NEW JERSEY — New Jersey has significantly reduced the rate of low-risk Cesarean deliveries, moving closer to the federal target set by the U.S. Department of Health and Human Services, according to new research from the Rutgers School of Public Health.
The study found New Jersey’s low-risk Cesarean birth rate dropped by 10% — from 30.2% in 2016 to 27.3% in 2023 — bringing the state nearer to the national goal of 23.6%. Among Medicaid patients, where many Nurture NJ policies have been concentrated, the rate fell even more dramatically, from 24.8% in 2018 to 21.3% in 2023.
Researchers credited the state’s progress to the Nurture NJ initiative, which includes policy and programmatic efforts aimed at improving maternal health outcomes. New Jersey showed the largest decline in unnecessary Cesarean procedures among states with high rates of such births.
“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 at the Rutgers School of Public Health.
Cesarean births account for nearly one-third of all deliveries in the U.S., with even higher rates among Black, non-Hispanic women. While Cesareans are sometimes medically necessary, the procedure carries risks and can lead to negative health impacts.
Despite the improvements, racial disparities in low-risk Cesarean birth rates remain in New Jersey, according to the report.
Governor Phil Murphy’s Nurture NJ initiative has advanced efforts to reduce unnecessary surgical births through measures such as limiting insurance payments for non-medically indicated early elective deliveries, establishing a Medicaid doula benefit, and equalizing Medicaid payments for perinatal health care providers. The state’s strategic plan also recommends comprehensive informed consent procedures for maternity patients.
“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 findings are detailed in a new policy brief, Progress in Reducing the Low-Risk Cesarean Birth Rate in New Jersey: An Examination of Data from 2016–2023. The study is part of a broader evaluation of Nurture NJ led by Leslie M. Kantor, professor and chair of the Department of Urban-Global Public Health at Rutgers.
