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From NJ PBS Studios, this is NJ Spotlight News with Briana Vannozzi.

>> Hello and thanks for joining us tonight.

I'm Joanna Gagis.

We're bringing you a special broadcast of NJ Spotlight News, an in-depth conversation with outgoing First Lady of New Jersey, Tammy Murphy.

It's been eight years since Murphy assumed her role as First Lady of the state.

Now, it's typical for the first lady to use the platform to champion ideas and causes, but Murphy took the role on with a different kind of gusto and intention than we've seen in the past.

She set her sights on maternal and infant health.

Her cause?

To stop the senseless deaths of women and babies during and after childbirth.

Her reality here in the state of New Jersey was a disparity that worsened the health outcomes for Black mothers who were seven times more likely to die than their White counterparts due to childbirth, and Black babies who were three times more likely to die before their first birthday than White babies.

So, in January of 2019, one year after taking office, the First Lady kicked off an effort called Nurture NJ to change all of that.

She's with me now to look at what's changed since then.

First Lady, Tammy Murphy, welcome to the show.

Thanks for being with us.

Thank you, Joanna, for having me.

Can you tell us what the evolution of Nurture NJ has looked like in the six years since you launched it?

Absolutely.

Well, when Phil first came into office, I was unclear what I would work on and how I could help him and help the people of New Jersey.

Having read initially that New Jersey was 47th in the country for maternal mortality rates out of 50, and we are the medicine cabinet, if not just to America, but to the world, it made no sense.

I naively assumed that that had to do with access to care and being that I'm a mother of four, thought that I would just jump in and try and fix that.

Little did I know that, you know, nearly eight years later, I would still be working on this.

But, you know, I'm really proud of what we've been able to achieve.

You've changed a lot.

We're going to talk about whether that needle has moved and how it's moved in New Jersey, but let's get into some of the things that you put in place as you realized, hey, this isn't the quick fix that we hoped or thought it would be.

One of the things we've heard from Black moms over and over is that they felt unseen, unheard by their doctors, continue to feel unseen and unheard by their doctors.

Midwives and doulas in the birthing space has been a real key initiative here.

Explain that.

Yeah.

I mean, first of all, you have to know that there has been an assumption over time that for whatever reason, Black women don't feel pain, that they're different from others, and obviously that's incorrect.

And that harkens back to slavery and the way that Black women were treated early on in this country?

100 percent.

100 percent.

So, you know, the fact of the matter is that having access to care, having people who are culturally competent-and that's the-those are the words that I would use when it comes to doulas and midwives-people who are embedded in the community, who understand the stresses and strains and actually know the individuals who are being helped or cared for.

Just acknowledging that midwives and doulas are professionals and that they add value and that they should be considered part of the labor and delivery team is a major step.

And that's something that was not the case, actually, before the pandemic.

And it was during the pandemic, in fact, that they became part of the care team.

So what does that look like now in terms of being part of that care team?

So, you know, during the pandemic, as you may recall, for so many reasons, we didn't have -- we didn't know what we were dealing with.

The group of people who were allowed in the hospital went down to basically one person.

In some instances, even a family member was not allowed in.

And if a - if someone was already working together with a doula or a midwife, and suddenly they're thrust into an operating room and there's no doula or midwife, that's really not fair.

It's not fair to anyone.

And it's also - it diminishes the patient's ability to communicate with the care team.

So thankfully, my husband understood that.

And during the pandemic, he changed that and made it possible for a doula or a midwife to join a mom and be considered part of that care team.

- And there have been several efforts underway to get more doulas and midwives into the healthcare space, yes?

- Exactly, exactly.

In fact, we are one of the first states in the country to actually reimburse via Medicaid for doula care and particularly building out the doula community to make sure that we're strengthening that group of people because their involvement has been shown to improve outcomes and not much more is needed than the evidence-based results, and that's what happened.

There's so much more we're going to talk about, but you mentioned Medicaid, and so I have to ask you, when we look at changes happening to Medicaid from Washington, from the federal government, how concerned are you that there could be impacts on some of the Medicaid expansion that has been signed into law here in New Jersey in the maternal health space?

Listen, of course I'm concerned.

But the fact of the matter is we just have to put our heads down and just keep at it, because where we can make someone's life better, healthier, and, you know, ensure people have food on their table, it's pretty straightforward for me.

So I think that at the end of the day, New Jersey is in a great place.

Our legislators are all on the same page.

And I think we'll keep at it and hopefully make sure that we're stronger for that.

You're still rolling out the at-home nurse care program.

This is through New Jersey Connects, right?

Just explain what that looks like and why it's important to have a nurse make that home visit especially for women of color.

Sure.

So it's called Family Connects NJ.

And this is a program that will be available in all 21 counties in New Jersey as of next month, which is very exciting.

It is the most robust universal nurse home visitation program in the country.

And basically what it means is that within the first several weeks of delivering a baby, a registered nurse will come into one's home and visit with the mom, the baby, the family, check on the mom's health, check on the baby's health, and essentially see what other resources are available in the state of New Jersey that might help that family.

There are so many fantastic outcomes of this, ranging from the fact that there's no stigma.

So historically, if you think about it, if you're a doctor and you're waiting to see a mom or a baby, you have no idea if that mom or baby took five buses, two trains, and they're wearing their Sunday finest to get to that doctor's appointment.

When you go into someone's home, you'll have a better sense of what their needs might be.

And because it's available, whether you have insurance, don't have insurance, whether you're on Medicaid, whether you're a billionaire, anyone is able to access this care.

And what are they looking for?

They are looking -- first of all, the most important thing is they're looking for the health of the mom and the baby.

And in the -- I think we've served over 7,000 -- we've had over 7,000 of these visits thus far across New Jersey.

And in the first year alone, over 17 percent of those moms and babies were referred back immediately, either to the emergency room or to their primary care physician, because they had a physical or a mental health challenge.

And three in four of all the others who were seen were also referred on for additional resources, whether it's diapers or Wi-Fi or food security.

It could be anything.

So the fact of the matter is, we know that having someone go in and have that personal contact is really going to improve the state of New Jersey, because if you can address a challenge early on, then it saves money and lives down the road.

And these are things that could have been missed or dismissed at the person's home, right?

A headache that could be the sign of a blood clot or some other type of postpartum complication that could lead to death?

Yes.

Well, let me just also say, you know, typically a baby is seen within two weeks of delivery.

A mom is not seen for six weeks.

If you have a mom who is experiencing a challenge and they're seen in their home by a nurse, the chances of catching that challenge early on are far greater.

And the same thing goes for the baby.

So the nurses do a physical check, they do a mental health check, they do all sorts of things that are not invasive.

And those visits can last up to an hour and a half.

So it's really phenomenal that we're doing this in New Jersey.

I'm really excited.

And like you said, it has rolled out now to all of the counties, because it was a slower rollout getting to the whole state.

We wanted to make sure that we had enough registered nurses who could speak different languages and also just make sure that we didn't over promise and under deliver.

That was really important to me and I know I talked to you about that previously.

As of January of 2026, we will be available in all 21 counties.

Which I think is ahead of the curve.

I think originally the plan was 2027.

We've been pushing the needle as fast as we can.

So I can't remember if the original plan was 27, but we're there.

I want to talk to you about something that you and I have discussed before, which is a question I posed to you during an episode of Her Story where we focused on this issue.

And I asked what it would take to remove or address implicit bias in our healthcare setting.

You said transformational change.

What transformational change has already happened or needs to continue to happen so that in a health care setting, whether a doctor knows it or not, they are not acting on some implicit bias that they walked into that room with?

Well, I think it's an array of things.

First of all, it's accepting that there might be a challenge.

So at least being aware that one might have a bias and being trained in that front, I think, is enormously important.

What does the training look like?

You know, we're -- all of our medical schools, we're now training all of our doctors, our nurses.

Everyone has to go through an implicit bias training, even down to receptionists and those who are dealing with patients at the outset, which is obviously fantastic.

We can always do more.

So one can look at the spectrum of, you know, I want to go from zero to 100.

You've got to take baby steps and you've got to bring people along with you and let them understand the benefits that they are bringing, not just to the people they're caring for, but probably to themselves as well.

What's the role of Black physicians in that process?

It's incredibly important.

I mean, I can speak for myself.

You know, when you walk into a room and have a doctor, you want to see someone who looks like you, who acts like you, who can understand you.

And so being able to expand our workforce, whether it's for doulas or midwives or nurses or OBGYNs, and make sure that everyone has the ability to find in that doctor, nurse or caregiver the attributes that they feel comfortable with, that's really important.

In trying to make sure -- I'm speaking for you, but you've told me -- in trying to make sure that this lasts beyond your administration, there was an effort by the Murphy administration to create the MIHA, which is the Maternal and Infant Health Innovation Authority.

And now there is a groundbreaking for an actual center this summer.

Just talk first about the authority, the goals there, and how you're working with providers on the ground to really have an impact, especially in cities and urban spaces.

Can I just go back one second?

So, in the very beginning, when we started out on this process, I did a listening tour around New Jersey just to understand the landscape.

We started off having two departments and agencies working alongside us within the administration.

Today, we have 22.

We started off externally.

I didn't know, you know, who was involved in this space.

We now have thousands of stakeholders who are working together.

And I think that's the most important thing you can remember, is that my power here was the power to convene and to be dogged about that.

And... And when you say stakeholders, let's just kind of laundry list who some of those are.

Oh, it can be anyone from health systems to mothers to nurses to doulas to midwives to legislators, to... It is... Lactation consultants.

Everything.

Yes.

Those who are on the ground doing the grassroots efforts, I mean, this is-this takes everyone to understand that every piece of our lives impacts our health.

And that goes-the easiest way to explain that is if you look at the fact that I started off with two departments and agencies, Family and Children's and Department of Health.

Seemed obvious to me at the time, working together to try and fix this challenge.

The fact of the matter is, we now have transportation, banking and insurance, Department of Environmental Protection, corrections, education.

Twenty-two departments and agencies are working with us because there are elements of every piece of what goes on around us that impact our health.

And this is no different in this space.

And that impact maternal health outcomes.

Correct.

So over the course of the past now nearly eight years, my husband has signed into law over 70 pieces of legislation.

And my concern, my overwhelming concern throughout was what happens after my husband is no longer in office?

Where does this where does this go?

Which caused us to create our strategic plan.

And the strategic plan has has 80 some initiatives of which we have tackled or at least started well over half of them at this time.

And the ultimate piece of this was to build an innovation and research center in New Jersey that would be the first of its kind in the country that deals with maternal and infant health.

Much the same way that we think of cancer centers and heart and heart centers.

So think of the Cleveland Clinic of this space.

So we are building that here in New Jersey, and that will ensure that all of these efforts stay focused here in New Jersey.

And there's a hub-and-spoke model.

It's being built in Trenton very specifically and thoughtfully, because Trenton is one of the areas that is a birthing desert, it's a food desert, it's our state capital, it's where all of this legislation started.

But, Mia, the Maternal and Infant Health Innovation Authority is what will ensure that all this work does not come to naught and that we are the safest and most equitable state in the country to deliver and raise a baby.

That was a beautiful wrap-up, but before we do wrap this topic up and we move on to some other things, I do want to ask you, do you have updated data to see what impact over these six years you've had?

Are those percentages of moms and babies dying down?

Yes, yes.

Where are they?

Let me just say this.

First of all, there are a number of different entities that look at benchmarks.

We just heard that we have moved from 47th in the country to 25th for maternal mortality rates, which, in and of itself, given that this has really been underway for the last seven years, is pretty amazing.

But if you look at whether it's severe maternal morbidity, whether you look at neonatal challenges, whether you look at infant mortality, every single benchmark has improved.

And I don't think that's an accident.

It's really impressive where we've come.

And, obviously, during COVID, we took a little step back, like everybody did in the country.

But we're on the -- we're on to something here.

And many people around the country are looking at us and to us for guidance.

We are going to switch gears, because you've done so much more than just maternal health, although we spend a whole lot of time talking about what you've done already.

So, the FIFA World Cup, you are the chair of the board of directors for that.

What has it taken for you to try to get this state ready for the World Cup to come here next summer?

First of all, everyone should come.

There's a place for everyone.

You know, the stadium itself, which is MetLife, which will be turned into the New York-New Jersey Stadium with no signage, that is -- you know, all 80,000 seats will be taken.

But we have fan fests coming all over the region.

Liberty State Park is tremendously exciting because we're going to have a fan fest there for all 39 days of the tournament.

Fan fests bring together music and videos.

We're going to have 22 large screens, backdrop of Ellis Island, Statue of Liberty, New York City, food, fun, entertainment, and a lot of like-minded souls.

And that will be very easy to get into.

But as chair of the board, I will tell you there are really four things that I'm focused on.

First and foremost is security.

Transportation would be secondarily.

The economic impact is obviously going to be tremendous, not just for New Jersey, but for New York, for the entire region.

And then the fan experience.

And every day, we're working as best we can to tackle all four of those.

And there are scores of people across New York and New Jersey who are working on this literally every single day.

- You and the governor are heading out later today.

We're taping this on Thursday, December 4th.

You are heading out later today, where there's going to be the final draw tomorrow morning.

What could that mean for New Jersey?

How does that all shake out for us?

- So the final draw, really excited about this.

We've been anticipating this date, which is December 5th, for a long time.

This will take place at the Kennedy Center in Washington, D.C.

There's a lot of special guests who've been announced who are going to be drawing some of the balls to figure out which venue will host which teams.

And I understand that the president's going to be there, and Tom Brady is going to be there, just to name a few.

- Yeah, name-dropping here.

- Yeah, there's a lot.

- There's a lot of fun people who are going to be there.

But the fact of the matter is, obviously, we hope that we have some of the really popular teams playing for us.

There's no question that if you have any of, you know, Germany or Brazil or, you know, the UK or France, I mean, there's a lot of super important teams in here that we would really love to have play in New Jersey.

You know, and, you know, let's hope that as much as I love them, we don't get this one of the smallest countries like Cape Verde, but we'll make we'll make a mountain out of it no matter who we guess.

You've obviously been a part of a lot of anyone who follows your social media.

You've been a part of a lot of the mission trips, the economic trips with the governor.

I'm curious how much of that has been tied to the World Cup or what other kind of economic initiatives have you been out there talking about?

Oh, my goodness.

Well, it depends on the country.

New Jersey sells really well overseas.

What do you mean by that?

We are one of the most diverse states in the United States.

We are one of the smallest states in the United States, which means we all live in each other's laps.

And we understand one another.

You know if you want to find Mexican food or Brazilian food or you know where to go.

You know to go to Newark to find your Brazilian spot.

Ironbound.

Ironbound.

I mean, there's just-because of that, and because we are so culturally aware, and we have some of the fastest-growing populations in the world-we have one of the fastest-growing Jewish populations, one of the fastest-growing Muslim populations.

So when you take all that and look at us overseas, and then you add onto that the ease of access for transportation, the incredible location where we exist between New York City and Washington, D.C.

There's so much that New Jersey has to offer.

Number one school system in the country, most talented workforce in the world, if you're looking at scientists and engineers, film, digital, TV.

You name it.

I mean, we've got it.

These trips have covered everything from bringing jobs and economic impact to New Jersey on the one hand.

Also, we were just in Mexico.

We went to visit Azteca, which is going to host the opening ceremony for the World Cup.

We will obviously host the closing ceremony July 19th.

So, some coordination there.

Yeah.

Let me ask you, because during your time, I don't know if this was ever planned, but you did take a run for the U.S.

Senate when the seat was opened by former Senator Bob Menendez.

Yes.

Obviously, you did not win that race.

I'm curious what that experience taught you.

And if you would ever consider running for office again.

Yeah.

Well, first of all, I never considered running initially.

And it was because of the work I've done through infant and maternal health, because of the pandemic relief fund where I was in food pantries and in the really the darkest corners of New Jersey where people feel like unseen.

These people said, why can't someone like you, who understands our needs and has been working so hard for us, step up and lean in and do this?

And I really -- it really wasn't something I thought I would do.

But the fact is, I'm happy that I did it.

And every day, all I have done for the last nearly eight years is try to uplift those who need a helping hand.

And if by virtue of my running I have helped someone else, then I'm so happy that I did that.

No idea what the future brings, but thanks for the question.

Yeah.

Well, that is another question.

What does the future bring for you and for the governor?

Do you envision either of you running for office?

Would you want to see the governor run for higher office?

I am being completely honest with you when I say to you that if I had followed through and completed the campaign to run for the Senate, and we had a nexus of New Jersey and Washington, then life would have gone in one direction.

When I pulled out of that race to make sure that we weren't being divisive at a very important time, I and Phil, together, we both agreed that he was elected not for four years or not for eight years minus two months, but for eight years.

And that's not eight years minus two months or eight years minus a day.

So we are going to run through the tape.

We've had all sorts of people who are asking us what we're going to do.

And the fact of the matter is, we're going to take a little step back.

We're going to take a vacation together.

And we are going to really then think about what we want to do when we grow up, and not before then.

When you grow up.

Let us know what happens then.

I'll let you know.

You decided early on you were not going to move your family into Drumthwacket when your husband took office, but you did take on a major overhaul of that space, of the governor's mansion.

What did you do there, and why was that important?

First of all, I don't think it was really in the shape to move into when we arrived.

And the statehouse was under construction, so there was really a necessity to have a place that we could convene people.

So it was really out of service to our state that I really wanted to get that into the right shape.

Saying that, Drumthwacket is a gem.

We should be-we should all, as New Jerseyans, want to be there, want to visit, want to understand the history of it.

You realize the land was owned by William Penn.

So, this is a property that really is magnificent and is storied in history.

Over 2,000 patents were initiated in Drumthwacket, ranging from the first spacesuit for NASA to latex.

So, you know, there's a lot of history that goes on there.

What have I done?

All I have done is try to make it a point of pride for New Jersey.

I've added everything from a respectful ADA-accessible elevator and bathroom.

We've expanded the gardens.

We've painted.

We've done -- we've reupholstered.

We have... Built a barn?

Built a barn.

And the barn is really special, because it's a place -- it's a previously standing historic barn from the 1700s.

It's from New Jersey, and it's now standing on the grounds of Drumthwacket.

And it enables over 150 people to be in one room at a time.

But importantly, we bring in thousands of Title I students every year to Drumthwacket.

These students really have never had a chance to be in a home like Drumthwacket, and they are studying that period in history.

So they go to this barn, and they can play with period toys and celebrate together and just be in a space that's conducive to camaraderie.

I know you say you're running through the tape.

We've heard it from the governor a whole lot.

Have you had a minute to stop and think, what do you hope your legacy is?

What do you hope collectively the Murphy administration legacy is and your own?

Listen, I haven't, to be honest with you.

I know on a day-to-day basis all I have tried to do is uplift anyone who needs a helping hand.

And I would say if you looked at my little office, we are a little bit like the catcher's mitt behind the governor's office.

And when I say that, I mean that if there's something that doesn't fit squarely into the governor's office, if someone has a request or a challenge and it doesn't-no one really knows what to do with it, invariably, we put our hand up and say, "Yes, we'll take it on."

And it can be anything.

Just today, a woman reached out who's trying to help get some legislation passed in the area of fentanyl.

And there's others who reach out, and it could be anything from, you know, something to do with the dog catcher to environmental issues to film, digital and TV.

I mean, it just runs the gamut.

So my hope is that everyone knows that we've tried our best to make New Jersey stronger and fairer, and that's all we've been trying to do every day.

Well, thank you so much for taking the time to sit with us, talk with us.

Thank you for everything you've done on behalf of mothers and babies across the state.

>> Thank you, Joanna.

>> That's all the time we have.

Thanks again to the First Lady for sitting down with us.

I'm Joanna Gagis.

On behalf of our entire team here at NJ Spotlight News, thanks for being with us.

We'll see you next time.

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