New Jersey will develop a plan to drive down its high mortality rate among new mothers and pregnant women and reduce enormous racial disparities in those numbers, thanks in part to additional federal funding.
First Lady Tammy Murphy, who has focused on maternal and infant health, and the state Department of Health announced Monday that New Jersey would receive $10.5 million over five years for the effort. The state appears to be one of just nine to receive the technical-assistance funding through a maternal health innovation grant program run by a division of the U.S. Dept. of Health and Human Services.
The money will support the work of the New Jersey Maternity Care Quality Collaborative — a multi-disciplinary stakeholder team created through legislation Gov. Phil Murphy signed this past spring — as it develops its blueprint for change and identifies proven strategies that birthing centers can use to improve outcomes. The funding will also allow the state to expand its ability to collect and analyze maternal and infant health data.
The funding comes on top of $2.25 million the state DOH was awarded in August by Washington to support the work of a panel that reviews dozens of deaths each year to determine cause and other factors. The New Jersey Maternal Mortality Review Committee, one of the nation’s oldest, is one of 25 state initiatives that received this support from the federal Centers for Disease Control and Prevention.
According to data on a website the state launched in April, New Jersey had one of the highest maternal mortality rates in America, with 37.3 women dying during pregnancy or within a year of childbirth or miscarriage per 100,000 births in 2013, the most recent figures available. Nationwide, the rate was 15.9 that year, more than double what it was 25 years ago.
Big differences in rates for black and white mothers
There was also a stark racial disparity in New Jersey and elsewhere in America. White mothers died at a rate of 12.8 in the Garden State, and 12.5 nationwide, while black women had a maternal mortality rate of 46.5 here and 42.8 countrywide, the data showed.
Similarly, although infant mortality has been on the decline both in the country and the state, black babies died at more than three times the rate of white infants. New Jersey’s overall rate of 4.7 deaths per 1,000 live births was below the country’s average.
“Every mother deserves the opportunity for a healthy birth experience and a healthy child,” said the First Lady, who joined the DOH at an annual summit Monday focusing on maternal health. “Skin color should not impact the quality of care received or chances of surviving childbirth, nor should it determine whether children live to see their first birthday.”
“This grant will go a long way toward addressing disparities in health outcomes and establishing New Jersey as a leader in maternal and infant health,” said Tammy Murphy, who launched the Nurture NJ public awareness campaign to combat these negative trends.
The federal funding announced Tuesday aids the latest in a growing number of state initiatives to address these concerns. Awareness of the issue has grown in Trenton since 2017, when several Democratic lawmakers made maternal mortality a priority. This spring, the legislature passed a package of bipartisan bills aimed at increasing public awareness, standardizing birthing procedures and expanding clinical training, and elevating women’s voices in the process. The collaboration was also part of this package of bills.
The Murphy administration also took a number of steps, boosting funding for women’s health care and expanding access to contraception, among others. In addition, the state health department invested $4.7 million to support local maternal health initiatives and to create several pilot programs to train culturally competent doulas — expert birthing coaches who work with the medical team to support the mother — in communities with high maternal mortality rates.
Focus on collaboration
Hospitals have also come together to share strategies, including reducing unnecessary C-sections and preterm births. And philanthropic organizations have prioritized maternal health issues, including the New Jersey-based Robert Wood Johnson Foundation, which earlier this month announced a multi-state effort to create more equitable Medicaid systems; in New Jersey, the work will focus on maternal health.
The grant funding from the federal government was awarded to help state officials collaborate with maternal health experts to design locally driven solutions. It requires recipients to establish a task force, improve data collection, and “promote and execute innovation in maternal health delivery service.” This could include addressing workforce shortages, supporting post-partum services and family planning between pregnancies, among other things.
Before applying for the funding, health officials in New Jersey said they assessed the needs of the maternal health collaborative and established several goals to align the various related efforts. They also worked with stakeholders to get input — through interviews, focus groups, site visits, case reviews and more — and identified certain areas that were ripe for evidence-based reform. The state has also worked with an expert consultant funded by the Nicholson Foundation, the department said.
Going forward, the new collaborative will help oversee a variety of initiatives by the state health department. They include providing implicit bias training and patient risk-assessment tools to providers, encouraging long-acting reversible contraceptives for women who just gave birth, and helping clinical providers, doulas and community health workers to better collaborate. The work is also designed to expand the capacity of the maternal data website and other public sources for relevant information.
“This grant funding will allow the Department to further implement this important work to avoid preventable death and injuries to New Jersey’s mothers regardless of their race or ethnicity, economic status or insurance coverage,” said DOH’s acting commissioner, Judith M. Persichilli.