As 'shocking' maternal mortality disparity worsens for Black mothers, Long Island experts say efforts will take time 

Efforts to reduce racial disparities in maternal mortality rates in New York have improved in recent years, but it will take more time to close the gap, local experts said following a report that found Black women continue to die at higher rates during or after pregnancy compared to other groups.

The national statistics released by the Centers for Disease Control and Prevention this week show overall maternal mortality across the U.S. dropped for the second year in a row.

The rate for white women, however, decreased from 19 deaths per 100,000 live births in 2022 to 14.5 in 2023, while it rose from 49.5 to 50.3 for Black women, though the report said the change was not statistically significant.

Maternal mortality refers to women who die while pregnant or within 42 days after the end of pregnancy, the report said.

Because statistics for New York State are done over a multiyear period it is difficult to compare to national figures. Between 2018 and 2020, the most recent years available, the overall state rate of maternal mortality was 18.5 per 100,000 live births. The rate among Black, non-Hispanic women was 54.7, while the rate for white non-Hispanic women was 11.2.

Dr. Dawnette Lewis, director of Northwell Health’s Center for Maternal Health, said Black women have traditionally faced numerous barriers such as not having the same access to health care and not being heard by their doctors.

"If you have a system that was built to exclude certain populations, then the system is working as it was created," Lewis said. "In order for it to change, there have to be system-level changes — it has to do with housing, nutrition and many things."

Lewis also pointed out that studies have shown even Black women in the highest income brackets had greater rates of maternal mortality than white women with less than a high school education.

"In other populations where education is protective, it’s not that way for Black women," she said.

There were 121 pregnancy-related deaths in New York between 2018 and 2020, the most recent maternal mortality data for the state that has a racial breakdown.

"When you're looking to address a problem as big and complex as maternal mortality, it is going to take a long time," said Martine Hackett, chair of Hofstra University’s Department of Population Health and cofounder of Birth Justice Warriors, which works to address maternal health issues. 

She called the disparity "shocking."

"It took us a long time to get here and it’s going to take a long time to dismantle it," she said.

Excessive bleeding, blood clots, high blood pressure, heart and mental health conditions are some of the major causes of pregnancy-related deaths, according to the CDC.

Lewis said the state Department of Health has told hospitals to have guidelines in place to help them better recognize and treat those conditions. At Northwell Health, Lewis said they carefully follow guidelines and work with teams of specialists to help women who may have preexisting cardiac and other conditions that may have gone undiagnosed before their pregnancy.

"Behavioral health is also a driver for maternal mortality," she said, adding that the standard has changed from screening just once during a pregnancy.

"Now we are screening at the beginning of pregnancy, during pregnancy and in the postpartum period to see if we can diagnose any anxiety or any behavioral health conditions in pregnancy," she said.

State Health Department officials note they have created several programs to reduce maternal mortality, including the Maternal Mortality Review Board, which examines pregnancy-related deaths, and Maternal Mortality and Morbidity Advisory Committee, which helps develop policies.

"The Department will continue to address how maternal mortality affects the Black community and remains dedicated to eliminating disparities so all people who give birth have birthing experiences that are safe, supportive, and empowering," the agency said in a statement to Newsday.

Women under Medicaid can now access services from doulas, who support and advocate for them during pregnancy as well as the postpartum period, and get Medicaid coverage for 12 months after pregnancy.

"This is really significant because we know that some of these maternal deaths happen in the weeks after delivery," said Hackett.

She said more health care systems are being held accountable when it comes to pregnancy outcomes.

"This is a great change but we have yet to see the impact of that on the culture of the health care system," she said.

Both Lewis and Hackett said Black women have felt their concerns were not heard by medical professionals, especially when they have troubling physical symptoms.

"This validates the CDC’s ‘Hear Her’ campaign," Lewis said, referring to the agency’s program to foster more discussion between clinicians and their pregnant patients. "Even when you do know your history and you are advocating for yourself, people don’t listen."

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.