New Jersey Legislation Provides Home Nurse Care to Mothers and Babies
Natalia Lucci, a mother of four who helps run a family business from her home in Princeton, New Jersey, is excited about a new state law providing free home nurse care to mothers and babies, regardless of insurance coverage.
"You could imagine how difficult it was for me every time one of our children came into the world and I could barely find time to leave the house," said Lucci.
Lucci, who was able to receive home postpartum care for her last two pregnancies through an extended insurance policy provided by her husband's employer, remembers how beneficial it was to have that kind of support. "It was well-needed, especially because of my C-section," she explained.
She's in full support of making this type of care readily accessible to all new mothers who require it, whether they have insurance or not.
State legislators felt the same way, and on Thursday, July 29, 2021, Governor Phil Murphy (D) of New Jersey signed this landmark legislation into law.
'By supporting parents and children from the beginning, we help to build strong, resilient families and overall support to the society as a whole.'
New Jersey is only the second state with this type of legislation. Oregon has a similar program in place, which was passed in 2019, but New Jersey's is "the most comprehensive and robust universal home visitation program in the nation," according to a press release from the governor's office. This law "will provide a registered nurse to conduct home visits for all mothers and newborns within two weeks of birth, and serves both adoptive and resource parents, as well as those families who experience stillbirths."
"I am very excited about this bill. It is definitely needed, especially for first-time mothers," said Betsy Greenleaf, D.O., FACOG, the first board-certified urogynecologist in the United States. "I wish this was in existence when I had my children."
The necessity of this legislation
The goal of the laws in both New Jersey and Oregon is to decrease the mortality rate of newborns and mothers. New Jersey has the fourth highest maternal mortality rate in the country, with Black New Jersey mothers seven times more likely to die than their white counterparts.
"The postpartum period is one of excitement coupled with intense levels of stress," explained Greenleaf. "Stress is in the form of severe sleep deprivation, physical demands placed on a healing body, emotional turmoil, mental health strains, severely fluctuating hormones and the need to rely on a support system, which not all women have."
The New Jersey legislation states, "Research indicates that postpartum education and care lead to lower rates of morbidity and mortality in persons who have given birth, as many of the risk factors for post-delivery complications, such as hemorrhaging or a pulmonary embolism, may not be identifiable before a person who has given birth is discharged following the birth."
The law provides for three free home visits through the first three months of the infant's life, starting at two weeks. The American College of Obstetricians and Gynecologists (ACOG) notes this is especially important because the first six weeks after a mother gives birth are typically "devoid of formal or informal postpartum support."
In the United States, women typically attend a postpartum checkup six weeks after delivery. But, according to ACOG, "as many as 40 percent of women do not attend a postpartum visit," due at least in part to limited resources on the part of the mother.
This new legislation could help to alleviate the burden on mothers to travel for postpartum care by bringing the care to them. "I see a great need for these services," Greenleaf said.
Benefits of home nurse care
Greenleaf described some of the benefits of the home nurse care provided by New Jersey's legislation:
- Decrease in maternal deaths
- Postpartum depression screening
- Infection screening
- Lactation consultant
- Sleep evaluation
- Fluid and nutritional assessment of parent and child
- Evaluation of normal growth with infant weight assessment
- Parental education
- Emotional support and intervention
- Management of chronic disease
- Connecting parents to resources in the community
Long-term benefits, according to Greenleaf, will include a decrease in infant and maternal mortality, as well as a decrease in the cost of medical care and healthcare spending. "By supporting parents and children from the beginning, we help to build strong, resilient families and overall support to the society as a whole," she explained.
Another important benefit of this legislation is cost. Regardless of insurance coverage, this care is free and no costs will be passed on to the patients receiving care. Cost is a deterrent for many new mothers to seek out additional help, especially if they don't have insurance. Laws like the ones in New Jersey and Oregon ensure mothers get the care they need, even if it's not part of their insurance policy.
Greenleaf is optimistic about what this means for the future of healthcare for women and babies. "I believe, in general, the traditional medical system...has been centered for years on triage care," she said. "It is great to see that the focus is shifting to prevention, especially in women's healthcare, an area of medicine often overlooked."
"It seems like it has taken a long time for our society to recognize the need for this type of program," she continued. "Early child support, in the long run, will save healthcare dollars and ultimately save lives."
