Health Sector

Thank you for joining us as we work toward achieving Nurture NJ’s mission to make New Jersey the safest, most equitable place in the nation to deliver and raise a baby. On this page, you will be able to find the recommended activities and associated resources to aid you and your fellow health leaders implement the plan.

Click on the STEP below that represents where you are in the process of supporting Nurture NJ.

If you are just beginning, click on Step-1.
If you have been implementing your NNJ action areas for more than three months, click on Step-2.
If you are more than six months into implementation, click on Step-3.
Finally, if you have been working on Nurture NJ initiatives for more than nine months, click on Step-4.

STEP 1

STEP 2

STEP 3

STEP 4

These recommendations apply to you if you are one or more of the following:

Doctors, nurses, midwives
Community health workers
Peer counselors (including breastfeeding peer counselors)
Doulas
Hospitals
Federally Qualified Health Centers and Clinics
Behavioral health providers
Specialists
Lactation consultants
Medicaid managed care organizations
Nutritionists
Private health insurers

We are thrilled to work in community with you. Welcome aboard!

Recommendation 4.2

Through a statewide communications campaign, promote a fundamental shift in ideology around the role of life course experiences and environmental and social exposures on women and infants' health.

Activities to Begin in Support of 4.2

Members of the health sector should seek learning around the key themes and topics of the Nurture NJ Strategic Plan, including the effect of racism on health, the need for transformative change to achieve racial equity.
Members of the health sector should seek to hear women’s stories directly as a primary source of information.

Tools, Resources and Models

Nurture NJ Strategic Plan Companion Document: A Deeper Dive into Data and Key Concepts.
- I.1, New Jersey Women Speak: New Jersey Isn’t the Greatest Place to Give Birth Now
- I.2, Maternal Morbidity and Mortality in New Jersey
- I.3, Infant Mortality in New Jersey
- I.4, Data Snapshot: Women’s Access to Healthcare, Social Services, and Supportive Policy
- I.5, Issue in Focus: Adverse Childhood Events, Substance Use and Infant and Maternal Morbidity and Mortality
- I.6, Racism in the United States
- I.7, The Science: Pathways of Racism’s Impact on Health
- II.3, Building Infrastructure to Support, Promote and Maintain Racial Equity and Community Power-Sharing in All Policies and Processes of Nurture NJ
I.4, Nurture NJ Resource Guide, Section II, Equity Assessment Tools
IV.1, Webinar on Structural Change adapted to Nurture NJ

Recommendation 7.12

The Department of Health should work with New Jersey healthcare providers to increase accountability on racial equity initiatives.

Activities to Begin in Support of 7.12

Health systems should institute requirements that quality improvement activities in health care provider settings include a racial equity lens. Site-specific planning, surveillance, and ongoing reporting activities for maternal mortality and morbidity must consider the demographic diversity of New Jersey’s mothers.

Tools, Resources and Models

Resources from the California Birth Equity Collaborative, which is a quality improvement initiative to improve birth care, experiences and outcomes for Black mothers and birthing people in California.

Recommendation 7.5

All 49 birthing hospitals and the birthing facilities in New Jersey should meet or attain rates lower than the national target for NTSV surgical/cesarean births.

Activities to Begin in Support of 7.5

All 49 birthing hospitals should institute comprehensive informed consent processes for all maternity patients before (1) any primary or repeat surgical/ cesarean birth and (2) any induction of labor. The former should clearly outline the short- and long-term risks of surgical births and the benefits of spontaneous labor for both parents and newborns. Likewise, before an induction of labor, the patient should be advised of and sign to the patient’s cervical Bishop score and the medical and non-medical indications for this intervention.

Recommendation 9.1

Ensure quality and respectful preconception care, interconception care and women’s wellness care is available, accessible, and affordable for all women, and that it conforms to CDC Guidelines.

Activities to Begin in Support of 9.1

Providers of wellness and preventive care for women should engage in learning around racial equity in health to improve the care they provide and expand the population they serve.

Tools, Resources and Models

New Jersey ACEs Report. The report details challenges health providers and stakeholders face to address ACEs in New Jersey and lays out opportunities and actions for a statewide response.

Recommendation 9.5

Increase the number of Baby-Friendly designated hospitals in New Jersey to at least one hospital in all infant mortality hotspot areas.

Activities to Begin in Support of 9.5

Hospitals can seek technical support for designation through contractors such as the CHAMPS project/Center for Health Equity, Education and Research at Boston University.
Hospitals should work with state departments and agencies to seek funding, as appropriate, for the technical and administrative burdens of seeking Baby-Friendly designation.

Tools, Resources and Models

https://pediatrics.aappublications.org/content/143/2/e20181897.full This article reports the research on impacts of Baby-Friendly designation on breastfeeding disparities in Southern hospitals.
https://www.babyfriendlyusa.org/for-facilities/practice-guidelines/ This website lists the Baby-Friendly guidelines and a listing of designated hospitals by state.

Recommendation 9.6

Recommendation 5.10

The Department of Health should implement a system of community-designed, real-time maternal feedback on quality of care.

Activities to Begin in Support of 5.10

The Department of Health should pilot the use of The Mothers on Respect index (MOR) scale post-delivery, with data captured in electronic medical records to facilitate analysis; after the pilot results, the Department should iterate on the model to develop and implement a system of community-designed, real-time maternal feedback on quality of care (in keeping with the statutory requirements of P.L. 2019, c. 75, which created the New Jersey Maternal Care Quality Collaborative).

Tools, Resources and Models

A selection of evaluation tools, including the MOR, is available here. The Mothers on Respect index (MOR) is a scale developed to assess the nature of respectful patient-provider interactions and their impact on a person’s sense of comfort, behavior, and perceptions of racism or discrimination. The MOR index is a reliable, patient-informed quality and safety indicator that can be applied across jurisdictions to assess the nature of provider-patient relationships, and access to person-centered care.