New York must improve follow-up to programs addressing maternal deaths, state audit says
![New York State Comptroller Thomas P. DiNapoli has released an...](/_next/image?url=https%3A%2F%2Fcdn.newsday.com%2Fimage-service%2Fversion%2Fc%3AOGZkYmIxMDMtOTY0Zi00%3AMDMtOTY0Zi00YjU5ZTY4%2Fstclimate240721_photos.jpg%3Ff%3DLandscape%2B16%253A9%26w%3D770%26q%3D1&w=1920&q=80)
New York State Comptroller Thomas P. DiNapoli has released an audit saying New York needs to do more to address the rise in maternal deaths. Credit: Jeff Bachner
A new state audit says New York needs to do more to curb deaths of women from problems associated with childbirth or pregnancy, pointing to a recent increase in maternal mortality rates and racial disparities in those figures.
Although New York has expanded access to doula care and started other maternal mental health initiatives, the state Department of Health is not doing enough to evaluate all of its maternal health programs, according to an audit from state Comptroller Thomas DiNapoli’s office. The lack of evaluation means that the state is not able to fully gauge how its efforts are impacting the maternal health crisis, the audit said.
"Despite New York’s efforts to reduce maternal deaths and pregnancy related health conditions, progress has stalled," DiNapoli said in a statement. "The Department of Health needs to strengthen its oversight of policy initiatives and take steps to help ensure all mothers, regardless of race or ethnicity, have access to the highest level of care."
"From 2018 to 2021, during the COVID-19 pandemic, maternal deaths were estimated to have increased up to 33% in New York, according to CDC estimates. According to DOH data, 78% of deaths during or after childbirth were preventable in 2018," the audit said.
WHAT TO KNOW
- A new state audit has found that New York must do more to evaluate and follow up on programs addressing maternal health.
- Maternal deaths have risen in New York in recent years, especially among Black women, according to figures cited in the audit.
- The audit found that the health department needs to follow up on programs that were recommended by state panels, but not put in place.
In 2020, Black women in New York had a pregnancy-related mortality rate of 54.7 deaths for every 100,000 live births — roughly five times the figure for white women, the state said.
The Health Department responded to the audit by saying, "The State Department of Health is committed to combating maternal mortality and continues to engage in a multifaceted effort to eliminate inequities and improve health outcomes." The department also responded to individual recommendations in the report.
The audit, which took place between 2018 and 2023, outlines how improved evaluation and rollout of maternal health recommendations are important factors in the state's effort to make childbirth safer.
Lack of follow-up evaluations of these programs could "affect the outcomes for birthing people across the state," said Dr. Dawnette Lewis, director of Northwell Health’s Center for Maternal Health.
In 2010, the state started taking the first steps toward dealing with maternal mortality with the Maternal Mortality Review Initiative, the audit said. In 2018, it started a task force on the issue, which made recommendations such as racial bias training for hospitals and better data collection of perinatal outcomes. In the following years, a statewide expert group and a maternal review board were formed — each coming up with recommendations.
Three state groups tasked to help deal with maternal mortality issued roughly 30 recommendations. Auditors’ review of 27 recommendations found that 37% were "partially implemented" or not implemented, the report found. Some of those not put in place included curricula for health care providers and the encouragement of birth preparedness, the report said.
The audit noted that the DOH has implemented 63% of the recommendations, including an investment of about $14 million to fund an initiative to improve the health of pregnant women and their families.
Still, the report found that while the department said it wants to reduce the rate of severe maternal morbidity — pregnancy issues that can include postpartum depression and medical complications with health consequences — it doesn't have data on the phenomenon. The DOH said it has hired someone to report on severe maternal morbidity, the audit said.
The report also found the Department of Health could increase its outreach to birth hospitals and others to see why they might not have participated in programs such as one on hemorrhaging — a leading cause of pregnancy-related deaths, according to the state.
Martine Hackett, a co-founder of the Birth Justice Warriors — which works to address the maternal health crisis — said more localized data on maternal health would be helpful to address the issue in the Long Island region.
Overall, Hackett, also chair of Hofstra University's Department of Population Health, said the audit is a necessary tool that’s shining a light on the specific action the Department of Health is taking and how that can impact lives.
"I think it's legitimate to acknowledge what hasn't happened, but we also have to, you know, say that there have been some significant changes that ... we still probably have yet to see what the benefits of those have been," she said.
![](/_next/image?url=https%3A%2F%2Fcdn.newsday.com%2Fimage-service%2Fversion%2Fc%3AMTg0Njg2M2EtNzI0NS00%3AMGI1ZmNhMzMtYmM4Yy00%2F911-jpg.jpg%3Ff%3DLandscape%2B16%253A9%26w%3D770%26q%3D1&w=1920&q=80)
Remembering 9/11: Where things stand now As we remember those we lost on 9/11, we're looking at the ongoing battle to secure long term protection for first responders and the latest twists and turns in the casesof the accused terrorists.
![](/_next/image?url=https%3A%2F%2Fcdn.newsday.com%2Fimage-service%2Fversion%2Fc%3AMTg0Njg2M2EtNzI0NS00%3AMGI1ZmNhMzMtYmM4Yy00%2F911-jpg.jpg%3Ff%3DLandscape%2B16%253A9%26w%3D770%26q%3D1&w=1920&q=80)
Remembering 9/11: Where things stand now As we remember those we lost on 9/11, we're looking at the ongoing battle to secure long term protection for first responders and the latest twists and turns in the casesof the accused terrorists.