Abstract
In this column, the editor of The Journal of Perinatal Education discusses how a champion for maternal health has supported legislation to improve maternal mortality in one state. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth and postpartum.
Keywords: perinatal education, maternal mortality, labor support, doula, postpartum care
Those who follow national news may have recently seen headlines that the first lady of New Jersey, Tammy Murphy, suspended her campaign for U.S. Senator of New Jersey. What many do not know is that Tammy Murphy has been a strong champion for improving maternal health in New Jersey. In early 2019, First Lady Tammy Murphy officially launched Nurture NJ, a multipronged, multiagency statewide initiative committed to ensuring equity in maternal and infant health outcomes for Black and Brown women and to reducing overall maternal and infant mortality and morbidity in the state. The aim is to make New Jersey the safest and most equitable place in the nation to deliver and raise a baby. New Jersey is currently ranked among the worst in the nation for maternal deaths and has one of the widest racial disparities for both maternal and infant mortality. At the root of these disparities lies generations of systemic racism and its effect on social determinants of health. These factors have historically limited women and infants, especially Black moms and babies, from having the opportunity to simply be healthy.
We invite readers to respond to the contents of this journal issue or share comments on other topics related to natural, safe, and healthy birth. Responses will be published as a letter to the editor. Please send comments to Wendy Budin, Editor-in-Chief (wendy.budin@rutgers.edu).
Through many of First Lady Murphy’s initiatives, key legislation has been passed in New Jersey, which can serve as a model for the rest of the nation. Recently, NJ Governor Phillip Murphy showed his support for pregnant patients and their right to a doula in a hospital or birthing center by signing S-4110/A-5739. This bill requires birthing centers and every general or special hospital licensed to provide maternity services to have written policies and procedures allowing doulas to accompany patients before, during, and after labor and birth. Trained doulas provide continuous physical, emotional, and informational support to the patient to achieve a healthy and satisfying experience. A summary of the facility’s policies must also be made available to the public through the facility’s website.
During a recent roundtable discussion, First Lady Murphy highlighted how increased access to doulas helps reduce birth complications, lower rates of cesarean surgeries, and improve the overall support and advocacy during the birthing process. The impact on low-income patients also includes increased successful breastfeeding initiation and continuation. These positive outcomes become increasingly important to help decrease healthcare disparities and improve health outcomes. In New Jersey, pregnant patients still experience a significant racial gap in maternal care where non-White patients are more likely to develop serious complications. Fifteen million dollars of Governor Murphy’s fiscal year 2023 budget was earmarked for increasing Medicaid reimbursement rates of perinatal, midwifery, and community doula care. The doula access bill was passed unanimously in the state assembly and senate and signed by Governor Murphy in January 2024.
Another feature of a Nurture NJ campaign, spearheaded by First Lady Murphy, is the Family Connects NJ initiative. As a result of this program, residents of five New Jersey counties are now eligible to have a specially trained registered nurse visit them at home within weeks of giving birth to a baby, thanks to a new state-funded program that has been shown to improve maternal and infant health elsewhere. The program will expand to the entire state.
The Family Connects NJ provides up to three home visits for new moms to help with things including breastfeeding and calming a cranky child and to connect them to other services for more serious issues, such as postpartum depression. The service is available free of charge to all families, regardless of their income level, residential status, or insurance coverage. These are just two of the many initiatives championed by First Lady Murphy that demonstrate what a champion for maternal health can accomplish to achieve the goal of improving birth outcomes in New Jersey, where the maternal mortality rate is high, especially for Black women.
IN THIS ISSUE
In this issue, four compelling articles support the need to promote safe and healthy birth and postpartum. Authors Viera-Martinez, Rosenblum, and Aberbook share results of their quality improvement project that explored expanding labor support education to nurses caring for women in labor. They discuss how the ability to provide emotional and physical support to a patient during one of the most significant moments of her life is a privilege afforded to nurses who care for laboring and delivering mothers. Authors used surveys, including the Self-Efficacy Labor Support Scale, to evaluate and document knowledge acquisition. Results support intrapartum nurses learning evidence-based labor support strategies to maintain comfort during labor to encourage a mother’s labor preference.
In an article describing the development, implementation, and evaluation of an innovative game-based online parental group organized for first-time expectant parents, Finish authors, Kokkinen, Malinen, Sevón, Hämäläinen, and Rönkä, discuss participant’s experiences of playing together. Although evidence exists on the use of gamification and serious games in many fields, game-based methods are relatively new phenomena in the family services sector. Authors used thematic analysis to analyze the data. Three main themes describing the expectant parents’ experiences were related to the game as a stimulator of discussion, the experience of gaming, and specific features of online group discussion. Authors concluded that playing online learning games with others can lower the threshold to participate and offer new possibilities for interactive parental education.
The content of all JPE issues published since October 1998 is available on the journal’s website (www.ingentaconnect.com/content/springer/jpe). Lamaze International members can access the site and download free copies of JPE articles by logging on at the “Members Only” link on the Lamaze website (www.lamaze.org).
Also in this issue, Cheryl Anderson shares results of a secondary analysis of baseline data from a previous longitudinal study exploring the mental health of 303 postpartum adolescents. This study examined associations and predictors of a negative birth perception including race–ethnic differences. No association was noted between partner violence and loss of control during labor. Race–ethnic differences were noted for demographic variables (marital status, birth mode, and stress level) and birth perception. Healthcare provider’s awareness of risk factors can guide perinatal assessments and supportive and educational interventions to promote a positive birth perception.
Lastly, in this issue, Halm, Hornsby, Shetty, Madray, and Kellams provide findings from their study that explored the views and experiences of maternal and infant healthcare providers on the care of women and infants in the postpartum period. Qualitative analysis revealed three themes: Gaps in Infant Care Education and Preparation for Parenting, Gaps in Maternal Pregnancy and Postpartum Care and Expectations and Knowledge, and Ideas for Integrating Care, Education, and Support in the postpartum period. Results suggest a need for care models that offer improved prenatal education and expectation setting, methods to help mothers prepare their social support networks, and integrated and convenient access to postpartum care.
As a reminder, we welcome birth stories from our readers. Please reach out to the editor if you have a story you would like to share. We also welcome high-resolution pictures depicting the magical moments of pregnancy, birth, and early parenting.
Trained doulas provide continuous physical, emotional, and informational support to the patient to achieve a healthy and satisfying experience.
New Jersey is ranked among the worst in the nation for maternal deaths and has one of the widest racial disparities for both maternal and infant mortality.
Residents of New Jersey are now eligible to have a specially trained registered nurse visit them at home within weeks of giving birth to a baby, thanks to a new state-funded program that has been shown to improve maternal and infant health elsewhere.
Biography
WENDY C. BUDIN is the editor-in-chief of The Journal of Perinatal Education. She is also Professor and Associate Dean for Entry to Baccalaureate Practice at Rutgers School of Nursing. She is a fellow in the American College of Childbirth Educators and member of the Lamaze International Certification Council Governing Body.
