TRENTON – Coinciding with the recognition of National Preeclampsia Awareness Month and Maternal Mental Health Awareness Month, and as part of the Phase II rollout of the Family Connects NJ initiative – the state’s Universal Nurse Home Visitation program – the New Jersey Department of Children and Families (DCF) has issued a Request for Proposal to expand the program to an additional six counties – Somerset, Sussex, Passaic, Hudson, Bergen, and Ocean – beginning January 2025.

The Family Connects NJ program, which launched earlier this year, offers a free nurse home visit to all families within two weeks of the arrival of a newborn, whether through birth, adoption, resource or kinship placement, and for families that have experienced the tragedy of stillbirth or neonatal loss.

Nurse home visits through Family Connects NJ have been available in Cumberland, Gloucester, Mercer, Middlesex, and Essex Counties since January 2024, and after expanding into the six new counties in January 2025, Family Connects NJ will continue to expand incrementally on an annual basis, until fully implemented in every part of the state.

“When we officially launched the Family Connects NJ program earlier this year, we did so with the understanding that the standard postpartum evaluation, which happens six weeks after delivery, was unacceptable and potentially dangerous. There can be no question that mothers need a wide range of support within this extremely sensitive timeframe to ensure their own personal health is assessed and that their families are thriving,” said First Lady Tammy Murphy. “Family Connects NJ ensures New Jersey families receive the critical support needed to prevent complications within the first two weeks of delivery and, by visiting families in their homes, barriers to getting support and relief are eliminated.

“I am proud of what we have been able to accomplish in the five counties launched earlier this year, and I look forward to expanding this incredibly common sense – but groundbreaking – program into more counties beginning in 2025. The fact that nurses are both identifying physical challenges early and ensuring critical follow-ups when merited as well as providing support and resources beyond a health check means we are actually building a stronger and more equitable system and state. To this end, we will continue to build a maternal health framework for our state that puts mothers, babies, and families first, making New Jersey the safest and most equitable state in the nation to deliver and raise a baby,” continued the First Lady.

Launched by First Lady Tammy Murphy in 2019, Nurture NJ is the statewide initiative committed to reducing the maternal and infant mortality crisis in New Jersey and ensuring equitable care among women and infants of all races and ethnicities. Family Connects NJ addresses two critical recommendations in the First Lady’s Nurture NJ Maternal and Infant Health Strategic Plan:

• Recommendation 5.19: The Department of Children and Families should continue to expand and universally offer evidence-based home visiting programs with focus on those models proven to reduce maternal and infant mortality.
• Recommendation 7.16: State departments and agencies and health care providers should incorporate community-based perinatal health workers in an interdisciplinary care approach to support pregnant women and caregivers into the postnatal period.

“Postpartum parents are often so focused on the health and needs of their new baby that they may be unaware of or overlook their own medical needs, which can put them at risk of serious medical complications, particularly with conditions like preeclampsia,” said NJ DCF Commissioner Christine Norbut Beyer. “This expansion will help us continue to reach and support new parents in New Jersey within two weeks of birth, an often tiring, confusing and emotionally charged time, and to improve maternal and infant health outcomes.”

According to the Preeclampsia Foundation, preeclampsia is defined as a pregnancy-related high blood pressure complication accompanied by high levels of protein in the urine or other problems. It is estimated that about 1 in 25 pregnancies in the United States is affected by preeclampsia. In New Jersey, preeclampsia was found to be one of the most common underlying causes for pregnancy-related death in the early postpartum period (42 days after pregnancy) per the most recent Maternal Mortality Report issued by the state’s Department of Health.

Some of the major risk factors for developing preeclampsia include age, a first pregnancy, obesity, a family history of preeclampsia, diabetes, high blood pressure, kidney disease, an autoimmune disease, or having twins or triplets, among others.

While some women do not experience any symptoms of preeclampsia, it can impact the health of the mom and infant before, during and even after pregnancy, often referred to as postpartum preeclampsia, which can occur within 48 hours or up to six weeks after birth. Among the most impacted parents are Black women whose risk of dying from these high blood pressure complications is up to seven times greater than that of white individuals, and who are over three times more likely to die than white women in pregnancy and during the postpartum period.

When assessing medical conditions at the time of delivery, 9.9% of New Jersey mothers in 2022 had chronic/gestational hypertension, both of which are an increase from 8.2% in 2016. When assessed by race and ethnicity, prevalence was highest among Black, non-Hispanic women (16.4%).

“As of 5/9/24, preliminary data shows 14% of Family Connects NJ visits result in a referral of the mother or infant to the emergency department or to their medical provider,” said Dr. Sanjna Shah, Medical Advisor to the Family Connects NJ Statewide Initiative. “In fact, more than 1 in 10 visits required immediate medical care, and the nurse was able to identify and get the family access to that care, potentially saving the mother’s life.”

“With statistics showing that more than 80% of maternal mortality is actually preventable, and 60% of preeclampsia cases are too, our Family Connects NJ nurses continue to be fundamental in ensuring that new parents and their infants receive a full health assessment, are connected to an in-community primary medical provider or medical home, and, as in these cases involving immediate health issues that could not wait until the next scheduled visit with the obstetrician, that mothers and their babies get the necessary and lifesaving medical attention they need,” said Sanford Starr, Assistant Commissioner of the Division of Family and Community Partnerships, the division that administers the state’s Universal Nurse Home Visitation Program. “Supporting and ensuring all parents and babies get a healthy start in life together is our number one goal and expanding the program across the state will help us reach that goal.”

Research on the Family Connects model has also found 44% lower rates of investigation of child maltreatment by child protective services within the first year, in addition to 50% fewer emergency department visits by families who were enrolled in Family Connects NJ within the first year of the baby’s life.  Family Connects parents were also 15% more likely to report greater connections to their community, and 28% less likely to report unmanaged, postpartum clinical anxiety. And families enrolled in the program were more likely to complete all postpartum and postnatal health and wellness checks with their OB/GYNs and pediatricians.

“Preeclampsia is one of the most serious conditions associated with pregnancy, and it can also present postpartum. It is critical that people learn its signs and symptoms to get treated immediately,” said New Jersey Health Commissioner Kaitlan Baston, M.D. “The period immediately following birth is an extremely vulnerable time for both mother and baby. Evidence-based interventions like home visiting can improve health outcomes by addressing both medical concerns and social determinants of health. The New Jersey Department of Health is proud to support the expansion of Family Connects NJ in hopes of decreasing maternal mortality and advancing health equity.”

Perinatal mood disorders are the most common mental health concern for birthing individuals, and these can occur at any time during the perinatal period. According to 2021 data from the New Jersey Pregnancy Risk Assessment (PRAMS), 7.9% of birthing people reported depression before pregnancy, 7.6% reported depression during pregnancy, and 10.6% reported postpartum depressive symptoms. Within the last three years, the rates of postpartum depressive symptoms have remained relatively stable, with rates higher among non-Hispanic Asian women (26.6%) and non-Hispanic Black women (14.9%) in 2021. Taken together, perinatal mood disorders are disproportionately affecting minority mothers and low-income mothers within New Jersey, highlighting the need for services and support for women of diverse backgrounds.

“We are providing ALL parents, access to concrete supports during a momentous time in their lives to ensure their emotional, mental health and physical wellbeing, whether that is through the Family Connects NJ and its Community Alignment Specialists that connect families to programs and services in the community, or the Maternal Success Toolkit the department recently completed,” added Commissioner Beyer.  “We all have a role to play to help expectant, pregnant and new moms succeed by sharing information, connections, and leveraging community to support and rally around families with newborns.”

To learn more about Family Connects NJ / Universal Nurse Home Visitation program, click here or visit https://www.familyconnectsnj.org/.

In 2022, DCF partnered with ChiByDesign, a Chicago-based human-centered design firm steeped in antiracism work, to engage lived experts and stakeholders to support families before they reach crisis points. From that engagement, the Maternal Success Toolkit was created, which represents a collaboration of thoughts and ideas from the community and system leaders, resulting in a resource that offers crucial connections to meaningful supports and services, as defined by the women who need them most.

To learn more about the Maternal Success Toolkit, click here or visit https://www.nj.gov/dcf/documents/PFPC-Maternal-Success-Kit.pdf.