Equity in Maternal Care

Pregnant people of color in New York City are at greater risk for death and complications related to their pregnancies and births. The NYC Health Department is committed to equity and acknowledges the impact of racism on these disparities (PDF).

We have adopted a comprehensive approach — partnering with government agencies, health care systems and community organizations and members — to address the root causes of preventable racial and ethnic inequities in maternal outcomes.

Maternity Hospital Quality Improvement Network

The Maternity Hospital Quality Improvement Network initiative is a part of the city’s plan to promote equity in maternal care. The initiative works with NYC maternity hospitals to prevent and reduce disparities in maternal mortality and severe maternal morbidity.

The following are the three main intervention areas:

  • Enhancing clinical practice change through severe maternal mortality case reviews.
    • The Health Department's strategy for advancing equity includes promoting surveillance of maternal mortality and severe maternal morbidity. Hospitals collect and review severe maternal morbidity case data to identify contributing factors. Reviews support hospitals in identifying key maternal health drivers and developing recommendations to improve patient outcomes.

  • Shifting hospital culture to support anti-racist hospital systems.
    • The initiative focuses on institutional transformation, with strategies that promote respectful and equitable care. We aim to address implicit bias and structural racism to promote both better patient-provider interaction and person-centered care. We do this by supporting hospitals in pathways for accreditation towards doula-friendliness. We help hospitals increase patient and staff knowledge of doula support, integrate doulas into the birthing team and develop and implement formal doula-friendly policies and practices.

  • Promoting patient-advocacy and empowerment.
    • The initiative aims to center the voice of the patient in their health and and empower them to advocate for respectful maternity care. We do this by:
      • Providing access to health promotion programs in communities through the neighborhood Birth Justice hubs.
      • Connecting birthing people with community-based doulas and services.

Respectful Maternity Care

The Health Department defines respectful care as promoting health equity by fostering an environment where patients feel empowered to assert their rights and advocate for themselves, where providers listen and trust their patients and establish respectful and dignified patient-provider communication.

This initiative uses two strategies using the New York City Standards for Respectful Care at Birth:

  1. The initiative seeks to create health care systems that support respectful maternity care along the reproductive care continuum (prenatal, birthing, and postpartum). Providers are educated on anti-racist maternity care practices, core racial equity and social justice areas and receive tools and technical support to implement respectful maternity care.

  2. Building demand through community advocacy for respectful care to support pregnant and parenting people in knowing their rights for respectful maternity care. Increase awareness, access and utilization of quality services focused on TRIE neighborhoods and neighborhoods with high severe maternal morbidity.
Learn more about New York City Standards for Respectful Care at Birth and the Companion Guide to the New York City Standards for Respectful Care at Birth.

Learn more about NYC Standards and other resources for Respectful Care at Birth.

Community Engagement

Connecting Hospitals to Community-Based Doulas

The Health Department partners with community-based doulas to support maternity hospitals in developing and implementing doula-friendly policies and practices. We help hospitals build referral pathways to community-based doula services.

Neighborhood Birth Justice Hubs

The NYC Health Department links hospitals to local birth justice defenders with lived experiences to provide sexual and reproductive health education. These connections help community members:

  • Get the reproductive health education they need.
  • Share information with their community and participate in conversations with providers to initiate change.
  • Build relationships with health care providers
  • Use personal birth stories as tools for advocacy and community organization.
  • Learn how to advocate for respectful care throughout pregnancy, birth and post-partum.

To learn more about the Maternity Hospital Quality Improvement Network, email mhqin@health.nyc.gov.

Below are the local birth justice hubs offering services, education and advocacy to New Yorkers. If you would like to become a Birth Justice Defender in your community, email BirthJustice@health.nyc.gov.

Resources for Maternity Hospitals in NYC

Our Partners

Additional Resources

More Information