Changing birth trends for Trenton mothers and babies: Trenton Health Team is defining needs and delivering solutions

The efforts of Trenton Health Team and allied agencies focus heavily on providing pregnant people with no-cost access to doulas.

Giving birth isn’t easy, no matter who you are or where you live. But for people of color living in Trenton, having a baby can be more challenging — and potentially more dangerous — than it is for other people in other American communities.

Trenton Health Team Senior Program Manager/Child and Maternal Health Videsha Joshi, MPH.

Trenton Health Team Senior Program Manager/Child and Maternal Health Videsha Joshi, MPH, explains just how challenging and how dangerous.

“In New Jersey, the rate of pregnancy-related deaths is 6.6 times higher among Black, non-Hispanic women than it is for white, non-Hispanic women. This disparity is true across the country, and Trenton is no exception,” Joshi said. “Further, in Trenton, Black non-Hispanic people giving birth have a 13.1% rate of preterm birth, compared to an 8.6% rate for people from other racial/ethnic groups. They also are twice as likely as others to have a child with a low birth weight, and they are at greater risk for having an unplanned Cesarean section and for having their newborn admitted to the neonatal intensive care unit because of health problems.”

Meanwhile, Mercer County ranks last among New Jersey’s 21 counties in terms of the percentage of pregnant people who start receiving care in the first trimester, when medical attention can prevent health problems or identify and manage issues at an early stage, Joshi added. One reason for this low rate is that some pregnant people have arrived recently from other countries, and perhaps weren’t able to receive care during their migration or, even if they reached Trenton before becoming pregnant or early in their pregnancy, were not familiar with how to access care locally or faced language-related or other practical barriers. “In 2020, more than half of all women giving birth in Trenton — 53% — had come to America from another country, in many cases quite recently,” she explained.

And while the need to make childbirth safer for people of color is a national imperative, it is particularly important in Trenton, where 58% of all children born in 2020 were of Hispanic heritage and another 34% were non-Hispanic Black infants.

“Clearly, there’s work to be done,” Joshi said. Fortunately, she and her colleagues at Trenton Health Team — a regional health hub working to improve the health and well-being of the greater Trenton community — and several allied agencies are doing that work through the Safer Childbirth Cities initiative. The initiative in Trenton aims to support local obstetric clinic providers in their ability to address the social determinants of health of their patients; bolster the ability of doula programs to emotionally, physically and informationally support pregnant women; and use data analytics to help better understand birth inequities, Joshi explained.

The Difference a Doula Can Make

Deyonna Pope, an advanced perinatal doula and senior case manager for Trenton-based Children’s Futures.

The efforts of Trenton Health Team and allied agencies focus heavily on providing pregnant people with no-cost access to doulas. Deyonna Pope, an advanced perinatal doula and senior case manager for Trenton-based Children’s Futures, said that while many expectant parents are unfamiliar with doulas, they soon come to appreciate the wide range of services a doula provides.

“A doula is a person who has been trained in providing practical and emotional support to a client throughout pregnancy, labor and delivery, and the postpartum period. That support extends to the client’s newborn child and, as needed and requested, to the client’s partner or family,” explained Pope, who has served as a doula for many years and who benefitted from the services of a doula herself when she was pregnant and following delivery.

Doulas from Children’s Futures, a nonprofit organization working with Trenton Health Team on the Safer Childbirth Cities initiative, will do everything from attending a prenatal care visit with a client to providing breastfeeding information following delivery or holding a fussing infant so its mother can get some sleep.

“It really depends on the client’s needs,” Pope said, explaining that doulas work to help clients advocate for themselves and to connect them with the information and resources they need.

Want to learn more about how doulas can help during pregnancy, labor and delivery, and beyond? Tune into the NJ.com Facebook page at 1 p.m. Nov. 16 for a group discussion on an innovative program to help expectant and new parents and their babies in Mercer County’s communities of color. Presented by Trenton Health Team.

And while the doula’s role can begin at the start of pregnancy and continue through the first several months of a newborn’s life, the support offered to a client during labor and delivery is a key component of a doula’s work.

Julie Blumenfeld, DNP, CNM, FACNM, FAAN.

Julie Blumenfeld, DNP, CNM, FACNM, FAAN, said that she and her midwife colleagues “appreciate when doulas are present during labor and delivery supporting the birthing person and centering their needs. Our philosophies of care are well aligned.” Dr. Blumenfeld, who practices as a midwife at Capital Health, another partner in the Safer Childbirth Cities initiative, explained that while obstetricians and midwives sometimes need to attend to multiple patients, a doula remains with the birthing person throughout the labor and delivery process. Knowing that one of her patients is receiving that constant support is very welcome, noted Dr. Blumenfeld, who serves as director of the Nurse-Midwifery & Dual Women’s Health/Nurse-Midwifery programs at Rutgers University – Newark. Beyond providing emotional support, doulas can help their clients better understand their options regarding pain relief, birthing positions, and other aspects of labor and delivery, she added.

Whether at a prenatal appointment, in the labor and delivery suite at the hospital, in the client’s home, or at a newborn visit to the pediatrician, the doula’s job is “to stand in the gap” and help clients obtain needed information, services and resources, Pope said.

And by filling that gap, doulas can help improve health outcomes in ways large and small, such as by helping a client ask questions at a clinic visit or remember guidance about taking a medication, by noticing when an infant may have a health problem or when a new mother may have indications of postpartum depression, Joshi added.

Doulas are equally adept at working with entire families — while always respecting the roles of partners and others — and with clients who may not have relatives or other support people, Pope said.

Welcome Improvements, But More Progress Needed

In 2018, New Jersey ranked 47^th among the nation’s states and territories in terms of maternal mortality. Today, the state’s ranking has improved to 29^th, Joshi noted. She credited that progress to a variety of causes, from the Nurture NJ initiative launched by the state’s First Lady, Tammy Snyder Murphy, to the passage of legislation championed by Gov. Phil Murphy, and programs such as Safer Childbirth Cities.

At the same time, Joshi said, further progress is needed, and ultimately will be achieved one person and one family at a time. “The doulas of Children’s Futures are available to help pregnant people, their families and their children at no cost. For their own health and well-being, and for that of our community, I urge all people who are pregnant or who are preparing for pregnancy to contact Deyonna Pope at 609-695-1977 to receive doula services throughout their pregnancy.”

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Future articles in this series will take an in-depth look at the role of doulas, share the story of a Trenton woman who benefitted from the services of a doula, and highlight how women can access various birth control options following delivery.

To learn more about the Safer Childbirth Cities initiative, contact the Trenton Health Team at 609-256-4555 or visit trentonhealthteam.org.