What we have seen and experienced during the pandemic makes clearer than ever the need to transform perinatal care to meet all people’s needs, including full integration of midwives with power-sharing in the provision of care, support for non-hospital births, doula support as an option for all, and community participation in planning for and making these changes. A core agency mission is to address the root causes of these disparities, structural racism, and gender oppression. On my last day at my office, I remember packing up as I prepared for the unknown. Unlimited viewing of the article/chapter PDF and any associated supplements and figures. (2020). I connected her to church-based food pantries, mental health support, and a labor support doula. Prior to the pandemic, access to resources, food, housing and employment were always important. For families residing in shelters in the Bronx, housing issues such as mold and pest infestations are constant worries. My hope is that we always center the needs of parents, children and families as they are the backbone of our communities. Normally, we recruit families directly at the hospital. We would use telehealth to teach childbirth education, sexual health education for teenagers, newborn care and even tenant rights. My team visits families all over the Bronx, the borough with the highest number of COVID-19 related cases, hospitalizations and deaths. Part of my work is to bear witness to whatever situation my clients are facing. When we received the news that New York was given the order to shelter in place in mid-March due to the pandemic, I was home sick with a confirmed case of COVID-19. If you have previously obtained access with your personal account, American Journal of Public Health, 106(1), 56–57. Maternal and Child Health Journal The high prevalence of early sex, coupled with its associated high‐risk behaviors and outcomes, underscores the necessity of implementing evidence‐based interventions that have been found to positively impact these behaviors beginning in middle school. How could a person stay out of the hospital if they needed to get a necessary prenatal exam? Breast milk is the gold standard for infant nutrition and the only necessary food for the first 6 months of an infant's life. New York City Department of Health and Mental Hygiene. (NYC Health 2020a) Meanwhile the NYC Health Department continued to do its work serving pregnant and parenting families, staying focused on the most marginalized New Yorkers, predominantly Black and Brown people residing in neighborhoods that have been intentionally disinvested in for decades due to systemic racism, resulting in high rates of poverty, poor housing, unemployment and chronic stress, and limited access to healthy and affordable food, all factors that jeopardize people’s health. Many of our staff, including myself, did not have laptops, or had limited internet service. Here are their stories. Usually, I recruit mothers from two local hospitals where I invite them to participate in the program. Assistant Commissioner, (dkaplan@health.nyc.gov), Bureau of Maternal, Infant and Reproductive Health, New York City Department of Health and Mental Hygiene, Gotham Center, 42–09 28th Street, 10th Floor, CN‐34A, Queens, New York 11101–4132. Our hope for the program is to provide people with a helpful and supportive presence so that every mother can do their best to care for their newborn. Correspondence to As a result, we are still birthing new ideas. We found that calling our clients on the phone was often the best way to contact them. In response, colleagues and I drafted a letter to obstetric chairs, highlighting the essential role that doulas play in positive birth outcomes—especially for clients who struggle against income inequality and racism. - Despite the fact that babies would keep being born, mothers and babies were forgotten. As a public health nurse, I am constantly trying to connect clients with the constellation of community initiatives that exist in the city. Deborah Kaplan Recently Retired as Assistant Commissioner at NYC Department of Health and Mental Hygiene New York City Metropolitan Area 36 connections At the same time, NYC Health Department staff were hearing daily updates about a growing number of COVID-19 cases and deaths among New Yorkers. (NYC Health 2018, 2020c). (2020). On Monday March 16th, casual conversations about weekend plans were replaced with an energy of confusion and fear. Join ResearchGate to find the people and research you need to help your work. She spoke to her mother daily when she had cell phone service, but she did not have a community and the baby’s father was working in Illinois without a reliable phone. Retrieved June 6, 2020, from https://www1.nyc.gov/site/doh/about/press/pr2018/pr098-18.page. We realized the significance of bringing our health education services directly into people’s homes. My work and passion are to serve birthing people and their families. At the height of the outbreak, there were so many questions and very few answers. Deborah has 3 jobs listed on their profile. https://www1.nyc.gov/assets/doh/downloads/pdf/ms/pregnancy-associated-mortality-report-2011-2015.pdf. Many clients sat with the constraints of the pandemic and the recent media coverage of the Black maternal death of Amber Rose Isaac amidst a stream of racist actions that were being reported. As a Black Queer woman, I am acutely aware that, for many, disrespect, disregard and dehumanization are common features of birthing while Black. These events compounded pregnant people’s anxiety, worry, and angst. (Minkoff and Chiasson 2017) At the public hospitals and poorly resourced private hospitals, 83% of live births are paid for by Medicaid, in contrast to the highly resourced private and academic medical centers, where just 30% of live births are paid for by Medicaid.Footnote 1,Footnote 2 Over 98% of the approximately 120,000 births in NYC each year occur in one of the 38 hospitals that provide maternity care. Early sex is associated with high-risk behaviors and outcomes, including sexual risk behaviors, forced sex, physical dating violence, and becoming pregnant or impregnating someone. It quickly became apparent that the needs of this population were an afterthought. Infant formula is deficient and inferior to breast milk in meeting infants' nutritional needs. I was concerned about her mental health and offered to connect her to mental health support services, which she declined. These factors are compounded by inadequate funding for public health. Use the link below to share a full-text version of this article with your friends and colleagues. Babies would not wait to be born. Mobilizing a Public Health Response: Supporting the Perinatal Needs of New Yorkers During the COVID-19 Pandemic, https://www.newyorker.com/science/medical-dispatch/a-chaotic-week-for-pregnant-women-in-new-york-city, https://www.nytimes.com/2020/04/21/nyregion/coronavirus-home-births.html, https://www.crainsnewyork.com/article/20170502/OPINION/170429861/when-choosing-a-hospital-can-be-fatal, https://www1.nyc.gov/assets/doh/downloads/pdf/ms/pregnancy-associated-mortality-report-2011-2015.pdf, https://www1.nyc.gov/assets/doh/downloads/pdf/ms/respectful-care-birth-brochure.pdf, https://www1.nyc.gov/site/doh/covid/covid-19-data.page, https://www1.nyc.gov/site/doh/covid/covid-19-prevention-and-care.page, https://www1.nyc.gov/site/doh/about/press/pr2018/pr098-18.page, https://www.tfah.org/report-details/publichealthfunding2020/, https://doi.org/10.1007/s10995-020-02984-6. Retrieved June 10, 2020, from https://www.newyorker.com/science/medical-dispatch/a-chaotic-week-for-pregnant-women-in-new-york-city. (2020c). And while the community and hospital were shrouded in death and illness, we continued to do our best to maintain the sanctity and joy of welcoming new life and new families. Retrieved June 6, 2020, from Long Island City, New York. Reports quickly emerged of the immense stress on hospital and public health systems, with critical personal protective equipment (PPE) shortages, lack of testing capacity, and strained emergency response. Retrieved June 6, 2020, from https://www.crainsnewyork.com/article/20170502/OPINION/170429861/when-choosing-a-hospital-can-be-fatal. This capacity must be built into future emergency responses, so that it is not an afterthought. I will share the story of one of my clients, who I had been working with for close to two years. Clients started to report that their prenatal appointments were being canceled and their anxiety levels went through the roof. (NYC Health 2020b) And then the restrictive visitation policy changed from only one support person to considering the doula to be an essential member of the birth team. Giving birth in New York City has long been plagued with racial inequities in maternal mortality, with Black women shockingly eight times more likely to die of a pregnancy-related cause than white women (New York City Department of Health and Mental Hygiene 2020) and three times more likely to have a life-threatening complication related to pregnancy. Himmelstein, D. U., & Woolhandler, S. (2016). Please log in. After swimming across the border from Mexico, she was held by Immigration and Customs Enforcement (ICE) in a detention center for several weeks until filing for asylum. We are essential workers taking care of other essential workers. 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