DOH Exempts Doulas from Hospital Delivery Support Person Limits

TRENTON – Recognizing the role of doulas as an essential part of an expectant mother’s care team, the New Jersey Department of Health (DOH) June 29 issued an executive directive exempting doulas from limits on support persons throughout a woman’s hospital stay during the COVID-19 pandemic.
According to a release, as COVID-19 hospitalizations decrease statewide, there is now sufficient Personal Protective Equipment (PPE) and testing capacity to allow doulas to resume their duties during labor and delivery as a member of a pregnant woman’s health care team.
Doulas support healthy pregnancies by providing culturally appropriate, social and emotional support to pregnant women throughout the prenatal period, labor and delivery, as well as the postpartum period. Research demonstrates that support from a doula is associated with lower caesarian section rates, fewer obstetric interventions, fewer complications, and the improved health of mothers and babies after delivery.
Under the directive, hospitals are required to allow at least one designated support person to be with the expectant mother during her hospital stay – the patient’s spouse, partner, sibling or another person she chooses. Doulas will no longer be counted toward this limit and can accompany the designated support person for the mother’s hospital stay. Hospitals may allow additional support individuals if the hospital has determined that sufficient personal protective equipment (PPE) is available.
“New Jersey currently has among the worst maternal and infant mortality disparities in the country,” stated First Lady Tammy Murphy, who has led the state’s efforts to address maternal and child health. “The culturally responsive care that a community doula can provide to a mother has shown to greatly improve birth outcomes for mothers and babies of color. Doulas are a critical part of Nurture NJ’s efforts to make New Jersey the safest place in the nation to deliver a baby.”
Maternal and infant health has been a key focus for the Murphy administration. First Lady Murphy has made maternal and infant health a priority through her statewide Nurture NJ campaign, a multi-pronged, multi-agency initiative focused on reducing maternal and infant mortality and morbidity, and ensuring equitable maternal and infant care among women and children of all races and ethnicities.
New Jersey ranks 47th in the nation for maternal deaths, according to America’s Health Rankings. Additionally, black women and babies experience disproportionate maternal and infant health outcomes. A black woman is five times more likely than a white woman to die from pregnancy-related complications, and a black baby is three times more likely than a white baby to die before their first birthday.
As part of this effort, the state’s Department of Health has increased outreach, support and services to women of color to improve health and birth outcomes. Doulas have long been engaged to support women during pregnancy, delivery and post-partum care.
In September 2019, First Lady Murphy and the DOH announced a $10.5 million grant over five years from the Health Resources and Services Administration to advance health equity and address disparities in maternal health outcomes. This funding supports the work of the New Jersey Maternity Care Quality Collaborative, a statutorily mandated multidisciplinary team of stakeholders who will oversee the transformation of maternal healthcare in the state. 
On Maternal Health Awareness Day, Jan. 23, First Lady Murphy announced the partnership between the Murphy administration, the Nicholson Foundation, and the Community Health Acceleration Partnership to develop a comprehensive, statewide maternal and infant health strategic plan as part of Nurture NJ. The strategic plan, which will build on the administration’s progress over the past two years, aims to reduce New Jersey’s maternal mortality rate by 50 percent and eliminate racial disparities in birth outcomes.
The strategic plan will include a statewide assessment of existing infrastructure to support improvements in maternal and infant health. The plan will examine community investments, clinical and social factors, private sector engagement, and policy development. Work will be further informed by speaking directly to women across the state; interviewing and engaging the Administration’s 18 collaborating agencies; working with leading state health providers; and talking to a range of community-based organizations, including our community doula programs. In parallel, the plan will incorporate national best practices for improving maternal and infant health and eliminating disparities, in order to identify areas where state activities could better align with scientific evidence.
To set up Nurture NJ for long-term success, the comprehensive plan will include specific, actionable recommendations for all stakeholders, and a concrete implementation plan for ensuring equity for mothers, babies, and their families.
Under the DOH’s Healthy Women, Healthy Families initiative, the department awarded $4.7 million to community-based agencies in 2018 to improve black infant, maternal mortality, including $450,000 for doula training in municipalities with high black infant mortality.
To date, the state has trained 79 doulas using the Uzazi Village model, which focuses on training doulas to serve women of color in their own communities. Through doula pilot programs, doulas have assisted or are assisting 349 women, resulting in 252 births to date.