Council hearing presses Health and Hospitals on maternal care, data and disparities

Councilmember Narcisse (co-chair, Committee on Hospitals and Committee on Women and Gender Equity) and Councilmember Lehi (co-chair) questioned officials from New York City Health and Hospitals (H+H) on staffing, data, training and patient protections during a joint hearing on maternal health on Oct. 28, 2025.

The hearing focused on H+H policies around substance testing, midwifery and doula access, mental‑health screening and postpartum follow-up, and the system’s ability to disaggregate outcomes by race, language and other factors.

Why it matters: New York City’s maternal mortality and morbidity rates remain a public‑health priority. City lawmakers sought to clarify what H+H is already doing and what it can do quickly to reduce preventable complications, improve follow‑up care after birth and root out disparities for Black and Latino birthing people.

Officials from H+H told the council that the system treats substance use disorder as a medical condition and that “written informed consent is required in order to test a pregnant person for substances,” adding that referrals to substance use treatment are increasing even as testing has declined. A H+H representative said the system’s maternal homes and social‑work teams are its largest referral source for community doula services.

H+H said midwifery services are available across most of the system but not at every facility: H+H provides birth and labor care at 11 maternity hospitals and “three of our facilities do not have midwives,” the representative said, naming Harlem, Lincoln and Queens hospitals as exceptions. The representative added that midwives in H+H generally manage low‑risk births and practice in an integrated model with physicians.

On cesarean delivery rates, the H+H representative pointed to routine fetal‑heart‑rate training and peer review structures: H+H uses professional standards (including guidance from the American College of Obstetricians and Gynecologists and nursing standards such as AWHONN) and said it sends outcome data monthly to regional perinatal centers. The representative provided a systemwide C‑section rate of 32 percent for 2024 and said that rate is “on par with the national level” and slightly lower than New York State’s 33.9 percent.

Council members pressed H+H about equity and the availability of disaggregated data. H+H said its Office of Population Health is beginning to produce race, ethnicity and other breakdowns, but that routine, dashboarded access is not yet available and requires involvement of the central data team. “We are looking forward to a day when we can… pull it up on a dashboard, but we’re not there yet,” a H+H representative told the committee and offered to follow up on timing.

On quality‑safety systems, H+H described multiple initiatives: an electronic early‑warning system in the electronic medical record to surface abnormal vital signs; a planned rollout of Perigen vigilance for fetal heart‑rate monitoring to automate detection of concerning tracings (H+H said implementation should be finished by the end of the year); and the use of MDstat to generate provider‑level reports from Epic. H+H also described a system‑wide anonymous reporting tool called Voice for staff to flag incidents or concerns.

Council members and advocates repeatedly raised mental‑health screening and postpartum supports. H+H said behavioral‑health services are embedded at some sites (the representative highlighted Woodhull as an example) and that maternal homes have made more than 1,300 referrals to behavioral‑health services through standardized screening. H+H also described expanding telehealth follow‑up visits, offering postpartum appointments before discharge and tailoring follow‑up according to clinical need; the representative said standard care typically includes at least one postpartum visit within the first month.

On language access, H+H said interpretation services are available 24/7 in more than 300 languages via on‑demand phone and video platforms and that H+H prefers certified medical interpreters to family members unless a patient declines the service.

Training and culture topics drew sustained attention. H+H said all employees must complete annual unconscious‑bias and diversity‑inclusion training through an Office of Diversity and Inclusion curriculum, and that bias and equity are embedded in high‑fidelity simulation exercises. H+H described a new I‑CARE initiative (Integrity, Compassion, Accountability, Respect, Excellence) and a requirement that employees sign a related pledge.

Council members asked about staffing and how potential federal cuts might affect services. H+H emphasized its mission to care for all patients regardless of ability to pay and said leadership is developing financial and strategic plans in response to federal actions; the representative said they did not anticipate immediate staffing losses but declined to forecast long‑term impacts absent more information.

What remains unresolved: H+H repeatedly offered to “get back to you” on items where the committee requested facility‑level details — for example, timelines for dashboarded equity metrics, the precise process when disparities are identified, and which hospitals specifically plan to expand midwifery units. Council members pressed for clearer timelines and promised follow‑up requests.

The hearing also highlighted technology and data gaps: H+H said Epic is the system of record across its facilities and that clinicians will attempt to obtain outside records when patients do not have MyChart access, but that cross‑system data access depends on patient opt‑in or separate record transfer processes.

Council leaders and H+H agreed to additional follow up on several points, including more detailed reports on disaggregated outcome data, the status of midwifery staffing at specific hospitals, and documentation of corrective actions after serious adverse events.

The exchange underscored a common theme at the hearing: H+H described multiple clinical programs and safety tools already in place, and council members and community advocates asked for faster public visibility into outcome data, clearer corrective‑action timelines and more staffing and programmatic detail so the city can better target investments and oversight.