Opinion: New York’s maternal health crisis continues to disproportionately harm Black mothers

Maternal health in New York state is at a crisis point. For some, the perinatal experience goes smoothly, but for many others, childbirth brings severe health issues and negative outcomes. 

In New York, Black women and birthing people experience maternal death rates over four times higher than their white counterparts – a disparity larger than the national average. Adverse outcomes are especially prevalent in rural and underserved areas and among Black, American Indian, and Alaska Native women. 

This disparity worsens in New York City. Between 2001 and 2018, Black mothers experienced pregnancy-related mortality rates 9.4 times higher than white mothers. At its worst, the rate for Black mothers was 12 times that of white mothers, while white maternal mortality rates steadily declined. Alarmingly, 2021 data found that discrimination contributed to nearly 70% of pregnancy-related deaths, reinforcing how systemic racism and barriers to health care access lead to preventable deaths.

With decades of experience, we have dedicated our careers to advancing sexual and reproductive health to better serve underserved communities. Our work across public health policy and legislation addresses systemic failures that disproportionately harm Black, Indigenous, and other people of color, especially during pregnancy. As state legislators, educators and advocates, we have witnessed the devastating consequences of structural inequities in maternal health care. 

Statewide data reveal persistent failures in care, with mental health conditions, substance use disorders and discrimination playing significant roles in maternal morbidity and mortality. From 2016 to 2021, mental health conditions were the leading cause of pregnancy-related deaths in New York City, with substance use disorders also being a major factor. Participants in the state Department of Health’s 2018 statewide listening sessions shared accounts of postpartum depression, limited access to mental health providers and the abrupt loss of care after childbirth. Many described being pressured into medical interventions without full consent and facing discrimination that threatened their ability to make informed decisions – symptoms of a power imbalance that often disregards the agency and autonomy of Black women.

Maternal death is the most tragic outcome, but for every death, there are up to 100 instances of severe maternal morbidity – serious childbirth complications that lead to significant health challenges. New York state consistently has higher rates of severe maternal morbidity than the national average. Black women are more than twice as likely as white women to suffer these life-threatening complications, exposing the deep inequities driving the state’s maternal health crisis.

The state’s Maternal Mortality and Morbidity Advisory Council and New York City’s Maternal Mortality Review Committee have called for expanded, culturally competent maternal health services, including mental health and substance use support. We echo these calls and have enacted and supported policy efforts to advance maternal health equity. In January, New York became the first state to offer paid time off for prenatal care, recognizing the importance of supporting expectant parents. During Black Maternal Health Week, we will again advance a Maternal Health Equity Agenda with legislation addressing the crisis’s leading causes.  

However, our work is far from over. Maternal health intersects with housing security, economic stability, environmental justice and immigration policy, requiring a comprehensive approach. Reproductive justice demands centering the voices of the most marginalized and confronting the injustices driving disparities in our healthcare systems. This means investing in community-based care models that prioritize culturally responsive, patient-centered support, expanding midwifery and doula services, increasing paid postpartum leave and further integrating mental health and substance use services into perinatal care. 

New York has the opportunity – and the responsibility – to lead the nation in addressing maternal health inequities. We are committed to prioritizing policy changes that address these, funding community-led initiatives and finding solutions shaped by those most affected.