New York could become first state to offer paid leave for prenatal care
Gov. Kathy Hochul on Thursday proposed a series of initiatives to address maternal and infant death in New York, including one that would make the state the first to provide paid leave for prenatal care.
The announcement comes as New York City tries to address troubling rates of life- threatening emergencies related to childbirth. The risks are especially stark for Black women in the city, who are nine times more likely to die from pregnancy or childbirth than their white counterparts.
Statewide, Black women are more than four times more likely to die from childbirth-related complications, according to state data from2016 to 2018. Nationwide, the rates of infant mortality are increasing for the first time in decades, Hochul said.
“Mothers and babies are dying unnecessarily across the nation and right here in New York,” Hochul said. “This could only be called a crisis. And as the firstmom governor, this is personal.”
To address the problem, Hochul, a Democrat, is proposing a six-point plan to improve maternal and infant health, which would include the elimination of copays for pregnancy services, expanded access to doulas statewide, training for clinicians on maternal mental health and free cribs for low-income parents.
She also is proposing a system to crack down on doctors who perform cesarean sections that are not medically necessary, which she said would involve monitoring and financial incentives.
The proposal is part of her annual State of the State plan, in which she lays out her priorities for the legislative session, which began Wednesday. Hochul will present her vision formally on Tuesday in the Assembly chamber.
Like a majority of her proposals, this one would require the support of the Democratically controlled Legislature.
Representatives for the Senate and Assembly Democratic majorities said that maternal health was deeply important to their conferences and that they would be reviewing the proposals.
Dr. Christina Pardo, the director of the women’s health practice at NewyorkPresbyterian/ Weill Cornell hospital, called the paidprenatal- leave proposal important, adding that the lack of such leave “has definitely been a barrier.”
But experts note that the factors contributing to maternal mortality run deep and reflect broader racial and economic inequities and disparities.
“There is no such thing as a quick fix,” said Pardo, who used to deliver babies at the SUNY Downstate medical center in East Flatbush, Brooklyn, a predominantly Black neighborhood that has one of the city’s highest rates of maternal morbidity.
In New York City in 2020, there were 29 deaths related to pregnancy and childbirth, according to a recent report by the city’s health department. Of those women, 12 were Black, nine were Latina, four were Asian and four were white.
Pardo noted that chronic diseases such as high blood pressure and diabetes make pregnancy riskier, and are more prevalent among Black and Latino adults than white adults in New York City. The overall prevalence of diabetes has soared over the past 30 years. To reduce maternal mortality, she said, “we can’t just focus on the pregnancy time period.”
Hochul’s proposal does little to address another factor that contributes to the disparities in maternal mortality: the varying quality of medical care across hospitals. In New York City, Black women tend to deliver at hospitals with worse safety records than those where white women deliver. That factor might account for nearly half of the racial disparity in maternal morbidity rates in New York City, according to research.
In Brooklyn, for instance, Woodhull Medical Center has emerged as a symbol of the city’s maternal mortality crisis. In November, Christine Fields, 30, died there when she hemorrhaged after an emergency C-section, according to the medical examiner’s office.
Previously, an anesthesiologist at Woodhull was investigated for botching epidurals. One woman, a 26- year- old first- time mother named Sha-asia Semple, received a botched epidural and died in 2020, according to a state medical review board.
Woodhull is part of the city’s public hospital system and about 85% of women giving birth there are Black or Latina.
The governor’s marque initiative would make 40 hours of paid leave available to pregnant women to allow them to attend medical appointments. Access to prenatal care can be crucial inmaking sure pregnancies and births go well.
There are some options already available to women who need to take leave before the birth of their children: New York offers short-term disability during the final weeks of pregnancy, but that can be used only after a seven- day waiting period. Federal leave is also available, but it is unpaid. And any leave women take before birth is subtracted fromthe time available to them to take off after birth— time that can be used for healing and bonding with their children.
Hochul’s proposal, which is similar to one offered in Washington, D.C., would expand the state’s existing paid family leave policy to include the prenatal period. Under that policy, New Yorkers receive 67% of what they would earn at work, up to a weekly cap of $1,151.16.
Politicians in New York City also have sought to address maternal mortality through a range of funding and legislative proposals.
Antonio Reynoso, the Brooklyn borough president, directed his entire capital budget for a year — some $45million— toward efforts to improve maternal health at Brooklyn’s three public hospitals, which include Woodhull. In 2022, Mayor Eric Adams signed seven maternal health bills that promised more education and more doulas.
Thursday’s announcement was an unusually personal one. The governor spoke proudly of being a working mother alongside Rodneyse Bichotte Hermelyn, an assemblywoman and chief of the Kings County Democratic Party, who carried her toddler son on her hip.
Bichotte Hermelyn recounted her own devastating experiences losing a son in childbirth and having complications that required surgery in another pregnancy. After being turned away from one hospital, she said she found good care at a public hospital in Brooklyn.