This fall, I am asking my health professions colleagues, throughout New York State, to support an important new recommendation that helps to address one of the most challenging problems we face today—reducing high rates of maternal mortality.
As a physician, the President of the Academy, and Chair of the Public Health Committee of the New York State Public Health and Health Planning Council (NYPHHPC), I and my colleagues have been deeply committed to working on this issue for several years. Not only are women in our state at risk, our inability to protect new mothers is a critical indicator of the health of our society.
While we have seen many advances in other areas of medicine, New York State ranks 46th out of 50 states—almost at the bottom of the scale—in maternal mortality and there are significant racial disparities. Black women in New York are 5 times more likely to die in pregnancy and after childbirth than white women. National figures are just as daunting, the United States ranks 50th in the world.
To directly address this problem here in our state, the NYPHHPC, working with recommendations issued by the New York State Department of Health, joined forces with other organizations such as the New York Partnership for Maternal Health (the Partnership) to issue a call to action to physicians statewide.
In collaboration with the Partnership (a group comprised of the New York State Department of Health, the American Congress of Obstetricians and Gynecologists District II, the New York City Department of Health and Mental Hygiene, the Healthcare Association of NYS, the Greater New York Hospital Association and the Academy), New York State Health Commissioner Zucker has sent a letter to the state’s health care providers to ask them to take an extra step to protect their female patients.
This letter asks physicians to ask women of reproductive age one essential question whenever they “touch” the health care system for themselves, or bring a family member: “Would you like to become pregnant within the next year?” Regardless of the answer, just starting the discussion offers an opportunity to engage the patient in a conversation about the critical importance of a woman protecting her own health, before becoming pregnant and during pregnancy, if that is her intention.
The decision to ask physicians and health professionals to take this step is based on what we know about the factors that contribute to poor health during pregnancy and health crisis events at delivery. Nearly 45 percent of pregnancies in NYS are unplanned, meaning that these women miss the opportunity to discuss preconception health with their physician. For millions of women, this may mean starting a pregnancy with unmanaged hypertension, heart disease or other conditions that can become life-threatening as a pregnancy progresses.
We know that health care providers often have difficulty finding time to talk with their patients when many already feel overwhelmed. We ask them to consider the possibility that sparing a few moments to initiate this important conversation, especially with patients suffering from chronic health conditions, may save a woman’s life.
Jo Ivey Boufford, MD