Building a Strong and Diverse Perinatal Workforce for New Jersey
By investing in a perinatal workforce that reflects the communities it serves, we can help reduce maternal and infant mortality, improve the patient care experience, and create greater economic opportunities for those workers and their families.
“Midwifery has been an ‘invisible profession’ for too long. Many people don’t know what midwives are or what we do. In fact, we are educated, licensed, and independent practitioners, with an excellent track record for supporting healthy births. In addition to getting out more information about midwifery, we need to reach out to students — especially in communities of color — as early as high school, to let them know midwifery is a viable career.”
– Linda Locke, nurse midwife and former chief of midwifery at St. Joseph’s Regional Medical Center in Paterson
Black women face seven times greater risk of death from pregnancy-related complications than white women in New Jersey.
Death rates among Black infants are 2.9 times higher than among white infants; among Hispanic infants the rate is 1.4 times higher than among white infants.
Black mothers experience higher rates of preterm births, lower birthweights, and more low-risk C-sections than their white counterparts.
Reducing these alarming disparities in our state requires growing, diversifying, and sustaining the state’s perinatal workforce to deliver strengths-based, patient-centered care to women and families. Cultivating and expanding a workforce that reflects the lived experience and languages of the communities where perinatal workers serve helps build trust and achieve healthier results. For example, increasing patients’ access to culturally congruent care has been shown to reduce maternal and infant mortality.40 Expanding the number of birthing professionals who are rooted in the communities they serve is a powerful tool to advance health equity.
Investing in perinatal workforce initiatives would do more than influence maternal health. It could have long-term community-wide health and wealth benefits as well. Making good-paying healthcare jobs available to people who struggle to make ends meet and who come from under-represented groups increases the likelihood that they and their families will experience better health in the long term. Stable, sustaining employment can provide families with health insurance, the means to afford healthy food, and more opportunities to exercise — all of which help decrease toxic stress.41 A healthier population reinvests in the local economy, contributing to a healthier and more prosperous cycle of security.
As part of its First 1,000 Days strategy, the Burke Foundation will enhance New Jersey’s perinatal workforce by expanding the pipeline for three professions:
- Grow the community doula workforce by training 1,000 additional doulas over 5 years, who could serve about 50% of Medicaid births in New Jersey. To ground our work, we will first engage doulas to examine what is needed to link training graduates to viable employment opportunities with living wages and then pilot sustainable career pathways in various employment settings.
- Recruit and train a diverse pool of Family Connects community nurses to support rollout of the state’s universal newborn home visiting program, which will reach 94,000 families who deliver babies in New Jersey each year.
- Strengthen the midwifery profession by supporting education and training opportunities to create a more racially and culturally diverse workforce. Midwife-led maternity care yields better maternal and infant health outcomes compared to other maternity models.
We approach this work with an eye to improving the long-term sustainability of these jobs and providing economic and career mobility. We will continue to share our learnings with partners and key decisionmakers to enrich the dialogue on fair Medicaid reimbursement rates and support for thriving wages.
At least 173 community-based doulas were trained in New Jersey by the end of 2021, who would have the capacity to serve less than 9% of Medicaid births.
As of 2019, 49% of births in the U.S. were to people of color, but the nurse midwifery workforce was 90% white.42
Even before the COVID-19 pandemic, New Jersey was projected to have the third-highest nursing shortage in the country by 2030 of 11,400 registered nurses.43
To support and grow a diverse perinatal workforce in New Jersey, the Burke Foundation invests in initiatives that:
-
Provide equitable, patient-centered, and culturally congruent care that promote health equity and better health outcomes
-
Create pathways for perinatal healthcare workers to opt to learn new skills and advance their careers
-
Establish supports and incentives for students to pursue in-demand perinatal healthcare jobs with living wages
-
Empower pregnant people and their families, regardless of socioeconomic status, to make informed decisions about their birthing preferences