N.J. has 1 of the worst maternal mortality rates. COVID-19 has made things worse. | Opinion

Posted Aug 09, 2020

By Tammy Murphy and Lisa Asare

New Jersey is ranked 47th in the nation, and for mothers and babies of color, the situation is even more dire. When the global pandemic hit, pregnant women became particularly vulnerable to stress, anxiety, and fear, say First Lady Tammy Murphy and Lisa Asare, the assistant commissioner of Family Health Services in the Department of Health.


Earlier this year, through the Office of the First Lady’s Nurture NJ initiative, we announced the development of a strategic plan to improve birth outcomes and achieve equity in maternal and infant health. This initiative is of urgent and grave concern, as the United States is ranked 55th in maternal deaths in the world. Worse, New Jersey is ranked 47th in the nation, and for mothers and babies of color, the situation is even more dire.

In fact, a Black woman in New Jersey are nearly five times more likely than a white woman to die from pregnancy -related complications, and a Black baby is three times more likely than a white baby to die before his or her first birthday.

To end this shameful and deadly reality, we set the bold goal of reducing maternal mortality by 50% over five years and eliminating racial disparities in birth outcomes. Since that announcement, the COVID-19 pandemic has placed extraordinary new hurdles in our path — but we have not been deterred.

When the global pandemic hit, pregnant women became particularly vulnerable to stress, anxiety, and fear. In many cases, prenatal care switched from in-person appointments to telehealth, access to testing and supplies were scarce, hospital visitors were restricted, and questions about the safety of breastfeeding and post-partum care were overwhelming both mothers and their caregivers.

New mothers need a lot of support. To boost the support they receive, Nurture NJ has been built as a public/private partnership, led by the Office of the First Lady and funded by The Burke Foundation, the Community Health Acceleration Partnership, and The Nicholson Foundation.

Through our Healthy Women, Healthy Families program, the state has invested $4.7 million to improve health and birth outcomes for women of color. Essential to this program is increasing access to doulas, trained professionals who provide physical, emotional, and informational support before, during, and shortly after childbirth.

Multiple studies show that doula care can lead to lower rates of maternal and infant health complications, fewer preterm births and low-birth-weight infants, lower rates of Cesarean sections, and higher rates of breastfeeding. Amplifying mothers’ voices and listening to their needs, community-based doulas have statistically improved birth outcomes for mothers of color.

To expand this critical support, the state partnered with Uzazi Village to train 80 community-based doulas who serve mothers-to-be in Newark, Trenton, Camden and Atlantic City. The doulas in this program come from those very same communities and have already assisted more than 350 women with their births. And, last year, Gov. Phil Murphy signed a package of bills into law to combat New Jersey’s maternal and infant health crisis, which included Medicaid coverage of doulas.

When the pandemic overwhelmed our hospital systems, drastic measures were taken to preserve personal protective equipment and resources, ultimately forcing mothers to limit the number of support people present during their labor and delivery. Given our dire maternal and infant health statistics, we knew, however, that we needed to get our doulas back into hospitals as soon as possible.

Together with our funding partners, we engaged the New Jersey Health Care Quality Institute, a non-partisan, non-profit organization dedicated to improving the safety, quality, and affordability of healthcare for everyone, to develop the New Jersey Perinatal Care During COVID-19 Work Group report, which now serves as a guide for health care providers and hospitals throughout New Jersey.

The report’s recommendations outlined steps needed to prioritize pregnant women during the pandemic, as they are at increased risk for hospitalization, intensive care admission and ventilator use. Based on the report, the state issued an executive directive designating doulas as essential to patient care. Thanks to our partnership, a woman may now have a support person and her doula present throughout labor, delivery, and her hospital stay - recognizing that doulas are a critical pillar of a mother’s support team and must not be sacrificed.

There is no denying that COVID-19 has presented new challenges and obstacles to resolving our maternal and infant health crisis, but our commitment to protect the mothers and babies of New Jersey has not waivered. In the last few months, our nation has seen what New Jersey is capable of when we prioritize the health of the most vulnerable. We may be in the middle of one of the greatest challenges of our time but we have never been more certain that together we will continue to build a village of support for our mothers and make New Jersey the safest and most equitable place in the nation to deliver a baby.


Tammy Murphy is the First Lady of New Jersey and the founder of Nurture NJ.

Lisa Asare is the assistant commissioner of Family Health Services in the Department of Health, a partner of Nurture NJ and the Black mother of three children.

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