By Jill Wodnick
IÃ¢â‚¬â„¢ve read about a bridge in India that is made from living tree roots woven together by residents who spend a lifetime crafting this safety net. This network of living root bridges has been sustained because of deliberate wisdom and intergenerational listening.
May we all learn from this lesson shared in Meghalaya, India, and from the voices of women and families, as New JerseyÃ¢â‚¬â„¢s legislators in Trenton focus on maternal health. Amidst strong pieces of legislation, there is one that holds the hope of wisdom and listening, it establishes a shared-decision making tool in the stateÃ¢â‚¬â„¢s maternity care facilities.
A4936 and S3375 are helpful pieces of legislation that may be part of this wisdom. These companion bills articulate the role of Ã¢â‚¬Ëœshared-decision makingÃ¢â‚¬â„¢ as a seminal part of maternal health services that posit family-centered maternity care. This bill would require the commissioner of health to develop a decision making tool for use by mothers and health-care providers at every birthing center and hospital that provides inpatient maternity services.
This shared decision-making tool would improve knowledge of the benefits and risks of, and best practice standards for, the provision of maternity care. It would also increase collaboration between a mother and the patientÃ¢â‚¬â„¢s health-care provider, assist the patient in making informed decisions about the maternity care they receive; and encourage a mother to create a birth plan, listing her preferences during the stages of labor.
The significance of this bill canÃ¢â‚¬â„¢t be overlooked. This past year, IÃ¢â‚¬â„¢ve been honored to write about when the #meToo movement meets maternity care, documenting with other writers the role of obstetrical violence, lack of consent and lack of access to safe and healthy birth practices that desperately need to change. We continue to know that birth is a critical window of the social, emotional and physical wellbeing, and how a woman experiences the care she receives impacts her for a lifetime.
In New Jersey, like the rest of the country, maternal death and near misses have been on the rise over the last 18 years. We are now at a watershed moment where media outlets and policy makers are making visible a broken system of maternity care where nationally 60 percent of these deaths could have been prevented.
Beyond the trauma of maternal loss, New Jersey suffers from dangerous levels of low risk cesarean births and lack of consistent access to vaginal birth after cesarean. The real focus in New Jersey is centered on stronger transparency and transformation of how maternity care is delivered by healthcare providers. There is so much work to be done, and while those system changes are occurring, there is direct consumer impact by focusing on shared-decision making.
The living bridge in India has survived and thrived because of deliberate teachings and lessons learned. New Jersey can take a step forward on improving maternity care by listening to women and families who too often are blamed, shamed and met with bias in clinical facilities.
When the New York Times published an opinion piece this month on obstetrical violence in Latin America, New Jersey parents piped up on social media that this was occurring here, too. Shared decision making will not be impactful without redesigning how maternity care is delivered. But it can be an important tool to deepen ways to put women and families at the center of improving maternal health as clinicians and systems do concurrent work.
Jill Wodnick, M.A., LCCE, is a perinatal educator and doula mentor at Montclair State University. She has been part of the United Nations Commission on the Status of WomenÃ¢â‚¬â„¢s Global Prenatal Initiative, as well as local and statewide programs for the health and wellbeing of childbearing families, infants, and communities.