Contact: Stephany Fong, fong@nyhealthfoundation.org
August 13, 2020, New York, NY – New York mothers have high rates of serious complications related to childbirth, with significant disparities across racial and ethnic groups, according to a new analysis released today by the New York Health Foundation (NYHealth).
In 2018, the overall rate of potentially life-threatening complications during or after childbirth—known as severe maternal morbidity—was 2.7% in New York State. But Black women were 2.3 times more likely than white women to experience such complications. Rates among Hispanic women were 1.7 times higher than for white women; among Asian women, rates were 1.5 times higher compared with white women. Such racial and ethnic disparities have persisted over the study period, which began in 2011.
Reducing complications, especially those that require the need for lifesaving procedures such as blood transfusions and ventilation, can spare women potentially life-long injuries. Doing so is also a key strategy for reducing maternal death rates.
“Race matters when it comes to health, and that continues to be glaringly evident on issues of maternal health,” said David Sandman, Ph.D., President and CEO of NYHealth. “New York is working to close the substantial racial and ethnic gaps that have persisted for far too long.”
Key findings include:
- In 2018, the overall rate of serious maternal health complications was approximately 271 out of every 10,000 deliveries, or 2.7%. This potentially amounts to nearly 6,000 women in New York State who experienced these complications.
- Disparities by race and ethnicity persisted from 2011 through 2018. They were seen in patients with private and Medicaid insurance plans, across all regions of New York State, and among women who had vaginal and cesarean deliveries.
- In 2018, the rate of severe complications for Black women delivering was 447 per 10,000 deliveries—2.3 times higher than among white women, for whom the rate was 191 per 10,000 deliveries. The rate for Hispanic women was approximately 1.7 times the rate for white women; the rate for Asian women was approximately 1.5 times higher than the rate for white women.
- Substantial regional variation exists within New York State. In 2018, rates of complications were more than three-and-a-half times higher in the region with the highest rate—New York City (324 per 10,000 deliveries)—compared with the region with the lowest rate—the Finger Lakes (90 per 10,000 deliveries).
- The majority of serious maternal health complications were related to blood transfusions. The number of blood transfusions has increased over time, which may be reflective of recent improvements in identifying and treating severe maternal hemorrhage. However, complications unrelated to blood transfusions have largely remained steady between 2011 and 2018.
“Factors at the individual, health system, and societal levels all contribute to the serious health complications we see during and after childbirth in New York State,” said Mark Zezza, Ph.D., NYHealth’s director of policy and research and a report author. “Chronic illness, the quality of hospital care, and structural racism and implicit bias all play a role. To make meaningful progress, we need serious and sustained efforts in all of these areas.”
The report highlights a number of actions to address complications during or after childbirth and to reduce persistent racial and ethnic disparities in this area:
- Implementing quality improvement efforts in hospitals focused on safer, more uniform responses to issues like maternal bleeding and high blood pressure.
- Instituting implicit bias training for health care workers to reduce racial and ethnic disparities.
- Expanding health insurance coverage for women of reproductive age.
- Improving data collection to better understand clinical patterns, identify disparities and deficiencies, and measure progress on maternal health.
- Expanding access to nonclinical supports like doulas and community health workers to improve quality and reduce disparities.
New York State has already undertaken a number of efforts to address maternal health, having implemented several recommendations of its 2018 Taskforce on Maternal Mortality and Disparate Racial Outcomes. These include establishing a statewide Maternal Mortality Review Board and increasing access to community health workers. New York City—where nearly half of the State’s births take place—launched a five-year plan in 2018 to reduce childbirth complications and eliminate racial and ethnic disparities in this area.
NYHealth has dedicated funding to develop an online tool to allow expectant mothers to compare local providers in New York City and on Long Island based on quality measures and other factors that affect maternity and newborn care. The Foundation is also supporting an effort by the 32BJ Health Fund to develop a high-value maternity care network for its members, who are predominantly lower-wage union workers.
The full report, “Complications of Childbirth: Racial & Ethnic Disparities in Severe Maternal Morbidity in New York State,” is available here.
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The New York Health Foundation (NYHealth) is a private, statewide foundation dedicated to improving the health of all New Yorkers, especially the most vulnerable. Find NYHealth online at www.nyhealth.org and on Twitter @NYHFoundation.
