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The Intersection of Maternal Health and Child Care: Why the Fourth Trimester Matters

Posted on January 14, 2026

Authored by:

Winifred-Head-Shot2

Winifred Smith-Jenkins, Ed.D.
Director of Early Childhood Policy and Advocacy

For more information on this topic, contact Winifred at wsmith-jenkins@acnj.org.

While early childhood is often discussed broadly as spanning birth to age five, the first three months after birth, known as the fourth trimester, are among the most fragile, formative, and high-stakes periods for infants and even caregivers.

The fourth trimester refers to the first 12 weeks of life, when infants are rapidly developing, and caregivers are recovering physically, emotionally, and hormonally from childbirth. It is a period of extraordinary brain growth, attachment formation, and physiological adjustment. It is also a time of heightened risk for postpartum complications, maternal mental health challenges, and family stress.

And yet, in policy and practice, the fourth trimester is often treated as a private family matter rather than a public concern. It is underemphasized and does not receive the focused attention it requires. This is a mistake.

Infants in the fourth trimester are building the foundational architecture of their brains through relationship, touch, and responsive caregiving. They cannot regulate their own emotions, stress, or needs. They rely entirely on caregivers to co-regulate them. At the same time, many parents are navigating pain, sleep deprivation, mental health challenges, feeding concerns, and the pressure to return to work. When families are unsupported during this window, stress can become embedded in both caregiver and child. This is where child care comes in.

Child care centers and family child care providers are often among the first consistent and trusted supports families encounter as they transition back to work and daily routines. Providers see families through day-to-day life and not just during medical appointments or moments of crisis. They witness exhaustion, overwhelm, emotional strain, and the realities of postpartum recovery, while building deep, trusting relationships with families over time.

This elevates child care as more than just a service; it makes child care a critical connection point particularly during the fourth trimester. New Jersey has yet to fully leverage the collaboration between child care and fourth trimester policy design, even though aligning these systems could amplify services and strengthen family support.

When providers are equipped with intentional messaging, developmental understanding, and referral tools, they can help normalize postpartum challenges, reduce stigma, and connect families to support before issues escalate. They can reinforce that infant behavior is a form of communication, not simply misbehavior. They can validate caregiver experience. They can help families feel seen rather than judged.

This is not about turning child care into a clinical setting. It is about recognizing what it already is: a front-line support system for families during one of the most vulnerable periods of their lives.

If we are serious about healthy development, school readiness, and long-term outcomes, we cannot keep ignoring the postpartum period. The fourth trimester is when attachment is formed, stress systems are shaped, and emotional foundations are built. Supporting families here is not a “nice to have.” It is prevention. It is equity. It is a smart policy.

Child care does not start when a child enters a classroom. For many families, it starts as early as the fourth trimester.

And it’s time our systems catch up.

Partnering with Providers to Support Families

As part of this commitment, ACNJ will be partnering with child care centers and family child care providers to share quarterly toolkits designed to support families during the fourth trimester. These toolkits are intended for display in high-traffic areas such as welcome tables, bulletin boards, and family spaces so that both families and staff can easily see and engage with the information. Each toolkit includes plain-language family resources, developmental insights, and connections to supports focused on postpartum health, infant development, and caregiver well-being.

If you are a center director or family child care provider and would like to receive a quarterly toolkit, please contact ACNJ at advocates@acnj.org.

Read the latest on early childhood and education.

ACNJ’s 10th Annual Breakfast Celebration Recap

Posted on December 10, 2025

On Thursday, December 4, 2025, ACNJ held its Annual Breakfast Celebration with the theme "Stronger Starts: Advancing Maternal and Infant Health in New Jersey." Board Chair Jennifer Robinson thanked our generous sponsors and reflected on the event's origins, sharing how former board chair and fund development committee chair Richard Trenk envisioned this gathering a decade ago—a way to bring people together to network, learn, and celebrate ACNJ's wins for children.

ACNJ president and CEO Mary Coogan welcomed attendees, emphasizing the importance of engaging community voices in our policy work to strengthen outcomes for children and families. She highlighted how our #NJVotes4Kids campaign secured a commitment from gubernatorial candidates to prioritize child care, which will be a major focus for 2026. Sign up for Start Strong NJ. Mary noted that while we may feel overwhelmed by the shifting landscape of policies for children and families, it presents an opportunity to reassess, fine-tune programs, and embrace collaboration. It is a time for action especially with federal changes coming to SNAP and Medicaid. 

The maternal health panel, moderated by Atiya Weiss, executive director of The Burke Foundation, was the cornerstone of the event. Thank you to all our speakers. The panel featured Dr. Nastassia Harris, founder of the Perinatal Health Equity Initiative, and Dr. Lisa Asare, CEO of New Jersey's Maternal and Infant Health Innovation Authority (MIA). Dr. Harris shared how her journey began as a perinatal nurse and lactation consultant, eventually founding her organization after witnessing how Black women were being dismissed and disrespected in healthcare settings. She emphasized that while maternal death rates are concerning, the morbidity rates and trauma experienced by Black mothers are even more alarming, with many women now fearful of having children due to the risks they see publicized.

Dr. Asare brought both professional expertise and personal perspective as a Black mother of three, noting that her daughters face seven times greater risk of maternal complications than their white counterparts—a reality that drives her work. She explained that the crisis stems from multiple factors including lack of paid family leave, systemic racism, healthcare bias, and insufficient social supports, emphasizing that maternal health extends far beyond prenatal visits to encompass housing, transportation, child care, and economic stability.

Both speakers highlighted how medical racism continues to manifest through diagnostic lapses, dismissiveness, and coercion in modern healthcare. Dr. Asare shared that New Jersey is taking a unique, multi-sector approach with 22 state agencies collaborating on maternal health, and MIA is hiring doulas with lived experience to inform policy. The speakers concluded by calling on everyone in the room—including men—to get involved, emphasizing that improving maternal health outcomes requires collective action across all sectors of society.

Immediately following the breakfast, ACNJ offered an extended question and answer session with the panelists as well as other maternal health advocates. This intimate gathering provided sponsors and guests the opportunity to engage directly with the speakers, ask in-depth questions, and gain additional insights into the issues shaping maternal and infant health in New Jersey. In addition to Dr. Harris and Atiya Weiss, the additional panelists included Mariekarl Vilceus-Talty (Partnership for Maternal Child Health of Northern NJ), Helen Hannigan (The Cooperative (SNJ)), Robin D’Oria (Central Jersey Family Health Consortia) and Jill Wodnick (Montclair State University).

View Full Playlist of All Speakers

Fact Sheet: Father's Role in Maternal and Infant Health
Fact Sheet: Insights from the 2023 NJ Maternity Care Report Card of Hospital Maternity Care
2025 Annual Breakfast Slideshow (1)

View Video of Attendees Sharing Why Child Advocacy Matters

View Photos from Breakfast Celebration

Highlight Video of ACNJ's Work and Wins

Camden Kids Count 2025, A City Profile of Child Well-Being

Posted on December 8, 2025

Camden Kids Count 2025: Measuring Child Well-Being Amid Economic Pressures, Threats to Federal Safety Net Programs

This Camden-specific Kids Count data report, published over two decades from the first one in 2004 by Advocates for Children of New Jersey (ACNJ), provides a comprehensive snapshot of how children are faring across nearly 100 indicators in areas including demographics, family economic security, child health, child protection, child care, education, and teens.

"The data tells a story of resilience and progress in Camden, but also reveals how vulnerable families remain," said Mary Coogan, President and CEO of ACNJ.

*Please note child care data update on page 40 on January 14, 2026. 

News Release
Contact: Lana Lee, llee@acnj.org, 609-651-5855

Camden Kids Count 2025: Measuring Child Well-Being Amid Economic Pressures, Threats to Federal Safety Net Programs Findings will be presented on Dec. 12th at education and advocacy symposium hosted by CPAC (Community Planning and Advocacy Council)

CAMDEN, N.J. — The City of Camden has made significant progress in reducing child poverty. However, economic pressures persist: 61% of households spend more than 30% of their income on rent, and the median family income remains well below what's needed to afford basic necessities. Meanwhile, roughly 13,500 children depend on federal programs like SNAP that face ongoing federal budget threats.

Of the roughly 19,600 children that call the city of Camden home, about two-thirds rely on SNAP and school lunch programs to support their nutritional needs. In 2025, 18,439 children under age 19 were enrolled in NJ FamilyCare, which is partially funded by Medicaid.

Read Camden Kids Count 2025
View Dec. 12th Event Flyer, where ACNJ will present findings at 9:15am

The first Camden-specific Kids Count child well-being data report published in over two decades by Advocates for Children of New Jersey (ACNJ), provides a comprehensive snapshot of how children are faring across nearly 100 indicators in areas including demographics, family economic security, child health, child protection, child care, education, and teens.

"The data tells a story of resilience and progress in Camden, but also reveals how vulnerable families remain," said Mary Coogan, President and CEO of ACNJ. "Although child poverty has decreased by 33% and median household income rose by 50%, families are struggling. The median income of $37,045 falls well below 200% of the federal poverty threshold, and 61% of households are spending dangerous shares of their income on rent. This is exactly why safety net programs are so critical—they’re helping families who are working hard but still can't make ends meet."

The report comes at a pivotal moment for Camden families. In 2024, 13,564 Camden children received SNAP benefits (formerly food stamps), 1,424 children lived in families receiving TANF (welfare), and thousands more depend on WIC, NJ FamilyCare, which is funded by Medicaid, and school meal programs. While a recent court order reinstated SNAP funding that had been threatened by federal cuts, other provisions in the federal budget reconciliation bill known as HR1—including Medicaid work requirements, increased state costs, and eligibility restrictions—continue to loom over families relying on these programs.

Camden Kids Count also reveals improvement in the city’s graduation rate, increasing to 66% in 2023-24, but the percentage remains far lower than the state rate of 91%, and this challenge is compounded by the fact that nearly half of all students are chronically absent.

Key Findings Growing Diversity:
  • In 2024, 35% of births were to foreign-born women, a 47% increase since 2019.
  • An estimated 19,596 children call the city of Camden home. Of these children, 64% identify as Hispanic or Latino and 40% as Black or African American.
  • Nearly half of Camden's population age 5 and older speaks a language other than English at home.
Economic Progress with Persistent Challenges:
  • Child poverty fell from 11,053 children living in poverty in 2014-2018 to 7,386 in 2019-2023.
  • Median family income increased 50%, rising to $37,045 in 2019-2023. However, 61% of households spend 30% or more of their income on rent, and 35% spend half or more of their income on housing.
  • The unemployment rate stands at 9%, significantly higher than the state average.
Safety Net Programs Remain Critical:
  • In 2024, 13,564 Camden children received SNAP benefits and 1,424 children lived in families receiving TANF in 2024.
  • Roughly 4,600 individuals are enrolled in WIC.
  • Of the Camden City school district students who received free or reduced-price lunch, 70% participated in school breakfast.
Education:
  • State-funded preschool enrollment in Camden City has decreased by 24% between the 2019-2020 and 2023-24 school year.
  • Camden City school district's graduation rate increased to 66% in 2023-24, up from 59% in 2020-21, but still much lower than the state rate of 91%.
  • 14% of Camden City school district students are multilingual learners, a percentage that continues to grow.
  • However, chronic absenteeism remains a challenge, with nearly half of students missing more than 10% of school days.
Child Protection:
  • Camden County saw an 8% decline in the number of children under NJ Child Protection and Permanency (CP&P) supervision between 2020 and 2024.
  • At the city, county, and state level, reports of abuse and/or neglect increased by 17%, 27%, and 29% respectively.
  • Black children remain over-reported and over-represented in the child protection system, accounting for 52% of abuse/neglect reports in the City of Camden despite only 5% of those reports being substantiated, and comprising 46% of out-of-home placements.
Maternal and Infant Health:
  • Women receiving early prenatal care increased 10% between 2019 and 2024.
  • Babies born with low birthweight decreased 18% between 2019 and 2024, though at 11.5%, Camden's rate still exceeds the state average of 7.8%.

This report, published with support of the Camden Community Planning & Advocacy Council (CPAC), not only provides critical data on children and families in Camden, but will help decision makers plan effectively and ensure funding is directed where it is needed most.

"For more than 30 years, CPAC has worked to advance social, racial, and economic justice so that individuals and families can thrive," said Anita Wemple, president and CEO of CPAC. "This report provides the data we need to understand and respond to the needs of resident children and their families.”

ACNJ encourages community members, policymakers, and advocates to use the report's findings to strengthen programs and policies that support Camden families. With a new governor and general assembly, and ongoing federal budget debates, the organization emphasizes the importance of ensuring children's needs remain at the center of policy decisions.

"We have data showing that when families receive support through programs like SNAP, WIC, and Medicaid, children thrive," Coogan said. "Camden's progress proves that investments in families work. Now is not the time to pull back on programs that are helping families climb out of poverty."

 

### Advocates for Children of New Jersey is the trusted, independent voice putting children’s needs first for more than 45 years. Our work results in better laws and policies, more effective funding, and stronger services for children and families. And it means that more children are given the chance to grow up safe, healthy, and educated.

Camden-Kids-Count-A-City-Profile-of-Child-Well-Being-2025

New Jersey Child Care Assistance Program Limited Re-opening

Posted on November 26, 2025

New Jersey Reopens the Child Care Assistance Program (CCAP), A Major Victory for Families
Advocates Urge Continued Focus on Long-term Solution to Affordable Child Care 

Newark, NJ — Advocates for Children of New Jersey (ACNJ) and the New Jersey Association for the Education of Young Children (NJAEYC) celebrate a major milestone with the reopening of the Child Care Assistance Program (CCAP), restoring access to essential child care support for working families across the state. This achievement reflects a strong, bipartisan commitment to strengthening family economic security and supporting the providers who anchor our child care system.

An anticipated shortfall in the CCAP program resulted in an application freeze over the summer, leaving families without access to child care and jeopardizing their ability to join or stay in the workforce. The State announced the reopening of the program - effective January 2026 - relieving some of that pressure. Children in priority groups can apply beginning in December.

While the reopening of the program provides relief for those who were shut out of the application process over the summer, a funding shortfall remains, leaving many children without the needed child care.

Read the full Release
Learn more about the CCAP funding shortfall.