Plus an update on a story we reported on last week looking at a new study conducted by the National Bureau of Economic Research that found that Black women in New Jersey are 25% more likely to receive an unplanned C-section than white, non-Hispanic women.

The results are alarming because they show why disparities in how black mothers are treated, even those with similar pregnancies, similar socioeconomic status, and even the same doctors treated in the same hospitals as white women.

Well, why does it matter?

You might be asking.

That's because C-section deliveries drive up postpartum complications and increase health risks for both mom and baby.

First Lady Tammy Murphy commented on the study last week, saying it proves what she and her team found when she first launched her nurture NJ program in 2018, aimed at reversing the horrific rate of black maternal and infant death in the state.

Well, she's with me now to talk about the study and what it says about maternal health changes that still need to be made here in New Jersey.

First Lady Tammy Murphy, so great to have you with us tonight.

Thank you.

Now, the study that we're talking about here was run between the years of the covered 2008 to 2017.

I know that was before you started your nurture NJ program.

How did your nurture NJ program specifically address C-sections here in new Jersey?

Thank you.

Yes.

This this study, I just want to really underscore that the study is so important, and I'm so thrilled that you all are paying attention to this, because we need more awareness, and it's only going to come from you all.

So I thank you for that.

We've done a number of things.

First of all, back in 20, I would say 2019, we said that we would no longer reimburse for non for, for elective, C-sections, which has been a very important driver of reducing our C-section rates here.

Secondarily, though, we have done everything from, you know, we're educating our workforce further.

We're trying to get the to get everyone out there to understand the challenges.

With C-sections in particular, can we just, can we talk culturally about what it looked like before, those reimbursements were taken away?

A lot of times, women were told, sure, you can pick the date that you want your your baby to be born.

Right.

And there was kind of a it seems a more laissez faire attitude around C-sections, but we know there are risks involved.

Have you seen data to point to a shift in that kind of culture here in new Jersey?

100%.

I mean, our C-section rates, we actually, have a hospital, maternal health report card that we have now started and we started working on that, also in 2019.

And that is our effort to make sure that families, mothers to be all have access, that we are completely transparent and that our hospitals are putting their best foot forward so that people can actually go online and check and see what their C-section rates were and what they are.

I would also say it's a little bit of a good thing here in new Jersey because it gets a little bit of a rivalry.

So it's a little bit of a competitive process here.

So our hospitals are all kind of trying to outdo one another.

And that's a great thing for us all.

It's alarming to see some of the data from this study that shows that, black women and white women were treated extremely differently, regardless of their socioeconomic status being similar.

Even seen by the same doctors in the same hospitals.

I know implicit bias has been a big emphasis as part of nurture NJ, but does this point to, in your mind, implicit bias playing out in the health care setting?

100%.

I mean, you can't have the same the same two patients with the same, the same symptoms, present to the same doctor and the same hospital and be treated so differently.

So, yes, absolutely.

And what we've been saying since the very beginning is we need to enable everyone across new Jersey to just be healthy in their own community.

We need to give them the resources, the respect, and we need to make sure that they understand what is available.

And we're just expanding that network, and we've been doing that since day one.

First lady does the presence of a doula, which is basically a birthing advocate for for pregnant woman.

Right.

Does that also reduce C-section rates?

Do we have data around that?

The presence of doulas and midwives in particular have been proven to, to, to better all outcomes?

I know that certainly with the midwives, there's a lower, a lower incidence of C-section rates.

And I believe that's right.

The same thing with the doulas.

But the fact of the matter is that we know that studies have shown that outcomes are better when you involve doulas in midwives, which is exactly why we've been not only building up both of those workforces, we've been trying to make sure that we are reimbursing them at respectable rates.

We are trying to make sure they're embedded in part of the of the care team.

And to be honest with you, we've taken it a step further and we are doing the same for throughout the entire perinatal workforce.

What can you tell me?

I know there are countless other steps that you've taken, but I want to look forward.

What still needs to happen in new Jersey?

What are going to be the efforts of the Maternal and Infant Health Authority that's just getting on its feet here in new Jersey?

Yeah, I mean, that's the first in the nation.

And I will tell you that it is community informed, and we will make sure that the community is embedded in every decision that we make with the Maternal and Infant health, Innovation Authority.

I'm very excited because my big concern was that when my husband left office, that all of the great work in the in the collaboration and the partnerships we built across the state would suddenly start falling apart.

And so this is going to be the connective tissue to not only ensure that the entire strategic plan that we unveiled several years ago will continue to be refined and rolled out.

But on top of that, that everyone is involved and that we are continuing to do everything we can to, eliminate the scourge and make new Jersey the safest place in the country to deliver a baby.

First Lady Tammy Murphy, thank you so much for your time today.

Thanks for talking this through with us.

Thanks, Joanna.

Support for the medical report is provided by Horizon Blue Cross Blue Shield of New Jersey, an independent licensee of the Blue Cross Blue Shield Association.