Almost daily, Dr. Damali Campbell Oparaji, an OB-GYN at University Hospital in Newark, delivers a baby, comforts the mother, and after issuing some perfunctory post-natal instructions, wonders whether she will ever see the new mom again.
“In the traditional model of care, women are discharged after giving birth and they return for an appointment in six weeks,” Dr. Campbell explains. “But the challenge is getting women to come back at all, because it is so much to put on them – new baby, not sleeping well, or child care and transportation issues.
“Far too many women don’t return for postpartum visits – I see it in my own practice – and we know that most complications occur within the first two or three weeks of giving birth.”
Nationally, 40 percent of new mothers don’t see an OB-GYN after they are discharged, and the outcomes of such detachment are especially dire in New Jersey, which has the fourth-highest maternal mortality rate in the country.
Our state’s racial disparity is especially terrible: A Black mother
is seven times more likely to die from pregnancy-related cause than a white mother, and a Black baby is three times more likely than a white baby to die before his first birthday.
It is during that postpartum period – the so-called fourth trimester – that both the mother and baby are at their highest risk of physical and mental health complications and need greater support and care, so our state has found a smart way to deliver it
Gov. Murphy signed a law Thursday that provides three free home nurse visits for all newborns starting within the first two weeks of delivery. It is part of a larger plan organized by first lady Tammy Murphy
called Nurture New Jersey,
which aims to cut the maternal mortality rate by 50 percent in five years.
These visits would be made by registered nurses on a voluntary basis, and they would cover the gamut: weight and health check of the newborn, breastfeeding support, an assessment of the mother’s physical wellness, help with identifying and coping with perinatal mood disorders, and more. Only Oregon has a statewide program like this.
“It addresses not only physical concerns, but emotional and social concerns that are part of having a newborn in the home,” says Kate Shamszad
, the policy expert
at NJ Health Care Quality Institute
. “We have smaller programs that do a great job improving outcomes for children and families, but they only reach 7,000 families each year, and we have 100,000 births in the state every year.”
Senate sponsors Joe Vitale (D-Middlesex) and Teresa Ruiz (D-Essex) modeled the program on Family Connects, a visitation program founded at Duke University that is acclaimed for sterling results.
Two controlled trials of Family Connects showed a 50-percent reduction in emergency room visits in the first year of life, a 30-percent decrease in a mother’s postpartum depression or anxiety, and a 44-percent lower rate of investigations for suspected child abuse or neglect.
All research shows that the more support mothers receive after giving birth, the better the outcomes for them and their babies – who, as Dr. Campbell says, “don’t come with instruction manuals.” At last, we can mobilize the instructors and save some precious lives.