GNYHA’s second forum in its Advancing Maternal Health and Well-Being Learning Series featured presentations on maternal mental health equity and care, hospital-integrated doula support, and innovations in postpartum care.
GNYHA Senior Director Kendall LaSane began the meeting with relevant Federal and State updates. On the Federal front, Mr. LaSane reported that President Joe Biden’s fiscal year 2024 budget proposal includes $471 million to fund the Biden-Harris Blueprint for Addressing the Maternal Health Crisis, which would implement a 24/7 maternal health hotline and invest $20 million to help community-based organizations (CBOs) build and diversify the doula workforce. The New York State Department of Health recommendation to expand Medicaid doula coverage statewide and increase reimbursement to as much as $1,500 per pregnancy (including coverage for prenatal, labor and delivery, and post-partum visits) was also highlighted.
Camille Clare, MD, MPH, CPE, FACOG, Obstetrics and Gynecology (OG/GYN) Chair at University Hospital at Brooklyn, noted that structural racism causes significant inequities in the diagnosis of and access to perinatal and maternal mental treatment. Dr. Clare, who also serves as an OB/GYN professor at SUNY Downstate Health Sciences University and Chair of the American College of Obstetricians and Gynecologists District II, said that Black birthing persons experience a higher prevalence of maternal mental health conditions, particularly postpartum depression and anxiety, compared to the US population as a whole. She said the five key pathways to addressing racism and inequities are educating and training practitioners; investing in the Black women mental health workforce; investing in Black women-led CBOs; valuing, honoring, and investing in community and traditional healing practices; and promoting integrated care and shared decision-making.
Maimonides Medical Center Department of OB/GYN representatives Kavita Ram, MD, Associate Chair, and Janet Stein, MD, Obstetrics Director, discussed their hospital-integrated doula program, which is operated by N’shei CARES. They noted the benefits of using doulas, including increased likelihood of vaginal birth, decreased need for pain medication during labor, raised breastfeeding rates, and potentially reduced health disparities. They reported that Maimonides’ doula program provides continuous support for laboring women and has improved the patient experience for the hospital.
Kavita Vani, MD, Montefiore Medical Center attending physician and OB/GYN assistant professor, discussed the hospital’s fourth-trimester clinic, which includes a dedicated clinic located at a federally qualified health center in the Bronx. The clinic addresses postpartum needs for patients at high risk for complications and offers care coordinator/community health worker outreach within days of delivery. The clinic’s continuum of care includes routine postpartum care and screenings for depression and social determinants of health, with referrals for any positive screens.