By Fajah Ferrer, Healthy Women, Healthy Futures Chair; Janice Minott, Co-Chair; Ekua Ansah-Samuels, Health Education/Program Coordinato; and Claudia Boykins, Engagement and Policy Director
Northern Manhattan Perinatal Partnership, Inc.
Pregnancy-related mortality in New York City is among the highest in the United States and has remained higher than the national average for the last 40 years. African American women in New York City are seven times as likely to suffer a maternal death as white women. For Hispanic women in New York City, the maternal mortality ratio is nearly twice as high as for non-Hispanic white women. These dramatic and persistent disparities are signals that more must be done at the program and policy levels to reach at-risk women and families to improve their health, especially any chronic conditions, before, during, following and between pregnancies.
Healthy Women, Healthy Futures is a citywide coalition of community-based organizations in New York City. Members of the coalition joined forces to fill the gaps in available services and improve health outcomes for women and infants. The coalition successfully acquired financial support from the New York City Council, and is now providing birth and postpartum doulas to support women during and after birth with breastfeeding, parenting skills, and screenings to reduce the risk of postpartum depression.
Doula care, which includes emotional, physical, and informational support before, during, and following birth, is widely recognized as a key evidence-based strategy to improve maternal and infant health. The 2014 consensus statement by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, titled "Safe Prevention of the Primary Cesarean Delivery," concluded that continuous labor support by doulas is "one of the most effective tools to improve labor and delivery outcomes. Given that there are no associated measurable harms, this resource is probably underutilized."
Studies show that support by a trained doula reduced cesarean rates by an average of 28 percent. Because cesareans are associated with an increased risk of maternal and infant complications and death, doula support for vulnerable women could help to improve outcomes for those at greatest risk, while reducing disparities. Postpartum doula care complements labor support and has been associated with increases in breastfeeding initiation and longevity as well as decreased risk of postpartum depression.
The Healthy Women, Heathy Futures coalition is poised to expand services to include preconception and interconception care, which is care before and in between pregnancies. Maternal and infant health involves good health in these periods. Unmanaged chronic conditions such as diabetes, hypertension, and obesity mean that women begin their pregnancy with significant health risks for themselves and their babies. Addressing chronic conditions before pregnancy yields the best chance of a positive birth outcome.
Healthy Women, Healthy Futures is now being considered for a $3 million dollar allocation from the New York City Council. $2M of this allocation will be used for preconception and interconception care and $1 million for doula care. The work of the coalition members under this initiative extends the continuum of care for women living in New York City helping to ensure that women are healthier in general and at their healthiest should they chose to become pregnant.
Please contact Fajah Ferrer at email@example.com to learn more about the Healthy Women, Healthy Futures coalition.