TRENTON – The New Jersey Department of Health (NJDOH) released its annual New Jersey Hospital Maternity Care Report Card Tuesday, which showed cesarean delivery rates have continued to drop for all delivery hospitalizations.
The report card outlines key metrics on maternal health care in 2020, using data provided by licensed birthing general acute care hospitals in New Jersey, so that individuals can make informed comparisons. The annual report card includes interactive data on hospital-specific and statewide surgical births, complication rates and severe maternal birth complications.
“When we launched the Nurture NJ Maternal and Infant Health Strategic Plan in 2021, one of our many recommendations was to lower the cesarean delivery rate for mothers in our state. It is promising to see this statistic improve and we are incredibly hopeful it is a harbinger of overall improvement in our maternal health outcomes,” said First Lady Tammy Murphy. “There is still much more to do to ensure that every mother in New Jersey enjoys a healthy and safe pregnancy and birth, particularly our Black and Hispanic mothers, but I remain committed to continuing this work with our dedicated health care professionals and building on these best practices so that we can achieve our goal of making New Jersey the safest, most equitable place in the nation to deliver and raise a baby.”
The U.S. Department of Health and Human Services Healthy People 2030 national target for surgical/cesarean birth rates among women considered at low risk for birth complications was 23.6 per 100 live births, and New Jersey’s 2020 rate was near that target at 25.9 per 100 live births. Seventeen out of 49 New Jersey birthing hospitals met that benchmark, which is an improvement over the last report when only 16 of those hospitals met that benchmark and from 2019, which noted 10 hospitals.
Cesarean delivery rates dropped to 32.9 percent of all delivery hospitalizations, a slight decrease of 1 percent from the 2019 rate. These delivery rates have steadily improved since the release of the first New Jersey Report Card of Hospital Maternity Card, which showed cesarean delivery rates at 35.7 percent.
However, cesarean deliveries still have higher rates of complications compared to vaginal deliveries per 1,000 delivery hospitalizations, including: obstetric hemorrhage (123.8 cesarean versus 16.1 vaginal); post-admission infections (25.1 cesarean versus 14.5 vaginal); and Severe Maternal Morbidity (SMM) with transfusion (41.6 cesarean versus 11.7 vaginal).
Disparities continue to persist among Black and Hispanic mothers in New Jersey. Non-Hispanic Black mothers had the highest rate of obstetric hemorrhage with 62.6 per 1,000 delivery hospitalizations, followed by Hispanic mothers with a rate of 52.5 per 1,000. Non-Hispanic Black mothers also had the highest rate of SMM with transfusion at a rate of 36.5 per 1,000 delivery hospitalizations, up from 35.6 in 2019, followed by Hispanic mothers at 25.2 per 1,000. The rate of SMM with transfusion for Non-Hispanic White mothers was the lowest at 15.7 per 1,000 delivery hospitalizations.
“Each report card provides invaluable data that will help guide us in our goal to make New Jersey the safest and most equitable place to have a baby,” said Health Commissioner Judith Persichilli. “We will also use this data to further inform our efforts to continue to reduce inequities in maternal health care.”
As 2020 was the first year of the COVID-19 pandemic, the report also shows the impact of the virus. Of all hospital deliveries in 2020, 3.8 percent of delivering mothers experienced COVID-19 infections at some point during their pregnancy. Among mothers with COVID-19 infection, more than half (60.1 percent) were positive at the time of delivery (within two days of admission for delivery) as opposed to positive any other time during pregnancy.
Key among the report’s recommendations, in collaboration with the New Jersey Maternal Care Quality Collaborative (NJMCQC), is the need for further research to understand the mechanisms that contribute to obstetric hemorrhage, third- and fourth-degree perineal lacerations that occur during vaginal births, post-admission infection, and SMM at the hospital level. Also cited was the need to study and identify modifiable risk factors that contribute to cesarean deliveries.
In January 2021, First Lady Tammy Murphy unveiled the Nurture NJ Maternal and Infant Health Strategic Plan, with the goal of reducing New Jersey’s maternal mortality by 50 percent over five years and eliminating racial disparities in birth outcomes.
Governor Murphy has signed 43 pieces of maternal and infant health legislation, including measures focusing on family planning, Medicaid, health equity, substance use disorder, and data innovation. Legislation established the report card, the NJMCQC, New Jersey Maternal Mortality Review Committee (NJMMRC), and the New Jersey Maternal Data Center (NJMDC).
This report card is part of the larger NJMDC in NJDOH, which is responsible for developing data collection and submission protocols for maternal mortality, morbidity, and racial and ethnic disparity data from relevant health care facilities in the state; conducting data analyses and developing reports and a public-facing dashboard on the state of maternal health; and disseminating information and analyses to the NJMCQC, the NJMMRC, other relevant stakeholders, and the public.
The ultimate goal of the New Jersey Maternal Data Center is to provide timely data on the state of maternal health in a transparent manner to the public and to help drive changes to improve maternal health outcomes.
To view previous Maternal Health Hospital Report Cards, click here.