(Illustration by The Jersey Bee)
This story was co-reported with The Jersey Bee as part of our joint Equitable Cities Reporting Fellowship, examining segregation in Newark and Essex County, New Jersey.
Cherelle Lloyd had just given birth to her son two weeks prior when she sensed something was wrong. With her hands and breasts in pain, she decided she needed outside help.
“It was hurting every time that [my son] latched,” says Lloyd. “It was just miserable.”
Finding resources near where she lived in East Orange, N.J. wasn’t easy. When she searched for support, all the in-person lactation consultants covered by her insurance were more than fifty miles away.
That’s when her doula connected her to Perinatal Health Equity Initiative (PHEI), a Black maternal health nonprofit offering community services in New Jersey.
“From [then], we’ve been locked in,” says Lloyd. Over the past two years, she’s received various pre and postpartum services, like lactation advice and free food boxes delivered. However, Lloyd says the most valuable thing PHEI has gifted her is a local network of other Black moms.
Now a mother of two, Lloyd is part of PHEI’s 700-member Sistahs Who Breastfeed Facebook group, where moms and lactation coaches in New Jersey connect online and in person to share resources. She also donates surplus human milk to the organization’s community milk bank for infants that need human milk – both resources she wishes more mothers in the state knew about.
In New Jersey, Black women are nearly seven times more likely to die than white women from a pregnancy-related death, with more than 90% of all pregnancy-related deaths being preventable, according to New Jersey Department of Health data. A 2024 report by the National Bureau of Economic Research also showed that Black women were 25% more likely to have an unscheduled C-section than white mothers in New Jersey – dangerous procedures that experts say are often unnecessary and performed due to financial incentives.
And while New Jersey’s overall maternal mortality rate has declined, the death rate facing Black mothers and infants has worsened.
“That means care improves for who?” says Nastassia Harris, executive director of Perinatal Health Equity Initiative, about the lack of progress on Black maternal health outcomes.
PHEI is one of several initiatives seeking to eliminate Black maternal health disparities in New Jersey. Since its founding in 2018, PHEI has supported more than 1,000 families through education, community engagement, direct clinical support, and advocacy across New Jersey, primarily in Essex County.
Now, Harris is preparing to build what she describes as the state’s first Black maternal health center, designed by and for Black women, in East Orange.
“What we are building is a safe place for Black women to come to receive their care,” says Harris, a nurse and mother of four. “Where they know they’re not going to be judged, they’re not going to have cases where they’re not being listened to.”
The center will open in phases, starting with its programs and classes available in February 2025 and a licensed health clinic set to open later in the year.
Limited data on Black maternal health in New Jersey
Lack of real-time, county-level data makes supporting Black mothers difficult, Harris says.
The New Jersey Health Department’s latest maternal mortality report was released in 2022 and relied on data from pregnancy-associated deaths from 2016 to 2018.
The report also focuses on statewide or regional data, not county-level information, Harris says, making it challenging to identify which interventions may be effective in different counties throughout the state.
Dalya Ewais, a spokesperson for the New Jersey Department of Health, says that a new maternal mortality report is “in progress” but did not provide an exact timeline.
National data offers more recent information that could be useful for health advocates and providers. The 2024 March of Dimes report shows that Black infants are being born prematurely at nearly twice the rate of white infants. Harris says stress remains one of the leading causes of preterm births and can affect the health of the mother and infant.
In the absence of timely state data, she and her team are gathering community-level research on the stressors facing Black women in New Jersey. Income inequality, lack of housing, and food insecurity are at the top of the list, according to Harris.
“Where we see the biggest gap is these income extremes in our state, where either you make so little that you qualify for anything, and then you make a little bit above that, and you qualify for nothing,” says Harris. “We don’t really have a good middle ground.”
This community-based research by PHEI is designed to provide a deeper understanding of Black women’s access to healthcare in New Jersey, given the gulf between existing data and PHEI’s clients’ stories.
The 2024 March of Dimes report suggests that 20 out of 21 New Jersey counties are considered “full access” for maternity care and suggests that women in New Jersey travel an average of 11 minutes to their nearest birthing hospital.
But Patrice Denman, a Roselle resident, says she traveled about an hour and a half from New Jersey to Brooklyn, New York, each week for her prenatal care.
“[My OB-GYN] was Black, so that, for me, felt very safe. Before I even got pregnant. I made sure that I found a doctor that understood me,” says Denman.
She planned to deliver her baby at a birthing center in Brooklyn near her OB-GYN, but several months into her pregnancy, she developed preeclampsia, a serious blood condition that disproportionately impacts Black women. One week shy of her due date and with dangerously high blood pressure, Denman changed her birthing plan and gave birth to her now ten-month-old daughter at a hospital in New York City.
Shortly after giving birth, her friend invited her to an upcoming Sistahs Who Breastfeed meeting hosted by PHEI. Since then, Denman says, she found “[her] tribe.”
“A lot of society will tell you that if you’re not doing it alone, then you’re not doing it. That’s [bullshit] because nobody can do it alone,” says Denman. “Everybody needs a village.”
East Orange resident Cherelle Lloyd didn’t give birth in New Jersey, either. She traveled nearly an hour to Staten Island for her doctor, a Black Jamaican woman. “That was really important to me,” she says.
Lloyd says she tried to access maternal healthcare locally several years ago due to an ectopic pregnancy, but felt she wasn’t given adequate information during her visit about why she might be in pain or details about her surgical procedure.
While Lloyd has since been able to find providers for her children in New Jersey, she says she still hasn’t been able to find doctors for herself in-state.
A statewide push to reduce Black maternal mortality
In 2019, New Jersey First Lady Tammy Murphy launched the Nurture NJ campaign, a statewide initiative to reduce infant and maternal mortality across the state. Since then, New Jersey has made several policy changes to improve maternal health, including expanding Medicaid coverage for birthing parents one year after delivery and adding doula care as a benefit for NJ FamilyCare members.
The campaign has also received generous state and federal backing. Central to Murphy’s Nurture NJ campaign is a maternal health center in Trenton that was awarded $25 million in federal funds for facility construction in March 2024.
However, advocates have flagged that the campaign’s efforts have yet to be actualized, partly because its policies and programs have not been thoroughly evaluated. Lisa Asare, CEO of the NJ Maternal and Infant Health Innovation Authority, said they will be working with Rutgers School of Health on its evaluation plans.
“We can’t really measure in any way that any of the money that’s being spent, any of the new programming that’s come out, is actually impacting Black women because we don’t have any data to demonstrate that,” says Harris of Perinatal Health Equity Initiative.
While still in its early stages, Family Connects NJ is one state initiative that has shown promising potential for impact, according to the sources we interviewed. Family Connects is a free nurse visitation program that connects parents with a nurse visit during the first two weeks after a child’s birth. Visits are also available to adoptive or foster parents and families who have experienced a stillbirth or loss of their newborn.
Since the program launched in January 2024, nurses have conducted over 600 visits with families in Essex County. About 17% of those visits resulted in follow-up trips to the emergency room for the parent or infant, says Siomara Diaz, nursing director of Family Connects.
“It’s definitely life-saving work that we are doing,” says Diaz. Family Connects plans to expand its services in northern New Jersey to Bergen County, Hudson County, Passaic County, and Sussex County, according to Diaz.
“What we constantly forget is that maternal and child health is really the litmus test for the community,” says Mariekarl Vilceus-Talty, CEO of the Partnership for Maternal and Child Health of Northern New Jersey.
Vicelus-Talty and Abegail Baffour, a home nurse visitor with Family Connects, say they have sent too many moms back to the emergency departments.
“I’m talking about moms that had a perfect, normal pregnancy, no preeclampsia, no complication whatsoever,” says Baffour. She adds that her clients often share symptoms like high blood pressure, swelling, and other postpartum warning signs during her home visits.
Tiara Smith, an East Orange mom who gave birth to her son last December, notes these are all symptoms she’s keeping an eye on thanks to what she learned from PHEI.
During her lactation support classes last year, Smith learned lactation techniques, when to introduce certain foods, and what the first few years may look like as a new mom. She says she wants to make the right decisions for herself and her son.
“The baby comes at nine months…and then we’re here for a lifetime together,” says Smith. “You want to make the right choices…so that they could grow to be a healthy baby.”