BILL NUMBER: S5517A
SPONSOR: BROUK
 
TITLE OF BILL:
An act to amend the public health law, in relation to requiring the
advisory council on maternal mortality and morbidity to undertake a
review of the cesarean births at hospitals in the state
 
PURPOSE OR GENERAL IDEA OF BILL:
To create a cesarean births review board for the purpose of lowering
cesarean birth rates and improving maternal health
 
SUMMMARY OF KEY PROVISIONS:
Section one of the bill amends public health law to expand the scope of
the maternal mortality review board to assess whether there was a vagi-
nal or cesarean birth when assessing cause of death.
Section two of the bill amends public health law to require the board to
assess whether there was a vaginal or cesarean birth when reporting on
each maternal death case.
Section three of the bill amends public health law to require the advi-
sory council on maternal mortality and morbidity to undertake a review
of the cesarian births at hospitals in the state. The council shall
issue a final report. and make recommendations to reduce the rate of
cesarean births in the state.
Section four provides the effective date.
 
JUSTIFICATION:
The rate of cesarean birth in this state, and in this country, is not
nearly spoken about enough. Since the 1970s, the national rate of cesa-
rean births has increased by 500% which translates to about 1 in 3
babies delivered via C-section presently, compared to just 1 in 20
babies in the mid-1970s. Despite this growing trend, research demon-
strates there is no evidence that cesarean births provide any benefit to
the mother or newborn when the procedure is not required, in fact, it is
quite the opposite.
Currently, New York ranks 12th in the nation, where approximately 33% of
all deliveries in the state are Cesarean. New York's cesarean birth rate
greatly exceeds the World Health Organization's and CDC's ideal rate
which is between 10 and 15 percent. While the state average is around
33%, it is important to note that cesarean birth rates vary greatly
across hospitals, ranging between 7% and 70% depending on what hospital
a birthing person goes to.
Further, studies have found that cesarean birth rates in hospitals are
directly linked to higher maternal death rates and higher costs for
healthcare. The increase in cesarean rates in the U.S. is linked to an
increase in maternal deaths overall as the procedure can lead to neona-
tal respiratory problems and maternal complications. In fact, cesareans
can account for three of the top six leading causes of maternal mortali-
ty-hemorrhage, complications of anesthesia, and infection. Many of these
maternal deaths are preventable given WHO's recommended rate of cesarean
deliveries.
Additionally, there is an alarming disparity in cesarean birth rates
among different birthing populations. Minority (non-Hispanic black,
Hispanic/Latina, Indigenous, and low socio-economic status) birthing
people receive cesareans at a significantly higher rate than non-Hispan-
ic white birthing people, which is also an indicator of low-quality
maternity care. Moreover, black birthing people are more likely to
receive a cesarean overall and importantly, they are also more likely to
undergo repeated cesareans compared to other birthing people, which
further increases the risk of mortality. In fact, in the U.S., black
birthing people die from pregnancy-related causes at higher rates and
have a four times greater risk of maternal death, more than any other
racial or ethnic group.
This bill would establish a "cesarean births review board" comprised of
experts in the field of maternal mortality, women's health and public
health, and must include healthcare professionals who are representative
of the racial, ethnic, and socioeconomic diversity of birthing people in
the state. The board will undertake a review of the rate of cesarean
births at hospitals across the state and consider several factors that
may impact the frequency of this procedure. The board will issue a final
report and make recommendations related to the impact cesarean births
have on birthing people and best practices that can be implemented to
reduce the rate of cesarean births and improve overall maternal health
in the state.
 
LEGISLATIVE HISTORY:
S8866 of 2022. Referred to Women's Issues.
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect immediately.