Medicaid Perinatal Care Standards

This policy outlines the New York State Medicaid Perinatal Care Standards, effective August 1, 2022, for New York State (NYS) Medicaid fee-for-service (FFS) and October 1, 2022, for Medicaid Managed Care (MMC) Plans [inclusive of Mainstream MMC Plans, HIV (Human Immunodeficiency Virus) Special Needs Plans (SNPs), as well as Health and Recovery Plans (HARPs)]. The former Medicaid Prenatal Care Standards have been updated and incorporated into this policy, and the 2022 Perinatal Care Standards replace the previously published New York State Prenatal Care Standards in full.

This policy is applicable to all Medicaid perinatal care providers who provide prenatal/antepartum care, intrapartum care, and/or postpartum care. This includes medical care facilities or public or private not-for-profit agencies or organizations, physicians, licensed nurse practitioners, and licensed midwives practicing on an individual or group basis, and managed care plans that contract with these providers. 

All pregnancy-related clinical care and services must be delivered in a high-quality, person-centered, cohesive, and comprehensive manner across all provider types. To accomplish this goal, all providers who deliver care to pregnant/postpartum persons must adopt, where applicable, a clinical practice philosophy that:

  1. Is consistent with current standards of care, evidence-based practice, and practice guideline recommendations of professional clinical organizations including (but not limited to) the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians, the Centers for Disease Control and Prevention (CDC), and the U.S. Preventive Services Task Force (USPSTF).
  2. Applies a health equity framework to eliminate racial and ethnic inequities, implicit bias, and racism. Engages with stakeholders, including but not limited to pregnant/postpartum persons, families, and community partners, to improve racial and ethnic equity, trust, and quality of care.
  3. Demonstrates cultural humility with and sensitivity to all pregnant/postpartum persons, including but not limited to those with limited English proficiency and diverse cultural and ethnic backgrounds, sexual orientations, gender identities, and faith communities. Interpretation services must be offered to pregnant/postpartum persons whose primary language is not English, in-person when practical, or via video chat or telephone if an in-person translator is not immediately available.
  4. Is patient-centered and focused on meeting the unique needs of the pregnant/postpartum person based on their biopsychosocial circumstances and pregnancy risk level. Provides respectful maternity care, defined as a universal human right that encompasses the principals of ethics and respect for the pregnant/postpartum person’s feelings, dignity, choices, and preferences.
  5. Promotes timely access to needed services, including timely referral to appropriate levels of prenatal care (basic, specialty, and subspecialty).
  6. Promotes comprehensive early and ongoing biopsychosocial risk assessment to prevent, promptly recognize, and treat conditions associated with maternal and neonatal morbidity and mortality.
  7. Utilizes an integrated care model, with emphasis on continuity of care and prompt communication with all members of the pregnant/postpartum person's care team, including the principal maternal provider, specialist practitioners, mental health providers, substance use disorder providers, nutritionists, social workers, and community organizations, as needed.
  8. Has systems and protocols in place for tracking, notifying, and engaging pregnant/postpartum persons who need follow-up services or visits, including those who need follow-up visits for abnormal test results.
  9. Conducts quality improvement activities including, but not limited to, the evaluation of the quality, safety, and appropriateness of care provided, and participates in quality improvement activities. Process and outcome data must be tracked, analyzed, and used for improving quality and patient safety.

Every pregnant/postpartum person must have a principal maternal care provider. The principal maternal care provider functions as the pregnant/postpartum person’s main maternal care provider and is responsible for leading and coordinating the pregnant/postpartum person's obstetric care throughout the course of the pregnancy and postpartum period (the 12 weeks immediately following delivery). Maternal care services can be provided by providers who have any of the following credentials:

  1. NYS licensed physician (MD/DO) practicing in accordance with Article 131 of the New York State Education Law, and who is Board Certified or Board Eligible in Family Medicine or Obstetrics & Gynecology, or has completed an accredited residency program in Family Medicine or Obstetrics/Gynecology;
  2. NYS licensed Midwives practicing within their training level and scope of practice, and in accordance with Article 140 of the New York State Education Law; or a
  3. NYS licensed Nurse Practitioner (NP) practicing within their training level and scope of practice, and in accordance with Article 139 of the New York State Education Law.

The principal maternal care provider serves as the pregnant/postpartum person's principal obstetric provider for the pregnant/postpartum person during the pregnancy and postpartum period (the 12 weeks immediately following delivery).

The designated primary care provider will remain the primary care provider for the pregnant/postpartum person during the pregnancy and postpartum period. When appropriate, the designated primary care provider may also be the principal maternal care provider.

Pregnant/postpartum Medicaid persons must be offered prenatal care in a timely manner that is aligned with the requirements of the NYS Medicaid Managed Care, Family Health Plus, HIV SNP, HARP Model Contract. Providers must, at a minimum, follow these standards but are strongly encouraged to see the pregnant/postpartum person as soon as possible.

Initial prenatal care visit:

First Trimester: visit must occur within 3 weeks of the request for care.

Second Trimester: visit must occur within 2 weeks of the request.

Third Trimester: visit must occur within 1 week of the request.

Initial Family Planning visit must occur within 2 weeks of the request.

Emergency care must always be available at an Emergency Room.

For specialist referrals and urgent matters during pregnancy:

Urgent specialist referrals must be seen as soon as clinically indicated, not to exceed 72 hours.

Non-urgent specialist referrals must be seen as soon as clinically indicated, not to exceed 2 to 4 weeks of when the request was made.

For non-emergent, but urgent matters, pregnant persons must be seen within 24-hours of request.

Maternal care practices must provide or arrange for the provision of 24 hour/7 day /week coverage as follows:

After hours and weekend/holiday number to call that leads to a person or option for leaving a message that can be returned by a health care professional within one hour.

The access-to-care standards mentioned above only depict the minimum required time frames by which pregnant persons must be seen if they request a visit. However, pregnant persons may require more frequent visits and follow-ups, and may need to be seen much sooner, depending on their unique medical-psychosocial condition and needs. Providers must consider each pregnant person's unique medical profile, health needs, and severity of the issue at hand when scheduling the pregnant person’s visits. Providers must always strive to see pregnant persons as soon as possible and as frequently as possible, depending on their medical, obstetric, and/or psychosocial needs.

For routine, periodic, non-acute prenatal care visits, maternal care providers must follow ACOG/AAP prenatal care visit timing and frequency recommendations.

Maternal care providers must assist or refer pregnant members for assistance with application for Medicaid and managed care plan selection.i

Medicaid enrolled licensed Article 28 providers of prenatal care must perform Presumptive Eligibility determinations and assist pregnant members in completing the Medicaid application and submitting the completed Medicaid application (DOH-4220) to the appropriate local department of social services for a full Medicaid eligibility determination. The Presumptive Eligibility determination is performed during a visit to the provider.ii

All prenatal care service providers must provide prenatal care services to pregnant individuals determined to be presumptively eligible for medical assistance but who are not yet enrolled in Medicaid.

Principal maternal care providers must conduct a comprehensive prenatal care risk assessment at the first prenatal care visit. The purpose of the comprehensive prenatal care risk assessment is to identify all relevant past and current maternal-fetal biopsychosocial risk factors as early in the pregnancy as possible, so that the identified risk factors can be promptly addressed before they cause any harm to the pregnancy. The comprehensive prenatal care risk assessment must include all the components in the ACOG Antepartum Record and Postpartum Form,iii and must also include the assessment of all the relevant past and current maternal-fetal medical, dental, mental health, substance use, nutritional, and psychosocial risk factors indicated in the tables below. The USPSTF recommends screening adults ages 18 and older for unhealthy drug use in the form of questions. Screening refers to asking questions about unhealthy drug use, not testing biological specimens. Screening tools are not meant to diagnose drug dependence, abuse, addiction, or drug use disorders. Persons with positive screening results may, therefore, need to be offered or referred for diagnostic assessment.iv

Pregnancy Risk Factors
Age <16 yr. or >35 yr. Preterm labor Fetal abnormality
Abdominal surgery Preterm birth <37 weeks Multiple gestation
C-section Low birthweight <2500g (5.5 lbs.) Hypertension/ Preeclampsia
Cervical incompetence Birthweight >4500 g (10 lbs.) Gestational Diabetes
Placenta abruptio Stillborn/Fetal death Sexually Transmitted Infections, including HIV
Placenta previa    

Medical and Dental Risk Factors
Anemia Dental problem Hypertension Eating Disorder
Asthma Diabetes Mellitus Kidney Disease Underweight
Autoimmune Disorder Deep Vein Thrombosis/Pulmonary Embolism Seizures Overweight/obese
Cardiac Disease HIV/AIDS Thyroid Disorder  

Mental Health, Substance Use, Nutritional, and Psychosocial Risk Factors
Alcohol use Financial/Employment strain Intimate partner/Family violence Physical abuse
Children in foster care Food insecurity Lack of childcare Physical disability
Communication/ Language barriers Housing instability Limited/No partner/family support Psychiatric disease, e.g., depression/anxiety
Drug use (parents, partner; past, present) Inconsistent or limited prenatal visits Low health literacy Risk of self-harm
Environmental/ Work hazards Intellectual or developmental disability Nutritional deficit/Special Supplemental Nutrition Program for Women Infants and Children (WIC) referral needed Sexual abuse

The comprehensive prenatal care risk assessment must be:

  • Conducted at the first prenatal visit,
  • Reviewed at each routine prenatal visit,
  • Repeated early in the third trimester,
  • Used to form the basis for developing the care plan [see next section], and
  • Documented clearly in the pregnant person's medical record.

If the comprehensive prenatal care risk assessment identifies a maternal-fetal risk factor at any point in the pregnancy, the maternal care provider must address the identified risk factor as soon as possible using the appropriate means, whether by providing treatment, counseling, education, or referral to the appropriate specialists or community resources for evaluation and management of the identified risk factor. Such specialists and community resources may include, but are not limited to, the following:

Asthma Educator Diabetes Educator Home Visit Provider Remote Patient Monitoring
Childcare Resourcesv Domestic/Intimate Partner Violence Services Mental Health Provider Substance Use Provider
Community Health Worker Health Home Nutrition/Lactation Counseling Supplemental Nutrition Assistance Program (SNAP)
Community Case Manager Health Plan Case Manager Office Case Manager Tobacco Dependence Treatment
Dental Care High-Risk OB Peer Family Navigator WIC

Principal maternal care providers must develop a care plan jointly with each pregnant/postpartum person that addresses the problems identified as a result of initial and ongoing risk assessments. The care plan shall describe the implementation and coordination of all services required by the pregnant/postpartum person, be routinely updated, and be implemented jointly by the pregnant/postpartum person, their family, and the appropriate members of the health care team.

Care must be coordinated by the principal maternal care provider to:

  1. Ensure that relevant information is exchanged between the principal maternal care provider and other providers, human service and community-based service providers, health plan case managers, and sites of care including the anticipated delivery site.
  2. Ensure ongoing communication between the provider and the pregnant/postpartum person’s health plan to facilitate plan’s timely awareness of the person’s pregnancy, health insurance application, and health needs.
  3. Ensure the pregnant/postpartum person and their family or other designated representative, with their consent, have continued access to information and resources and are encouraged to participate in the decisions involving the care and services being provided.
  4. Encourage and assist the pregnant/postpartum person in obtaining necessary medical, dental, mental health, substance use, nutritional, and psychosocial services appropriate to their identified needs. Refer to the appropriate specialists or community resources as outlined in the prior section.
  5. Provide the pregnant/postpartum person with the opportunity to receive prenatal and postpartum home visitation as required, and as medical and/or psychosocial benefits may be derived from the visits.
  6. Ensure that the pregnant/postpartum person provided appropriate medical care, counseling, and education based on their test results.
  7. Facilitate education, timely recognition, and appropriate intervention of early warning signs during and up to one year after pregnancy.
  8. Obtain special tests and services recommended or required by the Commissioner of Health when necessary to protect maternal and/or fetal health. The following tests are required by law and/or regulation, and the provider must follow current standards of care, evidence-based practice, and practice guideline recommendations for tests and services:
    1. New York State Public Health Law 2500-e requires that every pregnant woman be tested for the presence of hepatitis B surface antigen (HBsAg) and that the test results and the date be documented in the prenatal record. It also requires that infants of women who are hepatitis B surface antigen positive or whose test results are unknown receive treatment at birth with hepatitis B vaccine and hepatitis B immunoglobulin (HBIG).
    2. New York State Public Health Law 2112 prohibits the administration of vaccines containing more than trace amounts of thimerosal, a mercury-containing preservative, to pregnant women, unless the supply is insufficient.
    3. NYS Public Health Law and Regulations (NYCRR Subpart 67-1.5) requires that prenatal care providers provide all pregnant women with anticipatory guidance on preventing lead poisoning, information on the major sources of lead, and the means to prevent exposure while pregnant. At the initial prenatal visit, each pregnant woman shall be assessed for exposure to lead. If considered to be at risk, the pregnant person should have a blood lead test and be counseled on how to eliminate lead exposure. Providers are also required to provide anticipatory guidance on the prevention of childhood lead poisoning during prenatal and postpartum visits.
    4. NYS Public Health Law, Article 23 Section §2308; New York Code of Rules and Regulations, Title 10, §69-2.2 requires that pregnant women be screened for syphilis at their first prenatal visit and again at delivery. It is highly recommended that syphilis screening be repeated at 28 weeks and no later than 32 weeks of pregnancy to avoid congenital syphilis, and to pair this with the strongly recommended third trimester HIV testing.

The principal maternal care provider shall coordinate labor and delivery services by developing agreements with planned delivery sites which address, at a minimum, the following:

  1. A system for sharing prenatal medical records, including HIV test results;
  2. Pre-booking of pregnant person for delivery by 36 weeks gestation for low-risk pregnancies and by 24 weeks gestation for high-risk pregnancies;
  3. Scope of services; and
  4. Sharing of delivery/birth outcome information.

Care must be coordinated by the health plan to:

  1. Ensure that relevant information is exchanged between the principal maternal care provider and other providers, human service and community-based service providers, health plan case managers, or sites of care including the anticipated delivery site.
  2. Ensure ongoing communication between the pregnant/postpartum person’s health plan and the provider(s) to facilitate plan’s timely awareness of pregnant/postpartum person’s pregnancy, health insurance application, and health needs.
  3. Ensure proactive, ongoing outreach and communication from the health plan to the member regarding finding a provider, practice enrollment, adherence to evidence-based care and current practice standards, and health needs and benefits.

The Medicaid reimbursable visit is a skilled nursing home visit provided by agencies that are certified or licensed under Article 36 of the PHL and are either a Certified Home Health Agency (CHHA) or a Licensed Home Care Service Agency (LHCSA). Other home visit providers may include, but are not limited to, Nurse-Family Partnership Programs, local health departments, and community health worker programs, which may or may not be covered as a Medicaid benefit.

Prenatal Home Visits

Prenatal home visits must be provided to pregnant persons if ordered by the principal maternal care provider and if they are medically necessary for managing the pregnant person’s prenatal course or prenatal issue at hand. Criteria for medical necessity are as follows:

  1. High medical risk pregnancy as defined by the ACOG and the AAP Guidelines for Perinatal Health (Early Pregnancy Risk Identification for Consultation); or
  2. Need for home monitoring or assessment by a nurse for a medical condition complicating the pregnancy; or
  3. Pregnant person otherwise unengaged in prenatal care (no consistent visits); or
  4. Need for home assessment for suspected environmental or psychosocial risk including, but not limited to, intimate partner violence, substance use, unsafe housing, nutritional risk, unstable mental health, and inadequate resources or parenting skills.

The number and frequency of the home visits must be guided by what is medically necessary to manage the pregnant person’s prenatal course or prenatal issue at hand, based on the pregnant person’s unique medical, obstetrical and/or psychosocial profile.

The prenatal home visit must include:

  1. An assessment of the pregnant person’s obstetrical status and any pregnancy-related problems;
  2. An assessment of the pregnant person’s medical status and needs; and
  3. An assessment of the pregnant person’s psychosocial and environmental risk factors (such as unsafe environment and inadequate resources, including shelter, food/nutrition, and social supports).

The prenatal home visit assessment and its findings must be sent to the pregnant person’s principal maternal care provider for next steps as needed to manage any issues that are identified in the prenatal home visit assessment (such as referral to specialists and other community resources for evaluation and management).

Postpartum Home Visits

All postpartum persons are eligible for one initial postpartum home visit after they give birth. Additional postpartum home visits could be covered depending on the postpartum person’s unique medical, obstetrical, and/or psychosocial profile.

The postpartum home visit summary and its findings must be sent to the postpartum person’s principal maternal care provider and their health plan case manager for next steps as needed to manage any issues that are identified in the postpartum home visit (such as referral to specialists and other community resources for evaluation and management).

Initial Postpartum Home Visit

The purpose of the initial postpartum visit is to address acute postpartum issues, as per ACOG/AAP postpartum recommendation.

All principal maternal care providers and/or birthing hospitals must offer and arrange for the initial postpartum home visit with all postpartum persons. All birthing hospitals must have a system in place to arrange and schedule the postpartum person’s first/initial postpartum home visit prior to discharge.

If a postpartum person agrees to receive the initial postpartum home visit, then the birthing hospital is responsible for arranging and scheduling the initial postpartum home visit for the postpartum person, and the postpartum home visit should take place 36 to 72 hours after the postpartum person’s discharge.

The postpartum home visit must include:

  1. An assessment of the health of the parent and newborn;
  2. An assessment of the labor and delivery care history;
  3. An assessment of any current pregnancy-related problems;
  4. An assessment of the postpartum person’s psychosocial and environmental risk factors (such as unsafe environment, and inadequate resources, including shelter, food/nutrition, and social supports);
  5. Nutrition education;
  6. Infant feeding, including breastfeeding (BF)/chestfeeding (CF) education;
  7. Family planning counseling to ensure optimal birth spacing;
  8. Parenting guidance; and
  9. Guidance regarding the identification and treatment of early warning signs that occur up to one year after pregnancy.

Additional Postpartum Home Visits

Additional postpartum home visits could be covered if the postpartum person’s situation meets one of the four medical necessity criteria listed below:

  1. History of a high medical risk pregnancy as defined by ACOG and AAP Guidelines for Perinatal Health (Early Pregnancy Risk Identification for Consultation); or
  2. Need for home monitoring or assessment by a nurse for a medical condition complicating postpartum care; or
  3. Postpartum person otherwise unengaged in postpartum care; or
  4. Need for home assessment for suspected environmental or psychosocial risk including, but not limited to, intimate partner violence, substance use, unsafe housing, and nutritional risk.

All postpartum persons are to have an initial assessment by their principal maternal care provider within the first 3 weeks postpartum either in-person or via Telehealth to address acute postpartum issues. Ongoing follow-up care must be individualized and provided as needed. Postpartum persons with a complicated gestational history or delivery by cesarean section must have an initial visit scheduled as early as possible or within 7 days of delivery.

The comprehensive postpartum visit must occur in-person between 4 weeks and no later than 12 weeks after birth. The timing must be individualized and person-centered. The purpose of the comprehensive postpartum visit is to conduct a full assessment of all relevant maternal and child physical, behavioral, and psychosocial well-being factors, as per ACOG/AAP postpartum recommendations, and to facilitate timely intervention for warning signs associated with postpartum morbidity and mortality. For example, the comprehensive visit must include, but not be limited to, the following:

  1. Identify whether any medical, dental, psychosocial (including depression), nutritional (including BF/CF), tobacco/smoking cessation needs, and alcohol and drug treatment needs of the postpartum person or infant are being met;
  2. Provide anticipatory guidance on the prevention of childhood lead poisoning;
  3. Refer the postpartum person or other infant caregiver to resources and providers available for meeting identified needs, including chronic disease management, and provide assistance in meeting such needs where appropriate;
  4. Assess family planning/contraceptive needs and provide advice and services or referral when indicated;
  5. Provide guidance regarding well-person care, including appropriate inter-conception recommendations such as preconception daily intake of folic acid (400 mcg) as per CDC and ACOG guidelines, and encourage a preconception visit prior to subsequent pregnancies;
  6. Refer the infant to preventive and special care services appropriate to their needs;
  7. Advise the postpartum person/caregiver of the availability of Medicaid eligibility for infants;
  8. Advise or refer the postpartum person for assistance with an application for ongoing medical care assistance for themselves, in accordance with their financial status, health assistance program eligibility, and the policies and procedures established by the Commissioner of Health and the State of New York;
  9. Provide communication and collaboration with non-principal maternity care providers to ensure care coordination and seamless transitions of care; and
  10. Provide counseling and support to overweight/obese postpartum persons to have a healthy body weight.

In accordance with ACOG and USPSTF recommendations, health care providers are to educate and counsel pregnant and postpartum persons about infant feeding decisions and breastfeeding/chestfeeding at all prenatal visits, the maternity stay, and postpartum. Exclusive human milk feeding is recommended for the first 6 months of life and, with the addition of complementary foods, through the second half of the first year of life and as long as desired thereafter. Providers are to educate pregnant and postpartum persons about the known nutritional advantages and health benefits of human milk/ BF/CF for both the birthing person and the infant. Given that racial biases and practices contribute to BF/CF disparities, providers are to implement policies and practices in their offices and hospitals to provide culturally sensitive, equitable BF/CF education, lactation counseling, and maternity care.

All health care providers who care for pregnant and postpartum persons or newborns are to be knowledgeable about BF/CF and competent to provide lactation guidance, education, assessment, and referrals to the full range of lactation providers, including IBCLCs, to support a person's efforts to breastfeed/chestfeed. Pregnant and postpartum persons must also be referred to community BF/CF support groups and WIC for prenatal, postpartum, infant and child nutrition, and BF/CF education and support. For parents who are separated from their infant or returning to work or school, additional lactation support and counseling may be needed to ensure BF/CF success. BF/CF or feeding expressed milk is not recommended for HIV-positive persons and may be medically contraindicated in other situations.

Pregnant and postpartum persons are to be educated about New York State and federal laws that protect BF/CF in public places and maternity care facilities, provide the rights to express milk in the workplace, the availability, indications and use of breast pumps, and safe storage of human milk.

New York Laws:

  1. NY Paid Family Leave Law provides eligible employees with up to 12 weeks of job protected, paid time off to bond with a new child, care for a family member with a serious health condition, or to assist loved ones when a family member is deployed abroad on active military service. This time can be taken all at once, or in increments of full days. Employees receive 67% of their weekly wage, up to a cap of 67% of the Statewide Average Weekly Wage. Full-time employees who work a regular schedule of 20 or more hours per week are eligible after 26 consecutive weeks of employment and part-time employees who work a regular schedule of less than 20 hours per week are eligible after working 175 days, which do not need to be consecutive. Employees with irregular schedules should look at their average schedule to determine if they work, on average, fewer than 20 hours per week.
  2. NY State Labor Law § 206-c Right of nursing mothers to express breast milk. An employer shall provide reasonable unpaid break time or permit an employee to use paid break time or meal time each day to allow an employee to express breast milk for her nursing child for up to three years following childbirth. The employer shall make reasonable efforts to provide a room or other location, in close proximity to the work area, where an employee can express milk in privacy. No employer shall discriminate in any way against an employee who chooses to express breast milk in the workplace
  3. NY Civil Rights Law § 79-e Right to breast feed. Notwithstanding any other provision of law, a mother may breast feed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether or not the nipple of the mother's breast is covered during or incidental to the breast feeding.
  4. NY Penal Law § 245.01 Exposure of a person. An individual breastfeeding an infant is not subject to penal law that punishes exposure of a private or intimate part of their body.
  5. NY Correction Law § 611 allows a mother of a nursing child to be accompanied by her child if she is committed to a correctional facility at the time she is breastfeeding. This law also permits a child born to a committed mother to return with the mother to the correctional facility. The child may remain with the mother until one year of age if the woman is physically capable of caring for the child.
  6. NY Public Buildings Law § 144 requires that a covered public building shall contain a lactation room that is made available for use by a member of the public to breastfeed or express breast milk.
  7. NY Judiciary Law § 517 amends the Judiciary Law, provides an exemption from jury duty for breastfeeding women, allows that such breastfeeding mother’s jury duty shall be postponed up to a certain period after the date on which such service otherwise to commence.
  8. NY Social Services Law § 365-a includes pasteurized donor human milk, which may include fortifiers as medically indicated for inperson use, under standard coverage for medical assistance for qualifying infants.

Federal Laws:

  1. Title VII of the Civil Rights Act, 42 U.S.C. §2000e-2, 42 U.S.C. § 2000e(k), 29 C.F.R. § 1604.10, prohibits sex discrimination in employment on the basis of pregnancy, childbirth, and related medical conditions, such as breastfeeding and lactation. Employees must be given the same type of accommodations as others with temporary medical conditions for all employment-related purposes
  2. Title IX of the Education Amendments of 1972, 20 U.S.C. §1681 et seq, 34 C.F.R. § 106.40(b)(1),prohibits sex discrimination in educational institutions that receive federal funds and discrimination against students based on parental status, pregnancy, childbirth, recovery from childbirth, and related conditions. It requires that pregnant students and those recovering from childbirth-related conditions be given the same accommodations and support services given to other students with similar temporary medical needs.
  3. Section 7 of the Fair Labor Standards Act, 29 U.S.C. § 207(r), requires all employers to provide a private, non-bathroom space and reasonable unpaid break time to express breastmilk for up to 1 year. Employers with less than 50 employees who can demonstrate undue hardship are exempt from this law.
  4. Friendly Airports for Mothers (FAM) and FAM Improvement Act requires all airports to provide a clean, non-bathroom space in each terminal for the expression of breastmilk and a baby changing table in one men’s and one women’s restroom in each passenger terminal building.

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i. New York Codes, Rules and Regulations. (n.d.) Title: Section 360-3.7 - Presumptive Eligibility. Title: Section 360-3.7 - Presumptive eligibility. | New York Codes, Rules and Regulations (ny.gov) i
ii. New York Codes, Rules and Regulations. (n.d.) Title: Section 360-3.7 - Presumptive Eligibility. Title: Section 360-3.7 - Presumptive eligibility. | New York Codes, Rules and Regulations (ny.gov) ii
iii. American Academy of Pediatrics & American College of Obstetricians and Gynecologists. (2017). Guidelines for Perinatal Care (Eighth Edition). iii
iv. U.S. Prevention Services Task Force. (2020, June 9). Unhealthy Drug Use: Screening. Recommendation: Unhealthy Drug Use: Screening | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org) iv
v. New York State Office of Children and Family Services, Division of Child Care Resources. (n.d). Child Care Resource and Referral Agencies. Child Care Resource and Referral Agencies | Division of Child Care Services | OCFS (ny.gov) v