Bias at root of maternal health crisis, Tammy Murphy says

LILO H. STAINTON, HEALTH CARE WRITER | DECEMBER 6, 2021 

NJ Spotlight News

Real bias training for doctors, nurses and other medical professionals involved in reproductive health. Helping women to optimize their health before they become pregnant. Better engagement with the faith community on maternal and infant health initiatives.

These were among the recommendations participants shared during first lady Tammy Murphy’s 4th Annual Nurture NJ Black Maternal and Infant Health Leadership Summit, which convened online last week. New Jersey has struggled with one of the nation’s highest maternal mortality rates and massive racial disparities and Murphy said Black mothers are seven times more likely to die from childbirth-related causes than white mothers in this state.

“I’m incredibly proud of the steps we have taken so far,” Murphy said in welcoming the participants, “but we must understand sweeping change requires persistence and unfailing dedication. At the same time, we know that the urgency of this crisis remains and that its root cause is institutional racism, plain and simple.”

Initially she had believed barriers to health care caused these massive disparities, Murphy explained in an interview following the event, but eventually came to realize the problem is much more complex, involving everything from nutrition to transportation to individual finances. But the root cause is clearly bias, she said, pointing to the birthing struggles shared by entertainment icon Beyoncé and tennis star Serena Williams as examples.

“The fact that those two women were disregarded and had traumatic pregnancies, that speaks volumes,” Murphy said. She explained that despite the fact that they are wealthy, prominent and educated women, clinicians did not take their complaints seriously because of their race — both women are Black — and serious complications resulted. “If those types of people are having problems, can you imagine if you are feeling insecure, you don’t know the language or the terminology and you’re a person of color?” Murphy said. “God help you.”

Plan to improve

To address these issues, Murphy launched the Nurture NJ campaign in 2019. By the following January the group had attracted philanthropic support, drafted a national expert to lead the charge and outlined a bold public health goal: to cut New Jersey’s maternal death rate in half and eliminate racial gaps by 2025. A formal plan followed in early 2021 that identified nine areas of opportunity to improve birth outcomes in New Jersey.

The plan is not a set of instructions, Murphy told summit participants, but a “living, breathing document” that must allow for flexibility and innovation — and the event itself was “ground zero” for that work.

“We are not simply seeking to improve our maternal health statistics or data,” she said. “We are here to make sure every New Jersey mom and baby gets off to a healthy start and is put on a trajectory toward a full and healthy life.”

Working closely with state lawmakers, Gov. Phil Murphy’s administration has already acted on specific recommendations from the plan and has codified in law three dozen reproductive health-related proposals. The current state budget includes new money to extend Medicaid coverage for pregnant individuals for a full year after they deliver and expand access to doula care. It also funds the launch of a universal home-visit program for new moms, something that has been shown to reduce post-partum depression, maternal mortality and emergency care costs in Oregon, which began a similar program in 2019.

“It’s a game changer,” Murphy said of the home-visit initiative, scheduled to start this spring. “It’s going to expand our ability to help people in such a meaningful way,” she said, explaining how such visits can effectively connect new parents with critical housing, nutrition and other social services. “I’m proud of everything we’ve done but that piece is a massive, massive move on the chess board.”

Significant racial disparities

March of Dimes President Stacey Stewart said her organization’s latest report card show some minor improvements in New Jersey’s maternal health metrics in the past year — the state went from a C to a C+ and its pre-term birth rate declined slightly — but racial disparities remain significant. The rate of pre-term, or early, deliveries is at least 50% higher for Black women than mothers of other races, it notes, and pre-term birth rates increased in several counties, including Essex, Ocean and Middlesex.

Last week’s summit provided a chance for diverse stakeholders — government officials, academics, doulas, midwives and other reproductive care providers, advocates and moms, among others — to review the plan and provide feedback. The event included keynote remarks from Tammy Murphy, Stewart and U.S. Rep. Bonnie Watson Coleman (D-NJ) but Murphy made clear that everyone’s input added value to the process.

“The moms have to be at the table before the table is built,” Murphy said.

Nearly 300 people signed up for the virtual event — Murphy’s staff said they had to limit participation — and more than half stayed engaged for much of the three-hour event, a lot of which was dedicated to breakout groups that discussed how to build racial equity and infrastructure, support community-led initiatives and better share information. Other groups focused on addressing social determinants of health — things like housing, trauma and poverty — and making health care services more respectful and human-centered.

Murphy joined a session on engaging multiple sectors where people discussed the creation of a maternal health center in Trenton, something the strategic plan identifies as a critical step to foster collaboration among the multiple stakeholders involved. It would be a place to coordinate research, evaluate state programs and reforms, map areas without maternal health services and more. Murphy also wants the center to fill needs in the Trenton community, perhaps with a clinical component that allowed people to give birth on site.

Trenton, a ‘birthing desert’

“It’s looking at everything at once,” Murphy said after the event. “Trenton is a birthing desert, it’s a food desert. We want to solve some of these things.”

The New Jersey Economic Development Authority, which is overseeing the Trenton project’s development, has already collected ideas for the center from dozens of academic and policy groups, health care providers, maternal health organizations and people involved in reproductive health. Murphy said the next step is to hire someone to assess this information to clarify the mission and create a structure, both physical and organizational.

The current state budget includes nearly $3 million to get the process started, Murphy said, while construction will also involve funding from private sources. The Nurture NJ initiative and groups in other states are also interested, she added.

“My dream is that we take this entire initiative outside of government and we create an entity that will protect (this maternal health work) going forward,” Murphy said. “We can be the Cleveland Clinic, the MD Anderson of this space.”

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published this page in News and Politics 2021-12-06 04:21:15 -0800