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Health care access and equity now is more important than ever

By Donna C. Pressma

Originally published to Trenton Daily on October 9, 2021

New Jersey has some of the poorest maternal health outcomes in the US, ranking 47th with dismal racial disparities. To help reverse this trend, the New Jersey Legislature has before it a bill that would put health care services that are currently unaffordable or inaccessible within reach of all New Jersey women and families.

The Children’s Home Society of New Jersey (CHSofNJ), a community-based non-profit, headquartered in Trenton, has a mission to build healthy families throughout New Jersey. To fulfill this mission, CHSofNJ has worked for decades with low-income women and women of color to improve their health through community-based prenatal health education, connection to health care and health insurance, and now community doula services. CHSofNJ also values adoption as one of the lifespan choices for women and their families.

As the COVID-19 pandemic persists, we’ve seen how reproductive health care gaps are most pronounced when it comes to time-sensitive needs, especially in low-income communities. Targeted changes proposed in the Reproductive Freedom Act (RFA) would address these gaps by improving access to the full range of reproductive health services. Better access means better health, including better birth outcomes – a goal of Governor Phil Murphy and First Lady Tammy Snyder Murphy, medical providers, and community-based groups, like CHSofNJ.

What’s needed now is expanded access to the full continuum of health care, especially for low-income women, women of color, and immigrant women. It would improve reproductive health care through Medicaid by including community doula support and fully fund comprehensive reproductive health services – regardless of immigration status.

Community doulas are non-medical birth companions to pregnant women from the same culture and community. They offer physical, educational and emotional support in the prenatal, labor-and-delivery, and postpartum periods. Community doulas have a proven track record of improving birth outcomes and saving medical costs for Medicaid. Two University of Minnesota studies found that, with doula support, Medicaid saves about $1000 per birth due to a noticeable drop in cesarean deliveries and use of epidural anesthesia. Another study found low-income women matched with a community doula were four times less likely to have a low-birth weight baby – improving health outcomes.

New Jersey has become a leader among states in rolling out Medicaid coverage for community doulas this year. But not everyone will have access to community doulas because current NJ state regulations exclude undocumented immigrant women from certain Medicaid pregnancy-related benefits even though their children born here are US citizens. This represents an unnecessary logistical barrier.

In Trenton, community doulas and medical providers are working together to make sure women receive reliable, accurate medical information, continuous doula support and compassionate pregnancy care. Immigrant women who hail from across the world deserve the same in addition to culturally and linguistically appropriate support to effectively navigate New Jersey’s health care and hospital system. Community doulas can provide that support while saving taxpayers money on costly hospital bills and helping to prevent maternal illness and death.

The positive outcomes of the community doula program operated by The Children’s Home Society of New Jersey for women in Trenton speak for themselves:

In 2020, CHSofNJ moms had:

  • 97% babies born full-term vs. 90.3% full term in Trenton vs. 90% in Mercer County

  • 94% babies born with a healthy birth weight vs 90.6% in Trenton vs 92% in Mercer County

Health care access and equity is more important than ever. To learn more about CHSofNJ, visit

Donna C. Pressma is President & CEO of the non-profit Children’s Home Society of New Jersey, headquartered in Trenton and serving families throughout New Jersey.

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