Mayor Eric Adams is seeking to ramp up access to doulas and midwives across the five boroughs as part of a broader initiative to reduce disparities in maternal and infant mortality rates. Adams shared the details of the plan Wednesday outside the Brownsville Neighborhood Health Action Center.

“We are going to start the process of moving upstream to deal with some of the real problems families are facing and nothing is a more upstream approach than maternal health,” Adams said. Collectively, the mayor said the project contains three major parts: the Citywide Doula Initiative, the Midwifery Initiative and the Maternity Hospital Quality Improvement Network.

The city is seeking to train 50 new doulas and certify 70 uncertified doulas over the next three months, with the goal of reaching 500 families by the end of June. The city is targeting the free doula services to 33 neighborhoods that have been identified as having worse health outcomes during the COVID-19 pandemic.

People with low incomes who are first-time parents will be prioritized for the program. They will receive three prenatal home visits and four postpartum visits as well as support during labor and delivery.

The initiative is part of a $30 million package of maternal care services Adams included in the preliminary budget he released last month.

“For too long, barriers stood between doulas and the families who would benefit most from their support,” Dr. Michelle Morse, the city's chief medical officer, said at the press conference. “Accompaniment is about supporting, standing, walking alongside birthing people through all aspects of their birthing experience.”

Doula services often can’t be reimbursed by insurance. But they have been shown to improve outcomes, including by reducing the odds of a cesarean section, a procedure that can increase the risk of complications.

Sarah-Grace Sweeney, a birth doula based in Brooklyn, told Gothamist that her clients typically pay out of pocket for her package of services. Those costs run about $2,500, according to her website. She said they can sometimes get reimbursed through a health savings account or flexible spending account, which are supplements to insurance, but not directly through their plans.

Sweeney said she thought more people should have access to doulas, but also said they aren’t a magic bullet.

“We’re not a Band-Aid for the systemic issue [of health disparities] but I think it certainly helps to have more support and someone who’s looking out for you,” she said, adding that there also need to be changes to clinical care.

Adams’ plan will also seek to integrate midwives into clinical care settings and create opportunities for cross-training between midwives and doctors. And he will expand a program to provide training on racial equity, implicit bias, and trauma-informed care in city hospitals where people give birth.

In an emailed statement, New York City Public Advocate Jumaane Williams thanked the Adams administration for making the issue a priority.

"Birth equity is a social justice issue, and today’s announcement will help bring care to communities often underserved, and lower the economic barriers that have prevented some pregnant people from seeking critical care,” Williams said. “This initiative will also strengthen the ties between hospitals and community based organizations, meeting people where they are.”