A task force to improve the health of expectant mothers has held its first meeting.

“New York is committed to ensuring every woman in the state has equal access to high quality healthcare, and this initiative will help break down unnecessary barriers to care,” said Gov. Andrew Cuomo. “These listening sessions and task force meetings are critical steps in addressing unacceptable racial disparities in our health care system and creating a stronger, healthier New York for all.”

As discussed in Tuesday’s meeting, the task force will continue to provide expert policy advice on improving maternal outcomes, addressing racial and economic disparities and reducing the frequency of maternal mortality and morbidity in New York state. The task force includes health care professionals, Melissa DeRosa, secretary to the governor and chair of the New York State Council on Women and Girls; Lt. Gov. Kathy Hochul, Letitia James, New York City public advocate; and appointees from Senate Democratic Leader Andrea Stewart-Cousins, Assembly Speaker Carl Heastie, Senate Majority Leader John Flanagan and Assembly Minority Leader Brian Kolb, as well as other stakeholders and members of the community. The task force is led by Dr. Howard Zucker, state health commissioner; Sascha James-Conterelli, president of the New York Association of Licensed Midwives; Dr. Danielle Laraque-Arena, president of SUNY Upstate; and Dr. Wendy Wilcox, Chairman of the Department of Obstetrics and Gynecology, NYC Health and Hospitals, Kings County.

While New York State has made improvements in reducing maternal mortality rates since 2010, when it was ranked 46th in the nation for the lowest mortality rate, the state still ranks 30th in the nation. Black women are almost four times more likely nationally to die in childbirth than white women and three times more likely in New York. Research shows that in New York City, highly educated black women still fare significantly worse than white women with less than a high school degree.

Zucker led a series of statewide listening sessions in high risk communities. Meetings in the Bronx, Brooklyn, Queens, Harlem, Albany, Syracuse and Buffalo provided an opportunity to listen to local stakeholders, including pregnant women, explore the barriers that women face in obtaining routine prenatal care and discuss strategies to better increase awareness of the signs and symptoms of pre-eclampsia and other causes of maternal mortality and morbidity.

Additional initiatives discussed:

¯ Establishing the Maternal Mortality Review Board — At the recommendation of the Governor’s Council on Women and Girls, the Health Department established the Maternal Mortality Review Board, composed of health professionals from a cross-section of stakeholders around the state who serve and/or are representative of the diversity of women statewide, to work in collaboration with the American College of Obstetricians and Gynecologists and the City of New York to review each maternal death in New York state. The board, which will convene in early 2019, is tasked with making policy recommendations to the Health Department to improve maternal outcomes by reducing maternal mortalities and morbidities, and recommendations would specifically contemplate racial and economic disparities.

¯ Launching the Best Practice Summit with Hospitals and OB-GYNs — Cuomo, in partnership with the Greater New York Hospital Association, Healthcare Association of New York State, ACOG, and other stakeholders, will launch a summit this year to discuss the issue of maternal mortality and morbidity, including racial disparities. The summit will address statistics, best practices, community awareness, medical school curricula, graduate medical education, and practicing physician training, with the goal of implementing immediate measures and identifying future action items to improve maternal care and management.

¯ Piloting the Expansion of Medicaid Coverage for Doulas — The Health Department will pilot the expansion of Medicaid coverage for doulas in early 2019. Doulas are non-medical birth coaches who assist a woman before, during, or after childbirth if needed. Certified doulas have been shown to increase positive health outcomes, including reducing birth complications for the mother and the baby.

¯ Supporting Centering Pregnancy Demonstrations — New York will increase support for a program included in the governor’s State of the State First 1,000 Days of Life initiative, known as Centering Pregnancy. The program is designed to enhance pregnancy outcomes through a combination of prenatal education and social support and has been associated with reduced incidence of preterm birth and low birth weight, lower incidence of gestational diabetes and postnatal depression, higher breastfeeding rates and better inter-pregnancy spacing. Centering Pregnancy has also been shown to narrow the disparity in preterm birth rates between black women and white women.

¯ Requiring Continuing Medical Education and Curriculum Development — Cuomo calls on the state Board for Medicine to require appropriate practitioners to participate in continuing medical education on maternal mortalities/morbidities and disparate racial outcomes. Additionally, the Health Department will work with medical schools, including SUNY’s four medical schools, to build materials on maternal mortality/morbidity and disparate racial outcomes into their medical school curriculum, graduate medical education and training for practicing physicians. SUNY has established a statewide working group to coordinate efforts across middle schools and they have identified key experts who will advise on various aspects of the curriculum and training programs.

¯ Expanding the New York State Perinatal Quality Collaborative — The state has expanded its collaboration with hospitals across New York state to review best practices to address hemorrhaging and implement new clinical guidelines to reduce maternal mortality. More than 80 hospitals are engaged voluntarily in this effort, led and coordinated by the Department of Health. This collaborative has identified key metrics for measuring success in reducing maternal hemorrhage, as well as drafted clinical guidelines which will ultimately be used across the state to improve quality care.