- [Narrator] Funding for this edition of Think Tank with Steve Adubato has been provided by The Russell Berrie Foundation.

Making a difference.

The New Jersey Economic Development Authority.

The Turrell Fund, supporting Reimagine Childcare.

RWJBarnabas Health.

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Kean University.

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The Healthcare Foundation of New Jersey.

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And by Robert Wood Johnson Foundation.

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[MOTIVATIONAL MUSIC] - Hi everyone, I'm Steve Adubato.

You recognize the leader we have on camera.

She's the First Lady of the great state of New Jersey, Tammy Murphy.

Good to see you Tammy.

- And you Steve, thanks for having me.

- As always.

In just a little bit we're gonna throw to a panel discussion as part of our Russ Berrie Making a Difference group of honorees that are making a real difference, leaders who are involved in maternal and women's health.

But the First Lady has joined us many times to talk about this.

If you could tell us exactly where we are with the Nurture NJ Initiative, what it is, remind people, we'll put the website up, because there's, you've been making a tremendous amount of progress with your colleagues on this.

- Thank you.

So Nurture NJ is an initiative that we unveiled in 2019.

- Right.

- The purpose of Nurture NJ is, is not only to raise awareness of the problems that we have here in New Jersey with respect to infant maternal health.

For those who do not know, we are 47th in the country in terms of maternal mortality rates.

And when you dig down you find that if you are a person of color, your chances of either dying or having challenges from maternity related complications are significantly greater.

In fact, they are over six times greater than that of a white woman.

And for a baby of color, a black baby is three times more likely than a white baby to die before his or her first birthday.

So one cannot, being a mom as I am, one cannot possibly know those statistics and not feel a need to fix our challenges here in New Jersey.

Nurture NJ, the, the goal of Nurture NJ is to both reduce our maternal mortality rates by 50% over five years, and to eliminate the inequities in birth outcomes.

And we are, we're pretty determined to, to address both of those.

We have, you know I'm not sure how in depth you want me to go but we, we have been working at this we've got thousands of stakeholders with us these days.

We have, we host everything from, we just, we hosted our fifth annual black infant and maternal health summit just in, just in November.

We also, throughout the year we've re-upped our family festival series.

We have now had 16 family festivals which is essentially a combination of a, of a job fair, and a block party where we bring all sorts of resources under one roof.

So we've started those again.

We continue with an ask, ask our expert series on social media, and we, you know have interdepartmental meetings.

We're working with the legislation, legislature on a number of policy areas.

So there's a lot going on.

- There's a lot of progress.

And as we continue to have the Nurture NJ website up so people can find out more about the initiative and also how they can access some of the services that you're talking about.

But one of the things that really struck me, and all the times we've had you on, I don't, I don't, I picked this up in the notes in getting ready for today, and I've never asked you this.

Is it true that most of the deaths, most of the maternal deaths disproportionately among black and brown women, absolutely preventable?

- 100%, yes they are preventable.

They are preventable.

So, so we've done a lot of things in New Jersey to address some of these things.

For example, you know we no longer reimburse through Medicaid for early elective C-sections unless there is a medical need.

And I will tell you this is one of my favorite examples as to where you have good people who are trying to do the right thing, but the outcomes are terrible.

If you are a, a doctor and you say I'm gonna donate my time to a very impoverished area and I'm gonna give them, you know the third Friday of every month, then the clinic where they might go is going to naturally say this is great.

We've got this fabulous doctor coming in, so let's just line up all these women to get C-sections so that we can make sure they get the best possible care.

And that's major surgery.

And this mom may go home and either have an infection and not go see the doctor.

She may go home to a home where she has other children and she doesn't rest.

She may go back to work.

So there's all sorts of things that have happened and it's not because either the clinic was trying to do something bad or the doctor was, but it's just, it's just understanding what the needs are of the community.

So that's just a small example.

Another one is, is going into the.

- That's not a small, one second, I'm sorry for interrupting you Tammy.

A, that you know that clearly it's not a small example but also as you said many of those deaths are preventable.

But it takes a totally different approach instead of let's just do a C-section.

- Right, right.

- And sorry I interrupted you, you were gonna bring up another point.

- I was just gonna say a lot of these things are just common sense.

So, you know, if you, we now have a scenario where if a woman presents in an ER room, in the emergency room and they are feeling unwell, they may not look as though they're unwell.

And you could have someone come in with, you know, a broken arm or something.

And if it's obvious, we now require that when a woman presents in the ER, that the, one of the first questions that they are asked is have you delivered a baby in the last year?

That's a, that question can take you to the front of the line.

And that's a very, it's a very simple thing to do.

It's just making sure that people understand the importance of doing things like that.

Tammy, I know that the March of Dimes just released some information which is really important that talks about New Jersey standing out in this regard.

Go ahead.

- Yeah so, so the March of Dimes released their 2022 report card on infant and maternal health.

They go into in-depth analysis across 53 states and territories.

Of the 53 states and territories, 47 declined year on year in the United States.

One remained the same and four states improved.

And thankfully I can tell you that New Jersey is one of the four and we improved across all areas of their study which are, we, we have better outcomes for preterm births.

We have lower cesarean section rates which we were just discussing.

We have lower infant mortality and we have better prenatal care.

So I'm really proud of us.

I know that we're, we are onto something now and you know, we're bucking the trend across the United States so we'll keep at it.

- And, and lemme ask you this Tammy, and the only reason I call the First Lady Tammy is because she asked me to do that several years ago.

I wanna follow up on this.

We, the panelists we have coming up after this, they're all leaders of not-for-profit organizations committed to dealing with the challenges that you've raised right now around maternal and women's health.

What is the role in your view of the not-for-profit community and not-for-profit leaders in this fight?

- Listen, Steve, we have stakeholders across every area in our state.

And it is going to take every single person coming together and working on this space in order for us to have the transformational change that is required.

And that is not-for-profit sector, it's academia, it's our legislators.

It's, it's people like you who are helping us get the word out so that there's awareness.

It's truly, it's, it's everybody.

The not-for-profit sector is there.

Many people in the not-for-profit sector are, are huge allies of ours and have been real change makers.

And we are grateful for every person who shows up and leans in.

But they, they are highly needed.

- Before I let you go, you've been taking a national role with the National Governor's Association and you're a National Governor's chair the initiative on maternal and infant health.

And I know that the governor, and Governor Murphy has been very involved with the National Governor's Association as well.

Could you give us a, a minute on that?

- Sure.

So, so, so Phil is now the chair of the National Governor's Association.

- He sure is.

- His capacity as chair, he has the ability to pursue an initiative for this upcoming year across, across the entire country.

And I as his spouse also have the ability to pursue an initiative.

His is, is tackling youth mental health.

Mine is addressing obviously the disparities in infant maternal health.

We have already had one convening.

We had it in Salt Lake City.

We have another one that's coming up in short order in January.

And essentially what we are doing is we are working across party lines.

We are bringing in experts, we're bringing in people to give lived experiences and share those experiences so that legislators and governors and their staff can hear.

We're sharing best practices, we are learning from one another.

And at the end of the year our goal, Phil and I are going to release a playbook that will enable any other state to see what best practices we've gleaned over the course of the year.

We will share the work we've done.

Phil's signed 43 pieces of legislature in this area since he came into office.

So there's a lot that we can share and there's a lot we're gonna learn.

And thank goodness moms and babies are beloved by all.

So it doesn't matter what side, what party you're in or anything else.

Everybody is leaning in on both of these topics.

- You've been listening to and watching the First Lady of the great state of New Jersey, Tammy Murphy, fighting this fight with a lot of other colleagues because it's just too important to ignore and it has nothing to do with politics.

I'm off my soapbox.

Thank you Tammy Murphy, First Lady of of New Jersey.

We appreciate it.

- Thanks Steve, thanks so much.

- You got it.

Stay with us, we'll be right back.

To watch more Think Tank with Steve Adubato, find us online and follow us on social media.

- For those watching this entire program you just heard from the First Lady of the great state of New Jersey Tammy Murphy, talking about maternal and infant health.

We expand that conversation to a issue of women's health and the choices they have, the choices they do not have, and what needs to be done.

We're joined by leaders, advocates in the field of women's health.

We're joined by Mariekarl Vilceus-Talty, who is President and CEO of the Partnership for Maternal and Child Health of Northern New Jersey.

And Bridget Cutler is Founder and Co-executive Director of Moms Helping Moms.

Fraidy Reiss is the founder and Executive Director of Unchained at Last.

I'm wanna thank all of you for joining us.

Let's talk about this, Mariekarl, the disparities that the First Lady talked about, largely based on race, having to do with maternal health.

Talk about how serious the problem is and why we are not making more progress?

- Well, we know that the issue is abhorrent.

It is so difficult to make progress, because it is so multifactorial.

The issues are really upstream.

We cannot start with when you go to the hospital the episodic care.

We have to start with upstream issues.

So at the partnership, we attempt to make an impact every day with the programs that we have.

We have over 30 programs that are in the community.

We reach approximately 40,000 people a year with our various programs.

Anything from lead prevention, parents' teachers, anything that we are doing, we're working with the First Lady, Nurture New Jersey.

We have connecting NJ for people who have questions about their reproductive information, where to get help, how to refer people.

So it's about that scaffolding and amplifying the voices of the community.

When they need help, they need to know where to get help.

You just can't show up at the hospital and say, "Oh, I wasn't able to get prenatal care."

So if you can't get prenatal care, then you reach out to us and we are able to assist you with that.

We have grass root efforts that work every day to make a difference.

So that's really important.

So it's all of us working together to make that difference.

- Right, and that's why we're putting up everyone's website so people can find out more.

And let me ask you, Fraidy, tell us exactly what Unchained at Last is?

You've joined us in the past you've told your compelling story, Unchained at Last, the nonprofit committed to...

Finish that sentence.

- Committed to ending forced and child marriage in the United States.

And we do that through both direct services and advocacy.

- And that's very much related to women's health and a choice that you did not have, by way of background, let everyone understand how you came to this fight to be the advocate that you are as a survivor.

- Yeah, I came to this out of my own experience.

As you said, I'm a forced marriage survivor.

I grew up in Brooklyn, in New York City, but in a very insular religious community where I was forced to marry as a teen to a stranger who turned out to be violent and then trapped in that marriage with no reproductive rights, no sexual rights, no financial rights, even limited legal rights under religious law in that community.

I was not even allowed to divorce my husband.

Only he as a man had the right to divorce me.

So after I managed to escape, I founded Unchained at Last to help others in this horrific situation.

- And Fraidy, before I move to your colleague, to Bridget, is this still happening?

- Oh, it is happening.

And at any given time at Unchained we have between 90 and 100 open cases.

And we're just one tiny non-profit organization based here in New Jersey, but operating nationwide.

And we also know in terms of child marriage or marriage before the age of 18 which often is forced and can easily be forced, because of children's limited legal rights.

We know that between 2000 and 2018 300,000 minors were married in the United States.

Some as young as 10, almost all of them girls married to adult men with an average age difference of over four years.

So yes, this is happening a lot in the United States.

- And Fraidy, the website of Unchained at Last has been up.

And now we move to Moms Helping Moms.

Bridget, tell everyone briefly what Moms Helping Moms is and how it's part of this larger initiative and this campaign, this effort to promote better women's health and frankly create healthier choices for women, particularly women of color, who are treated less than what any one of us would want for our own loved ones.

It's happening consistently and it's been happening for too long.

Please, Bridget?

- Sure, so Moms Helping Moms is primarily a baby supply, diaper supply and menstrual supply bank.

So what we do is we distribute basic essentials to underserved families all over the state.

Two of the major things that we focus on that really affect women in a lot of different ways are something known as diaper need and something known as period poverty.

So diaper need, which affects one third of the families in our country, that is the inability to be able to access a sufficient supply of diapers to keep your infant clean, dry, and healthy.

So as I said, about a third of families report that they're facing this need, and of them about 60% actually report that they're unable to go to work or to school or really just to live their lives and be productive citizens, because of a lack of diapers.

That primarily is due to the fact that if you need to utilize any sort of childcare, you are required to drop off diapers for your child.

Those centers do not provide diapers even the ones that are, a low cost and available to low income families.

You still have to have the diapers.

So those 60% of families are reporting that they're missing up to four days of work per month which you can imagine is setting them back tremendously.

- But hold on a second.

There are not government significant government subsidies in this regard?

- There are not, no, there's no current government program that is helping families with purchasing diapers in any significant way.

TANF, which is a very small amount of families receive, and it is a very- - TANF, is a federal program.

- Low amount of money.

It's very hard, that could possibly cover purchases of diapers.

However, families need to pay their rent, they need to pay their electric bills, they need to buy food.

There's rarely any money left.

So really, there is no significant program that's helping families.

They have to come to organizations like ours.

- So Mariekarl, it's clear that the government state and federal government only doing so much clearly not doing enough.

Ironically, we had a guest on recently who said, most people in urban communities, particularly Black and Brown men and women are not looking for a handout, they're looking to create a stronger economy.

I'm sure all that's true, but at the same time, if you can't afford diapers and therefore your child can't be in childcare, because the childcare center doesn't provide the diapers, it's not a handout, it is just acknowledging that people start at a very different place in this race of life.

I'll get off my soapbox.

Mariekarl, help us on this the Dobbs decision by the United States Supreme Court allowing each state to determine what their policy would be vis-a-vis Roe v. Wade and a right to a legal abortion for a woman.

Talk about the impact of the Dobbs decision on the work you and your colleagues are doing.

- So I want to add that with Bridget, we are so happy that we do work with her to ensure that people get some information about the diapers and where they can be found using Nurture New Jersey and connecting NJ diaper drives and so on and so forth.

So with the consortia, what we do is really provide reproductive education.

Education is the key.

We're lucky enough to live in the great state of New Jersey where we are not affected as much, but we do understand that people will be traveling to New Jersey probably to get some reproductive rights that they have made the decision that they want.

At the partnership, we offer education, education to different services, education that you can make a really informed decision for yourself and your family.

And that is really key to ensure that women, children and their families are thriving to make sure that they're getting the education and the referrals that they need to make those socioeconomic choices for themselves and their families.

So, the decision in other states is abhorrent.

We know that Black and Brown women are really at a disadvantage.

When you look at the 2016, 2018 report about the state of maternal mortality, that 80% of these pregnancy complications, 80% are preventable.

We have to look at upstream issues.

We have to look at those social indicators.

I hate to say determinants of health- - So you're talking about...

I'm sorry for interrupting, social determinants of health.

- Yes, they are social determinants, but determinant is such a strong word that we really need to say, we need to look at them as indicators of health, because it does not determine my livelihood.

if I live in a certain neighborhood.

It is really an indicator that I can change and we can change those indicators with education about systematic racism, about weathering, about where we start and where we begin.

Like you said, it's not a handout.

We're looking for a hand up.

We are looking to amplify voices.

We're looking to ensure that when I go into anywhere doctor's office, a hospital to get urgent care that I receive equitable, inclusive care, that they look at me and listen to me and hear what I am saying, as opposed to using stereotypical language, and stereotypical ideas of what they believe I should be doing or saying or experiencing, very important.

- You know it's so interesting, Fraidy as I come back to you, that Bridget and Mariekarl sharing information not-for-profits working together.

People watching might say, well, what weaves all these organizations together?

But the reality is, while Mariekarl talks about the right to a legal safe abortion, again, people can decide what they believe those limits should be.

But right now the states are determining that.

If there's a forced marriage, very often we're talking about a forced pregnancy.

Your organization's, your advocacy is linked together.

Is it not a fact that there are more forced pregnancies in forced marriages?

Obviously, please Fraidy, talk to us.

- Yeah, absolutely, that's a really good point.

So the forced pregnancy in forced parenthood is important in terms of forced marriage, because a, it is unfortunately an effect of and it is caused by a forced marriage, as you said often leads to forced parenthood, forced pregnancies as I experienced within my own forced marriage.

But the reverse is true as well, that often a rape and a pregnancy then lead to a forced marriage.

Parents who think that a pregnancy outside of marriage is shameful and are willing to sacrifice their own daughter to cover up that shame or to prevent some nice guy from going to prison.

We see that all too often.

And in fact, what we're doing now is studying the impact of the Dobbs decision on race of a child marriage in the United States.

We're very concerned that because of the Dobbs decision we're going to see an increase in the already very high rate of child marriage in the United States.

And we're also, by the way partnering with Columbia University professors on a study of forced marriage, forced marital sex and forced parenthood in the United States.

The first study of its kind we're going to start that in January.

- Let's make sure we stay on, we monitor that situation and report back on those findings.

I'm gonna come back to you, Bridget.

You're talking about period poverty.

Please clarify, help us understand that the disparities that we're talking about for young women as it relates to their menstrual cycles and how they're able to deal with that is largely based on economics, race and socioeconomic factors, please.

- Yeah, so about 25% of people who menstruate report that they cannot, they don't have access to the number of products that they need every month.

They are not currently available in schools.

This means that a lot of young girls as well as older women, are missing school and they're missing work.

- Millions, these are millions of young women, girls and...

Hold on, I'm sorry.

- And in addition to that it's really the stigma around menstruation is that it's disgusting and it's unclean when really it's just a healthy biological process.

Because of that stigma, especially young people in schools, they feel so much shame and they lose their dignity, on top of feeling anxious and having higher levels of depression and missing out on their education, because when you miss a couple days of school a month, guess what?

That's a whole lesson, that's a number of lessons and a variety of subjects and it's a really solvable problem.

I mean, it costs $5-7 per student per year to be able to provide these products in the schools.

And we feel that it's a basic essential, it's a public health issue if they don't have them, and they have the right to have them just as they provide toilet paper in the bathroom, menstrual products are another necessity that needs to be provided.

Our children should not have to be dealing with these problems.

- I only have a few seconds left, I wanna be clear on this.

So Bridget, you're saying in the school budgets it's not across the board mandated that no, it's not, as if this is controversial.

Our daughter happens to be 12.

It is what it is, it happens.

And to say that, oh, nevermind.

It's just that the fact that there's even a debate about this speaks for itself.

But way more importantly to Mariekarl to Bridget to Freddie, to each one of you and to your organizations, it's one thing to be recognized as Russ Berrie awardees for Making a Difference and fighting the fight every day, but to come on and join us and motivate and inspire others to make a difference in their community, particularly as it relates to women's health, is really important.

We thank you for being the leaders that you are every day.

We thank you so much and wish you all the luck and I promise you we'll have you back in the future.

Thank you very much.

- Thank you.

- Thank you Steve.

- I'm Steve Adubato.

We thank you so much for watching.

Hopefully, we'll see you next time.

- [Narrator] Think Tank with Steve Adubato has been a production of the Caucus Educational Corporation.

Funding has been provided by The Russell Berrie Foundation.

The New Jersey Economic Development Authority.

The Turrell Fund, supporting Reimagine Childcare.

RWJBarnabas Health.

Let'’s be healthy together.

Kean University.

The Healthcare Foundation of New Jersey.

Horizon Blue Cross Blue Shield of New Jersey.

New Jersey Sharing Network.

And by Robert Wood Johnson Foundation.

Promotional support provided by NJ.Com.

And by ROI-NJ.

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