S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2367--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2023
                                ___________
 
 Introduced   by   M.  of  A.  PAULIN,  BURDICK,  GONZALEZ-ROJAS,  SIMON,
   JEAN-PIERRE, WOERNER, FORREST -- read once and referred to the Commit-
   tee on Health -- committee discharged, bill amended, ordered reprinted
   as amended and recommitted to said committee
 
 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
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (a)  of  subdivision  1 of section 2509 of the
 public health law, as amended by chapter 142 of the  laws  of  2019,  is
 amended to read as follows:
   (a) There is hereby established in the department the maternal mortal-
 ity review board for the purpose of reviewing maternal deaths and mater-
 nal  morbidity  and  developing  and disseminating findings, recommenda-
 tions, and best practices to contribute to the  prevention  of  maternal
 mortality  and  morbidity.  The  board  shall assess the cause of death,
 INCLUDING WHETHER THERE WAS A VAGINAL OR CESAREAN BIRTH, factors leading
 to death and preventability for each maternal death reviewed and, in the
 discretion of the board, cases of severe maternal morbidity,  and  shall
 develop  and  disseminate  strategies  for reducing the risk of maternal
 mortality and morbidity, including risk resulting from racial, economic,
 or other disparities. The commissioner may  delegate  the  authority  to
 conduct maternal mortality reviews.
   §  2.  Paragraph  (a)  of  subdivision 5 of section 2509 of the public
 health law, as amended by chapter 142 of the laws of 2019, is amended to
 read as follows:
   (a) shall make and report findings and recommendations to the  commis-
 sioner,  and  in  the case of the city board to the commissioner and the
 city commissioner regarding the  cause  of  death,  factors  leading  to
 death, and preventability of each maternal death case, INCLUDING WHETHER

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05723-03-3
              

 A. 2367--A                          2
 
 THERE  WAS A VAGINAL OR CESAREAN BIRTH, and each case of severe maternal
 morbidity reviewed by the board, by reviewing relevant  information  for
 each  case in the state or the city of New York, as the case may be, and
 consulting  with  experts as needed to evaluate the information for each
 death; and shall provide such findings  and  recommendations,  including
 best  practices and strategies for reducing the risk of maternal mortal-
 ity and morbidity, to  the  advisory  council;  provided  that  material
 provided  to the advisory council shall not include any information that
 would be confidential under this section;
   § 3. Paragraphs (b) and (d) of subdivision 8 of section  2509  of  the
 public  health  law,  as amended by chapter 142 of the laws of 2019, are
 amended to read as follows:
   (b) The advisory council:
   (i) may review the findings of the boards;
   (ii) may develop recommendations  on  policies,  best  practices,  and
 strategies to prevent maternal mortality and morbidity;
   (iii) may hold public hearings on those matters;
   (iv)  may make findings and issue reports, including an annual report,
 on such matters; [and]
   (v) may request and shall receive the assistance of the  commissioner,
 the  city commissioner, and the boards in carrying out its functions[.];
 AND
   (VI) SHALL UNDERTAKE A REVIEW OF CESAREAN 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.  THE  COUNCIL  SHALL
 CONSIDER  FACTORS  INCLUDING, BUT NOT LIMITED TO: THE PRIMARY AND REPEAT
 CESAREAN BIRTH RATES AMONG HOSPITALS IN THE STATE; THE HOSPITALS IN  THE
 STATE  THAT ALLOW OR ENCOURAGE VAGINAL BIRTHS AFTER CESAREAN BIRTHS; THE
 RATE OF VAGINAL BIRTHS AFTER CESAREAN  BIRTHS  AMONG  HOSPITALS  IN  THE
 STATE;  THE  RATE  OF  VAGINAL  BIRTHS  AFTER  CESAREAN BIRTHS THAT WERE
 OFFERED BY HOSPITALS IN THE STATE BUT DECLINED BY THE  BIRTHING  PERSON;
 THE RATE OF VAGINAL BIRTHS AFTER CESAREAN BIRTHS THAT WERE ATTEMPTED BUT
 FAILED  AMONG HOSPITALS IN THE STATE; THE TIME OF DAY UNPLANNED CESAREAN
 BIRTHS OCCUR IN HOSPITALS, AND WHETHER SUCH CORRELATES WITH THE RATE  OF
 CESAREAN  BIRTHS  IN A HOSPITAL; THE NUMBER OF BIRTHING PEOPLE WHO ELECT
 TO HAVE MIDWIVES ATTEND LABOR AND DELIVERY IN HOSPITALS  IN  THE  STATE;
 THE  FREQUENCY  OF  MIDWIFERY  CARE DURING LABOR IN HOSPITALS ACROSS THE
 STATE AND WHAT IMPACT, IF ANY, THIS HAS ON THE RATE OF CESAREAN  BIRTHS;
 AND THE NUMBER OF BIRTHING PEOPLE WHO WERE INFORMED BY THEIR HEALTH CARE
 PROVIDER  ABOUT  THE POTENTIAL RISKS, BENEFITS, AND ALTERNATIVES RELATED
 TO CESAREAN BIRTHS BEFORE LABOR.
   (d) The members of the council shall be comprised of multidisciplinary
 experts INCLUDING TWO LICENSED MIDWIVES and lay persons knowledgeable in
 the field of maternal mortality, women's health and  public  health  and
 shall  include  members  who serve and are representative of the racial,
 ethnic, and socioeconomic diversity of the  women  and  mothers  of  the
 state,  and  to  the extent possible, the medically underserved areas of
 the state or areas of the state with disproportionately high occurrences
 of maternal mortality or morbidity.
   § 4. This act shall take effect immediately.