What's happening
This bill requires New York hospitals to implement standardized obstetric hemorrhage protocols, including reporting and readiness measures, to improve maternal health outcomes.
Why it matters
Standardizing obstetric hemorrhage protocols ensures all hospitals follow best practices in recognizing and managing one of the leading causes of maternal morbidity and mortality, reducing variability in care and improving patient safety.
Requiring hospitals to use readiness tools—such as checklists, simulation training, and clear response plans—means staff are better prepared for emergencies, which can translate to faster interventions and better maternal outcomes.
Mandating regular data reporting to the state enables ongoing monitoring and evaluation of hospital performance in this area, providing transparency and accountability, and informing further improvements in maternal healthcare policy.
Including requirements for triage and transfer plans ensures that patients who need higher-level care can be quickly and appropriately moved, potentially saving lives when complications arise.
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Who cares
Headline styles
Require Hospital Birth Safety Plans
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Substituted by A6962A
- Ordered to third reading cal.396
- Reported and committed to rules
- Print number 4498a
- Amend and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Require Birth Bleeding Protocols
Signed by Governor · Sponsor Latoya Joyner
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4498--A
2019-2020 Regular Sessions
IN SENATE
March 13, 2019
Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee 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 the establishment of obstetric hemorrhage protocols; and providing for the repeal of certain provisions upon the expiration thereof
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 1 of section 2803-n of the public health law is amended by adding a new paragraph (c) to read as follows:
(c) (i) The commissioner shall provide guidance to hospitals on obstetric hemorrhage protocols, in consultation with clinical experts, and develop or identify an existing toolkit on obstetric hemorrhage management, which may include a hemorrhage care checklist for use by hospitals as part of the protocols and guidance on simulation training. The commissioner shall report to the temporary president of the senate and the speaker of the assembly on data reported to the department under this paragraph within two years from the effective date of this paragraph, and every two years thereafter.
(ii) The hospital shall adopt, implement, periodically update and submit to the department standard protocols for management of obstetric hemorrhage. Such protocols shall address early recognition and assessment, readiness to respond in a multidisciplinary manner, and data reporting to the department sufficient for the department to monitor and report pursuant to this paragraph. Such protocols shall utilize risk assessment tools such as the toolkit established or identified by the department under this paragraph and shall include a response plan providing for the triage and transfer to higher level facilities if needed.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10300-02-9
S. 4498--A 2
§ 2. This act shall take effect six months after it shall have become a law. Effective immediately, the commissioner of health shall make regulations and take other actions reasonably necessary to implement this act on that date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to the establishment of obstetric hemorrhage protocols; and providing for the repeal of certain provisions upon the expiration thereof
Purpose
Requires that hospitals adopt, implement, periodically update and submit to the department standard protocols for management of obstetric hemor- rhage.
Summary of provisions
Section 1 of the bill amends section 2803-n of the public health to direct the Commissioner of Health in conjunction with clinical experts to develop or identify management protocols and strategies related to obstetric hemorrhages to be utilized by hospitals. Hospitals would be directed to adopt, implement, and regularly update their protocols related to obstetric hemorrhages, including a response plan for emergen- cy transfers to facilities that can provide a higher level of care. The Commissioner of Health would be directed to produce a biannual report to the Legislature on the protocols and strategies developed and imple- mented by this bill.
Read the full memo (624 words)
Section 2 of the bill sets forth the effective date.
Justification
The United States has the largest maternal death rate among the world's developed nations, with 26.4 deaths per 100,000 births. While other countries have been improving, U.S. rates continue to worsen. It is estimated that over half of the 700 annual maternal deaths could have been prevented by better care. In 2017, the American College of Obstet- ricians and Gynecologists recommended all hospitals put in place "organ- ized, systematic processes ... to help coordinate the response and management of postpartum hemorrhage," the leading cause of maternal mortality worldwide. According to the Department of Health, 97% of all cases of obstetric hemorrhages occur at a hospital and are highly preventable.
New York currently ranks 30th out of 50 states in its maternal death rate. The rate of maternal mortalities in New York has risen from 15.4 per 100,000 live births in 2001-2003 to 19.6 per 100,000 in 2014-2016. Between 2012-2014, hemorrhage accounted for 16% of maternal deaths. The issue is compounded by significant racial and ethnic disparities, with black women nearly 3.4 times more likely to die during pregnancy and childbirth compared to white women.
One of the few states tackling this deadly issue head on is California. Through their Material Quality Care Collaborative, which established an obstetric hemorrhage toolkit, hospital best practices, and statewide outreach, they were able to reduce severe maternal morbidity by 20.8% over a two-year span. Despite the professional guidance and the wide- spread knowledge that the California program has saved lives, many hospitals still lack the proper protocols and training to properly iden- tify and treat obstetric hemorrhage.
Hospitals in New York have begun working with the Department of Health and the American College of Obstetricians and Gynecologist to do hands- on simulation and to reinforce best practices on accurately quantifying blood loss to reduce hemorrhage related deaths. While such voluntary efforts are a positive step, more is needed to ensure every woman in the state is provided the appropriate standard of care regardless of hospi- tal. Formal guidance from the Department of Health, along with the adoption of standard protocols in all hospitals will ensure hospitals statewide are practicing proper care for obstetric hemorrhages. Recog- nizing the need for similar protocols to address the increase in sepsis deaths in our state, we were successful in reducing hospital mortality rates. Using this model, we will see similar outcomes for maternal mortality rates. This legislation, combined with legislation the Senate passed establishing the Maternal Mortality Review Board, New York will move into the modern era where women will not have to worry about making it out of the delivery room.
Legislative history
New bill.
Fiscal implications
None.
Effective date
This act shall take effect six months after enactment
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.