Governor Kathy Hochul today announced New York’s latest effort to combat the maternal and infant mortality rates, as infant mortality rose nationwide for the first time in decades. Legislation S.1867A/A.5435A directs the New York State Department of Health to create and maintain a New York directory of doulas – birthing experts who provide physical, emotional and informational support before, during, and after the child-birthing experience. Governor Hochul also announced that doula services will be covered for all Medicaid enrollees starting on January 1, 2024. The governor also highlighted $4.5 million in annual funding for Regional Perinatal Centers secured in the FY23 budget, which has been allocated by the New York State Department of Health.
“Our maternal and infant mortality rates are a disgrace,” Governor Hochul said. “Expanding access to doula services is an effective, evidence-based strategy to support expectant parents and allow their babies to grow and thrive. As the first mom and grandma to serve as Governor of New York, I’m committed to doing everything in my power to tackle the disturbing rise in infant mortality.”
New York State Department of Health Commissioner Dr. James McDonald said, “The State Health Department remains committed to addressing the increased mortality rates among Black people who give birth. Doula services can improve birth outcomes and provide families with emotional support during a time that can be challenging. I stand with Governor Hochul to continue to fight for services that will ensure all people who give birth have a safe and empowering birthing experience.”
The Governor signed legislation S.1867/A.5435A, which requires the New York State Department of Health (DOH) to establish and maintain a state community doula directory on the DOH website for the purposes of Medicaid reimbursement. This piece of legislation will promote doula services to Medicaid recipients and establish criteria for admittance into the New York State community doula directory.
State Senator Samra Brouk said, “I’m grateful to Governor Hochul for her support of this legislation to create a Community Doula Directory. This bill will ensure that doula care is more accessible to families who need it and marks a crucial step forward in combating rising maternal mortality rates, especially for Black New Yorkers, who are five times more likely to die from a pregnancy related complication. I look forward to continuing to work alongside Governor Hochul, my partners in the legislature, and community doulas themselves to expand access to doula care in New York State.”
Assemblymember Michaelle Solages said, "This bill is a significant step toward expanded access to doula care in New York State. Pregnant people of color, especially Black women, face disproportionately higher rates of pregnancy complications and maternal mortality. Doulas help combat this by providing low-cost support to birthing people. I commend Governor Hochul for signing this legislation, which will provide a centralized and accessible space for pregnant people to find the quality doula care that they need to have a positive birthing experience.”
Additionally, Governor Hochul encourages eligible New Yorkers to enroll in Medicaid, which will cover doula services starting on January 1, 2024. Typically, the doula-client relationship begins a few months into a pregnancy (with the doula supporting the creation of the birth plan) and spans the pregnancy and post-partum period.
In April 2018, DOH announced the New York State Doula Pilot Program, which provided Medicaid coverage for doula services to pregnant and postpartum people in Erie County, extending these services to many low-income residents for the first time. In this year’s State Budget, Medicaid coverage for doula services was extended statewide, effective January 1, 2024.
Despite national data, New York State has made great strides in decreasing the rate of infant deaths and is currently ranked 4th in the nation for lowest infant mortality rates. However, racial and geographic disparities reflect national trends – with Black infants almost three times as likely to die as White infants. The statewide maternal mortality rate peaked at 24.1 per 100,000 live births from 2008-2010, and in response, DOH created the Maternal Mortality Review Initiative (MMRI) to systematically review all New York State maternal deaths and develop strategies and interventions to decrease the risk of these deaths. As a result of these measures, New York State improved significantly in national rankings.
The FY23 State Budget allocated $4.5 million in annual funding to support the state’s Regional Perinatal Centers (RPCs), which are hospitals that provide the highest level of perinatal and infant care and serve as coordinating entities over their networks of affiliated birthing centers. RPCs provide oversight of their networks to identify areas for improvement, like additional provider training or enhanced protocols. Funding supports RPCs across the state as they convene key stakeholders to foster collaboration and referral and discuss regionally relevant topics of interest.
Today’s legislation, sponsored by Senator Brouk and Assemblymember Solages, will go further to keep pregnant people safe by creating a publicly accessible ‘Doula Database’ which would support the growing number of New York State doulas working with pregnant people and their families. According to the American Pregnancy Association, “studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50 percent, and the length of labor by 25 percent.”
State Senator Cordell Cleare said, “I am thrilled the Governor is signing the Doula Directory Bill, which I proudly co-sponsor and which has been so effectively championed by Senator Brouk. Having access to the empowerment, support, understanding and experience of a doula is absolutely necessary for the physical, mental and emotional health of mother and child and it must be a baseline human right.”
State Senator Lea Webb said, “We know that doulas facilitate safety and good health outcomes for all mothers, especially mothers of color both during birth and the postpartum period. This legislation will create a doula directory, which will improve equitable access to these health providers and help combat maternal health disparities and ensure healthy outcomes for more infants and mothers. I am proud, as Chair of the Senate’s Women’s Issues Committee, to have championed this bill, and I am grateful to my colleague, Senator Brouk, for her leadership on this issue. I thank Governor Hochul for demonstrating her commitment to maternal health by signing this legislation into law today.”