races. And black women who reside in the wealthiest neighborhoods have worse outcomes than white, Asian and Hispanic mothers in the poorest ones.

“If you are a poor black woman, you don’t have access to quality OBGYN care, and if you are a wealthy black women, like Serena Williams, you get providers who don’t listen to you when you say you can’t breathe,” said Patricia Loftman, a member of the American College of Nurse Midwives Board of Directors who worked for 30 years as a certified nurse-midwife in Harlem. “The components of this initiative are very aggressive and laudable to the extent that they are forcing hospital departments to talk about implicit bias.”

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MOST MOMS AREN’T AWARE OF FREE BREASTFEEDING INSURANCE BENEFITS, SURVEY SHOWS

Progress has been slow, but we’re starting to see the US become a more supportive place for breastfeeding moms. Laws entitle women to nurse in public, pump at work and have access to free products and services designed to give breastfeeding a boost in this country. But surprisingly, 82 percent of moms aren’t aware of all their legal rights and benefits, a new survey shows.

By law, women have the right to a private space to pump (and no, the bathroom doesn’t count), and their employers are required to let them take pumping breaks at work—something 61 percent of women weren’t aware of, according to a recent survey sponsored by Byram Healthcare, a medical supply company that provides no-cost breast pumps through insurance. The fact is, there are a whole host of free health benefits breastfeeding moms are legally entitled to, thanks to the Obama-era Affordable Care Act—but these big money-savers apparently aren’t well known.

Of the 1,000 expectant mothers surveyed, 64 percent didn’t know that sessions with a lactation consultant are covered at no cost to them under most of today’s insurance policies. That’s right—it’s mandatory for most insurance plans to cover lactation support and counseling, as well as equipment for the duration of your breastfeeding period, including before and after you’ve given birth.

That means you’re entitled to a breast pump through your health insurance (and whatever else your doctor deems medically appropriate for you). But 42 percent of women didn’t know you can order a breast pump, usually at no cost (though some policies might require a co-pay). And we’re not just talking a basic manual pump—insurance also covers premium double-electric pumps. Worried you won’t be able to get your pump of choice? You’re not alone, the survey shows, but rest assured plenty of popular name-brand breast pumps, like Medela, Spectra, Lansinoh and others, are available.

 

So how can you go about getting your free pump? First check with your insurance policy to see what’s fully covered and what retailers would be considered in-network. You can place an order as soon as get that positive pregnancy test, if you’d like. The only caveat for many insurance companies is that the pump won’t actually be shipped until 30 days before your due date.

The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months and continuing as long as mom and baby desire—so taking advantage of these benefits could save you big bucks. Breastfeeding isn’t always easy, but at least there are policies in place to help you succeed. If you’re in need of more help, check out these 12 tips for making breastfeeding a little easier.

PAMPERS DIAPERS ARE ABOUT TO GET MORE EXPENSIVE

EXPECT TO SEE SLIGHT PRICE HIKES STARTING THIS FALL.

PUBLISHED ON 08/02/2018

Parents know just how quickly you can blow through a stash of diapers—and for every wet nappy you toss, your mental cash register tallies up the cents you just spent. It’s estimated that families spend $2,000 to $3,000 on diapers alone in those first two years. Unfortunately, that price tag may be getting even higher, now that Pampers is jacking up their prices.

Procter & Gamble, Pampers’ parent company, announced this week they’re raising prices for Pampers diapers by an average of 4 percent, although the exact increase will depend on the size and type of diaper as well as the retailer.

Before you get too upset, a 4 percent price hike likely won’t break the bank. According to MarketWatch, Target sells a 100-count pack of Pampers Swaddlers diapers for $25. With the increase, the cost will be about $26. It’s not great, but it’s likely not going to be a total deal-breaker.

So why the jump in price? Procter & Gamble pointed to the rising cost of pulp, a raw material used to make disposable diapers, and higher transportation and freight costs. This isn’t the first time they’ve had to raise their prices, and it likely won’t be the last. In 2011, P&G and Kimberly-Clark Corp., the company that makes Huggies diapers, upped their price points for similar reasons.

For now, the new higher prices are expected to roll out between October and December, making now is a good time to stock up on Pampers if you’re looking to save a few dollars.

 

If you’re going to buy in bulk from Amazon, a word of warning: Be on the lookout for counterfeit diapers. There have been multiple reports of people buying what they believe are Pampers brand diapers, only to discover they’ve actually purchased lesser quality fake versions when the package finally arrives. If the price looks too good to be true, it probably is.

PHOTO: Courtesy Manufacturer