In addition to these trends, the data also show higher maternal mortality ratios for Southern New Jersey compared to the Northern and Central regions of the state and higher rates of pregnancy-associated deaths among women covered by NJ FamilyCare (Medicaid) compared to those not on Medicaid. In 2019, 50.4 women per 1,000 delivery hospitalizations suffered an obstetric hemorrhage, with much higher rates among women undergoing cesarean deliveries in comparison to vaginal ones.
Preventability & Leading Causes of Death
A key component of the work of the NJMMRC is to assess maternal deaths for preventability. The NJMMRC found that 39 of the 43 pregnancy-related deaths assessed were preventable and 57 of the 63 assessed pregnancy-associated, but not related deaths were preventable. In addition to preventability, the Committee reviews the leading factors contributing to maternal deaths. Among both pregnancy-related and pregnancy-associated, but not related deaths, continuity of care and care coordination ranked at or near the top of the list. Continuity of care is a broad concept, but it can refer to consistent healthcare providers with whom patients have built trusting, long-term relationships or thorough levels of communication between healthcare providers as patients transition between healthcare services. Ensuring continuity of care throughout the perinatal period often equates to higher quality care, as healthcare providers have had the opportunity to get to know their patients, and patients, in turn, may feel more comfortable asking questions or raising concerns.
Notably, for pregnancy-associated, but not related deaths, substance use disorder and mental health conditions fell among the leading contributing factors for maternal deaths. These factors indicate a need for stronger linkages between birthing people and community supports. New Jersey has a wealth of initiatives and resources--including Connecting NJ, which can act as hubs for families, connecting them to health insurance options, doula care, and home visitation services.
Conclusion
The latest NJMMRC report provides the most comprehensive data on maternal deaths for the Garden State. Though the data reference cases from several years ago, several of the trends identified through the report have remained persistent in our state--in particular, disparities among Black women and women of color. And maternal morbidity data (pregnancy-related injuries not resulting in fatality) remind us that many women face a number of risks when giving birth.
With several statewide initiatives in place, it will be important to monitor the next report to see how we can collectively improve the experiences of women who give birth.
