Rutgers Health report highlights improvements in care following Nurture NJ policy initiatives
Researchers with the Rutgers School of Public Health found that New Jersey reduced low-risk Cesarean deliveries, bringing it closer to meeting the federal Department of Health and Human Services' target of 23.6%.
Highlighting the importance of the Nurture NJ initiative, the Rutgers report found that, among states with high rates of unnecessary Cesarean procedures, New Jersey saw the most significant decline. Cesarean births account for nearly one-third of all deliveries in the U.S., with even higher rates among Black, non-Hispanic women. While Cesarean deliveries can be a necessary intervention, the procedure carries health risks and can have negative health impacts.
It is encouraging to see the amount of progress New Jersey has made in lowering low-risk Cesarean birth rates and we hope to see further reductions as well as narrowing of the racial gaps in the coming years,
Slawa Rokicki
Assistant Professor, Rutgers School of Public Health
According to the new analysis, the low-risk Cesarean birth rate decreased by 10% to 27.3% from 30.2% between 2016 and 2023. Among those with Medicaid, where many Nurture NJ policies are focused, rates fell to 21.3% in 2023 from 24.8% in 2018.
Despite overall improvements, however, racial disparities in low-risk Cesarean birth rates persist in New Jersey.
The findings are described in a new policy brief "Progress in Reducing the Low-Risk Cesarean Birth Rate in New Jersey: An Examination of Data from 2016-2023," which highlights changes following New Jersey policy and programmatic efforts aimed at improving maternal health outcomes in the state.
"It is encouraging to see the amount of progress New Jersey has made in lowering low-risk Cesarean birth rates and we hope to see further reductions as well as narrowing of the racial gaps in the coming years," said Slawa Rokicki, who led the analysis and is an assistant professor in the Department of Health Behavior, Society and Policy at the Rutgers School of Public Health.
Through the Nurture NJ initiative, Governor Phil Murphy signed legislation limiting insurance payments for nonmedically indicated early elective deliveries, created a Medicaid doula benefit and equalized Medicaid payments for perinatal health care providers.
Through payment reforms, quality improvement efforts, confronting provider biases and more, we have been working toward this result since the launch of Nurture NJ.
First Lady Tammy Murphy
Additionally, the Nurture NJ Strategic Plan provides recommendations such as comprehensive informed consent procedures for maternity patients. These policies were informed by scientific research on effective strategies for reducing unnecessary Cesarean births.
"It brings me great hope to learn we are reducing the number of unnecessary surgical births in New Jersey, and I am grateful to Rutgers School of Public Health for this analysis of our maternal and infant health trends," said First Lady Tammy Murphy. "Through payment reforms, quality improvement efforts, confronting provider biases and more, we have been working toward this result since the launch of Nurture NJ. With each and every initiative and policy reform, we are making steady progress, and we are well on our way to becoming the safest, most equitable state in the nation to deliver and raise a baby."
The report's results highlight the progress New Jersey has made in reducing low-risk Cesarean births and that full implementation of Nurture NJ policies sets the stage to make New Jersey a leader in maternal and infant health.
The analysis is part of a broader evaluation of Nurture NJ being conducted by the Rutgers School of Public Health and led by Leslie M. Kantor, a professor and chair of the Department of Urban-Global Public Health.
