New Report from The Burke Foundation: Expand Midwifery Care in NJ to Improve Maternal Health, Promote Equity
PRINCETON, New Jersey (June 7, 2022)— Major reforms are needed so midwives can play a greater role in improving New Jersey’s poor maternal health outcomes, a report released today recommends.
The report calls for:
• Reducing barriers to entry in midwifery education
• Diversifying the midwifery workforce
• Increasing opportunities for clinical training
• Payment reform for midwifery services
• Supporting midwifery research and data collection
The report, Delivering Better Care: Midwifery Practice in New Jersey, was released by the Burke Foundation and the New Jersey Health Care Quality Institute. The report was developed through research and analysis of available literature, policy analysis, interviews, and a multistakeholder convening with midwives and maternal health advocates.
Midwives are trained health professionals who for hundreds of years have helped individuals during labor, delivery, and after the birth of their babies. Midwife-led care is a proven way to reduce neonatal deaths and preterm births, as well as reduce labor inductions. Midwives provide care across the lifespan, including their annual preventive care needs, reproductive healthcare, and care for newborns during their first month of life.
The report cites evidence that the midwifery model of person-centered care might help reduce racial disparities and improve outcomes for people of color. In 2018, New Jersey ranked 47th in the United States for maternal health outcomes and is characterized by significant racial disparities. Non-Hispanic Black women in the state are 7.6 times more likely to die from a pregnancy-related complication than white women.
Despite the benefits midwives provide, midwife-attended births account for a small number of births in New Jersey for such reasons as: inadequate insurance reimbursement rates, burdensome policies and regulations, and lack of training opportunities and integration into care that limit the growth of the profession and access to midwifery services across the state.
“Midwives are an essential part of the health care workforce, yet their role is often misunderstood, underutilized, and undervalued,” said Kate Shamszad, Director of the Medicaid Policy Center at the New Jersey Health Care Quality Institute. “To address these issues, the practice of midwifery must be better understood, streamlined, and integrated into the New Jersey birthing landscape.”
This report builds on the work of providers, academics, and other advocates who for decades have pushed for strengthening the presence and value of midwives in New Jersey. Systemic changes to diversify and strengthen the midwifery profession would help reduce health inequities and should be prioritized.
“Midwifery care should be the norm, not the niche,” said Linda Sloan Locke, CNM, MPH, LSW, FACNM, who has practiced midwifery and advocated for the profession in New Jersey for decades. “We need to develop, promote, and implement policies that support midwifery care as increased access to our services directly improve outcomes in maternal health.”
“The patient-centered, culturally-sensitive care midwives provide helps reduce intolerable health disparities along racial, ethnic, income, and other lines,” said Atiya Weiss, executive director of the Burke Foundation. “We are excited to be partners in producing this important report and look forward to collaborating with maternal health advocates to grow, sustain, and diversify the midwifery workforce — to make New Jersey a healthier, more equitable place to raise a family.”
“All members of our maternal health workforce are essential to support our patients and provide them with high-quality care,” said Dr. Nicole Lamborne, MD, Vice President of Clinical Operations for Women's Services at Virtua Health. “This work clearly highlights the need to support midwives and better integrate their services into health care delivery in New Jersey.”
“We look forward to the release of this report and to continuing to collaborate with the Quality Institute and the Burke Foundation on the work ahead of us to create a robust and diverse midwifery workforce, modernize midwifery in New Jersey, and optimize public access to midwifery care.” said Julie Blumenfeld, DNP, CNM, IBCLC, FACNM, President of the New Jersey Affiliate of American College of Nurse-Midwives.
Over the next year, the Quality Institute and the Burke Foundation plan to continue to convene midwives training and working in New Jersey, as well as stakeholders, advocates, and other related professionals through learning collaboratives and advisory boards to support moving the recommendations in this report into necessary action.