The state Health Department's ongoing study of pregnancy-related deaths in New York is inspiring some lawmakers to take action when they return to Albany next month.
Gov. Kathy Hochul committed $20 million to improve affordable prenatal and postnatal care across the state, including expanding postpartum coverage for people eligible for Medicaid. But as the state's Maternal Mortality Review Board continues to closely examine pregnancy-associated deaths in the state, some lawmakers are preparing to tell the governor that isn't enough.
"Although I appreciate all the investments that the governor has made, we still need to address real issues like racism and disparities and tackle them for the long run as it relates to maternal care," said Assemblywoman Rodneyse Bichotte Hermelyn, a Democrat from Brooklyn.
Bichotte Hermelyn is using her personal experience to shape how the state responds. Her son, Jonah, died after being born 22-and-a-half weeks premature in 2016, and she almost lost her life.
Mental health is the third-leading cause of pregnancy-related deaths in New York, affecting nearly 20% of cases, according to the latest state data. Pregnancy-related deaths due to hemorrhage, mental health conditions and cardiomyopathy were determined to be 100% preventable, according to that report.
The state's Maternal Mortality Review Board last month recommended health providers better coordinate mental health treatment for pregnant women as members perform in-depth analyses of different areas on pregnancy-related deaths.
The board recommends not stopping psychiatric medications outright during pregnancy and continuing depression screenings and care for up to a year after delivery, according to a Health Department brief released last month.
"We realize that mental health is key to good maternal health," said Dr. Marilyn Kacica, the state Health Department's Family Health Division medical director. "[The brief] was a way in a timely fashion to lead providers around the state to see what we're seeing as far as maternal deaths in order for them to incorporate that into what they're doing to prevent further maternal deaths."
Bichotte Hermelyn on Tuesday said she'll meet with Hochul's staff in the coming weeks to influence what should be prioritized in her Executive Budget proposal due in mid-January.
"Gov. Hochul's first budget included investments to strengthen maternal health and combat maternal mortality and morbidity, including expanding postpartum Medicaid coverage, and we look forward to releasing details of the governor's State of the State and Executive Budget next month," Hazel Crampton-Hays, the governor's press secretary, said in a statement Tuesday.
Bichotte Hermelyn gave birth to a healthy baby boy Oct. 6 and continues to monitor her mental health and risk for postpartum depression. She celebrated her 50th birthday this week.
The assemblywoman sponsors multiple bills to improve maternal care standards, expand insurance coverage and upgrade hospitals and health centers with modern medical capabilities, among others.
She also sponsors Mickie's Law to ensure mothers who encounter fetal deaths to get care quickly regardless of a hospital's religious beliefs.
"When we talk about mental health, we need to think about even the aftermath of losing a baby, whether it was a dead fetus, whether it was stillbirth," she said.
The state Office of Mental Health's Project Teach helps primary care providers answer their patients' mental health questions, but the Brooklyn Democrat says that doesn't go far enough — especially to address racism and disparity for maternal deaths.
Black women in New York are about five times more likely to die during birth than white women, according to the latest state data.
"We have to enact legislation that will change the behavior of how hospitals and health care workers treat expectant mothers differently based on their socio-economic and racial status," Bichotte Hermelyn said.
She's hopeful the governor will increase funding for maternal care in the next state budget because Hochul has two children.
"She's certainly paying attention and I believe that she will deliver for sure," Hermelyn added.
The state Maternal Mortality Review Board is expected to release its next report about pregnancy-related deaths at the end of 2023. The group will work with the state Health Department to issue a brief about the impact of substance use on these deaths early next year.
DOH Commissioner Dr. Mary Bassett is leaving her post Jan. 1, but Kacica said that won't impact the board's work. The issue has been a priority for the department and with national health experts over the last decade. The United States has one of the highest maternal mortality rates of high-income countries across the globe.
Pregnancy-related deaths climbed in the first year of the COVID-19 pandemic, according to the National Center for Health Statistics. It's more than tripled over the last 35 years.