Delivering babies by Cesarean section is not an uncommon practice, but it can be a risky one for mom and newborn if it’s not medically necessary.
That’s why Gov. Phil Murphy on Wednesday signed into law a bill (S3378) that will prohibits New Jersey’s Medicaid program and the health plans for state workers and public teachers from paying for c-sections that are not essential, thereby discouraging doctors from performing them.
It was one of four bills Murphy enacted to address the alarming number of women who die during delivery or shortly after childbirth.
About 38 women die on average for every 100,000 births in New Jersey compared to about 21 deaths nationally, according to America’s Health Rankings, a report by the United Health Foundation. Black women are five times more likely to die during childbirth, accounting for 47 percent of maternal deaths in the Garden State for a group that represents only 13 percent of the state’s population.
“By enacting these measures today, New Jersey is making a strong statement that every mother, every birth, and every child matters,” Murphy said during a ceremony at University Hospital in Newark. “I am proud to sign these bills into law and commend my partners in the Legislature for their commitment to improve the health and safety of New Jersey’s women, children, and families.”
New Jersey ranks 45th for its maternal mortality rate, said First Lady Tammy Murphy said, who has made reducing maternal and infant mortality her signature priority. through her NurtureNJ public awareness campaign.
The infant mortality rate is nearly as grim for black newborns, who are “three times more likely to never see their first birthday,” Tammy Murphy said.
“We can and will make New Jersey the safest place to give birth in America,” the first lady said.
Another bill (S1784) would require Medicaid to provide pregnant women with a doula, a non-medical birth coach who is available before, during, or after childbirth, to provide emotional support and physical help.
Jaye Wilson, a nurse, a mother of two and founder of a mothers’ support group for minority women, Melinated Moms, spoke emotionally about the need for doulas, “amazing, beautiful birth workers who devote themselves to women to change their birthing outcomes,” Wilson said.
Wilson said she could have used that support when she was diagnosed with preeclampsia, a dangerous high pressure blood condition associated in two of her pregnancies. Her obstetrician told her to end one the pregnancies because of her condition.
“I didn’t know I had any other option,” she said.
As she researched the illness, she learned 76 percent of preeclampsia cases are diagnosed in women are minorities. Studies have shown there is bias in medicine to pay less attention to the medical concerns of minority women, and she felt that firsthand. “The bias toward my treatment were very significant,” Wilson said.
Murphy also signed bills that would launch a three-year pilot program in Medicaid that would tie payments to managed care companies who improve care (A4932) and create a perinatal risk assessment managed care companies would use to evaluate a pregnant woman’s health, (S3406).
“We don’t need high-tech equipment or costly drugs to improve maternal-child health. Instead, good policies and best practices that put mothers and their babies at the center will drive improvements in outcomes,” said Linda Schwimmer, president and CEO of the Health Care Quality Institute of New Jersey, a consumer advocacy organization, said praising the bills.
As Murphy signed the bill into law, U.S. Sen. Cory Booker, D-N.J., introduced federal legislation Wednesday to expand Medicaid coverage for pregnant women. About half of all births are covered by the federal-state health care program.
The Mommies Act, for Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services, would provide coverage for new mothers for a full year after birth, up from the current two months. Pregnant and postpartum women also would get full Medicaid coverage rather than just for pregnancy-related issues, as is the case in some states, and would get better access to doctors and other health providers such as doulas.
“As mayor of the city of Newark, we saw that too many of our women were getting their prenatal care in hospital emergency rooms,” said Booker, who is seeking the 2020 Democratic presidential nomination. “That’s deeply unacceptable.”
Three other Democratic presidential candidates, U.S. Sens. Kirsten Gillibrand of New York, Kamala Harris of California and Elizabeth Warren of Massachusetts, signed as co-sponsors, while Rep. Ayanna Pressley, D-Mass., was introduced the same bill in the House.
The legislation is one of several measures that Booker has introduced to correct disparities between wealthier and poorer Americans.
Other proposals include expanding the earned income tax credit and offering “Baby Bonds,” in which each child would get $1,000 at birth and lower-income children would get additional payments every year.