In his 2024 NJ budget speech, Phil Murphy touched on Cover All Kids, as well as Veterans and Maternal health.
More than 20 years ago when Dr. David Sorrentino was a young neonatal specialist taking care mostly of infants born prematurely, he began noticing a troubling trend: more and more babies born full-term had complex medical problems that required significant intervention.
"I was like 'What's going on here?'" he said. "I'm seeing sicker and sicker moms and more full-term deliveries that are problematic."
Sorrentino didn't know it at the time, but he was witnessing the beginning of a maternal health crisis that would see childbirth complications rise, putting the lives of mothers and their babies in jeopardy.
Today Sorrentino oversees New Jersey's newest neonatal intensive care unit at Holy Name Medical Center in Teaneck -- a response to the crisis that has left New Jersey wirh one of the highest maternal death rates in the nation.
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Holy Name joins several New Jersey hospitals that have opened or expanded their NICUs in the past decade to care for the smallest and often sickest patients.
This includes a large facility at St. Barnabas in Livingston -- where babies born at Holy Name in serious condition were often transferred in the past. That no longer needs to happen as Holy Name opens its $3.5 million, 11-bassinet facility this week that will be manned by 27 medical personnel who specialize in neonatal care.
"We saw this as a gap that needed to be filled," said Michele Acito, Holy Name's chief nursing officer. "We would often have a baby delivered and transferred to another facility while the mom remained with us. And then the dad would have to choose who to be with. It was hard to watch a family suffer through that."
NJ has among the worst rates of maternal deaths
Despite having one of the highest per capita income levels in the nation and some of the top hospitals in the nation, New Jersey has had one of the country's worst overall maternal mortality rates.
New Jersey was ranked fifth-worst in the nation, with 36.2 maternal deaths per 100,000 births from 2012 to 2016, according to a USA Today analysis of data. The Kaiser Family Foundation ranked it number 14 a few years later, with a maternal death rate of 24.1 per 100,000 births from 2018 to 2020.
A combination of women getting pregnant later in life, increasing obesity rates and more signs of hypertension and other stress-related conditions in women all "have a downstream effect on the infant," Sorrentino said.
"If mom is sicker, it makes it harder on the placenta and the baby," he said.
The rate of premature births has remained steady in New Jersey. Of the 102,890 births in 2022, about 9.3% were preterm at less than 37 weeks of pregnancy. Similar rates were seen almost every year since at least 2010, according to Health Department data.
While more hospitals have expanded and upgraded their NICU units, New Jersey had a lower percentage of babies that required NICU admission compared to the rest of the nation -- 13% as opposed to 14.3% in 2020, according to the March of Dimes.
Researchers this year have presented data showing the decline in maternal health may have been overstated by taking into account deaths of mothers long after they had given birth.
Reducing C-sections and serious maternal complications
Still, New Jersey has made some strides with the number of cesarean sections and serious maternal complications decreasing in recent years after First Lady Tammy Murphy led a campaign to improve conditions nearly seven years ago.
Hospitals began a program in 2017 by adopting a uniform standard of care to reduce the state's high rate of C-sections and lower the amount of blood pressure complications and excessive bleeding during pregnancy, labor, delivery or postpartum.
While the numbers have declined, there still remains a significant racial gap in maternal health, with Black women having significantly higher rates of complications.
At Holy Name, the new NICU has been upgraded to a Level III center meaning it can now handle infants who have very low birthweight, critical illnesses, problems breathing, the need for surgery surgery or a host of other ailments.
The center joins 18 other New Jersey hospitals with Level III NICUs, and will have some of the latest technology, including incubators, ventilators and monitors to help keep the babies safe and video cameras and in-room accommodations to help keep parents at ease.
"The fact that it's become more mainstream in terms of the discussion is important," Sorrentino said. "The fact that we're sending resources in so many ways on maternal health is even more important."