NJ Maternal Health Crisis Demands Urgent Policy Shifts
Preventable Deaths and Systemic Barriers Threaten New Mothers
New Jersey faces a persistent crisis in maternal health, with far too many women experiencing life-threatening complications during and after childbirth. Despite ongoing efforts, outcomes remain stubbornly unequal, particularly for women of color, demanding immediate and comprehensive policy changes.
Alarming Statistics and Systemic Failures
Each year, roughly 100,000 families in New Jersey welcome a new child. However, data from the New Jersey Maternal Mortality Review Committee (2016–2018) revealed 44 pregnancy-related deaths, with over 90% deemed preventable. For every maternal death, an additional 20 to 30 women suffer severe complications like hemorrhage, infection, or hypertension. According to the CDC, the U.S. maternal mortality rate rose to 32.9 deaths per 100,000 live births in 2021, a significant increase from 20.7 in 2019. (CDC Data)
Rebecca Ofrane, a mother, doula, maternal health researcher, and former state health department leader, has witnessed these systemic failures firsthand. She notes that many women experience bias from healthcare providers, with their concerns dismissed and their autonomy undermined during pregnancy and labor.
NurtureNJ Plan Faces Implementation Hurdles
In 2021, First Lady Tammy Murphy launched the NurtureNJ Strategic Plan, a comprehensive initiative to improve maternal and infant health. While commendable, the plan’s impact has been limited, with maternal health outcomes remaining largely unchanged, especially for women and birthing people of color. A recent report by the Rutgers School of Public Health found that policy implementation is hampered by conflicting directives across state departments.
Three Key Policy Priorities
Expand Doula Access and Support
Increasing access to doulas, trained birth professionals offering physical, emotional, and educational support, is crucial. Although doula services were added as an NJ FamilyCare benefit in 2021, the program is underutilized due to low reimbursement rates and complex enrollment requirements. Ofrane emphasizes the need to simplify requirements and expedite payments to encourage more doulas to serve Medicaid clients.
Remove Barriers to Birth Centers
Midwife-led birth centers offer a safe and empowering alternative to hospital births, yet they represent only 0.2% of births in New Jersey. New Jersey’s Medicaid reimbursement rate for birth centers—just $1,300 per birth—is among the lowest in the nation, significantly lower than Massachusetts’ $4,589 rate. Updating reimbursement would allow more families to choose birth centers and free up hospital resources for high-risk pregnancies.
Grant Midwives Full Practice Authority
New Jersey is one of a dozen states requiring midwives to practice under physician supervision, an unnecessary restriction. Granting midwives full and independent practice authority, aligning with standards in most states, would improve person-centered care and support the expansion of birth centers. Assembly and Senate bills A-5527/S-4487 aim to achieve this and deserve swift passage.
Ofrane believes these policy changes align with the NurtureNJ Strategic Plan and should be prioritized. Montclair State University, under her leadership, recently received a grant to develop a new graduate-level maternal and child health curriculum, preparing the next generation of public health professionals.
A future where doulas are accessible to all, birth centers thrive, and midwives practice to their full potential is within reach. Bold, immediate policy change is essential to make New Jersey a national leader in maternal health and ensure safe, equitable care for all mothers and babies.