Rutgers Celebrates 50 Years of Growing Midwifery in the Garden State

Rutgers graduate Naja Damallie keeps track of the number of births she attends at Newark Beth Israel Medical Center, where she works as a certified nurse-midwife. Since October 2023, when she started at the teaching hospital, she has attended almost 80.

“I love this job,” said Damallie, beaming as she prepared to start another shift. “It doesn’t even feel like work.”

Damallie is one of hundreds of New Jersey midwives who’ve graduated over the past half-century from the midwifery education program at Rutgers School of Nursing. As health care providers, these Rutgers alumni work with women and birthing people, families and communities to provide care throughout the lifespan of their patients – from annual preventative visits to reproductive health care needs.

They also attend births – lots of them.

“Being there for a woman,” and “then to deliver their baby, it’s beautiful,” said Damallie, who was inspired to become a health care professional and follow in the footsteps of her late uncle, Earl Damallie, who earned his undergraduate and doctor of medicine degrees at Rutgers and was a board-certified surgeon.  “Rutgers wasn’t easy, but it opened the door to so much joy,” she said.

For five decades, the Rutgers nurse-midwifery program has been educating and training much of the state’s midwifery workforce. Since Teresa Marsico, the program’s founder, was awarded a U.S. Department of Health, Education and Welfare grant on June 24, 1974, the midwifery program has expanded from humble beginnings – two staff and a dozen students – into a long-standing, well-established program that consistently graduates a diverse class of midwives reflective of the population of New Jersey.

Rutgers midwifery students earn either a master of science in nursing, post-master’s certificate, or doctorate in nursing practice – all of which prepare them to sit the exam for national certification by the American Midwifery Certification Board (AMCB). The school also offers a dual-track, nurse-midwife/women’s health nurse practitioner program.

Marsico was a midwifery pioneer who not only founded and led the Rutgers midwifery program for more than a quarter century but served as president of the American College of Nurse-Midwives (ACNM), the professional organization for nurse-midwives in the United States. She was awarded the ACNM’s Lifetime Visionary Award, the college’s highest honor, for her exemplary contributions to the profession over her lifetime.

Subsequent directors have been equally impactful on the national and New Jersey midwifery landscape. Elaine Diegmann, a member of the program’s first class of graduates, joined the faculty in 1978 and succeeded Marsico as program director in 1990. As she led continued development of the academic program, she founded midwifery practices at three Newark-area hospitals and attended more than 5,000 births. Diegmann, a recipient of ACNM’s Distinguished Service Award, retired as a tenured professor in 2016 after 38 years on the faculty. She was followed by program directors Joyce Hyatt and Ginette Lange, nurse-midwives who made impressive contributions to midwifery education and practice.

While 50 years of academic excellence makes for an outstanding legacy, there is still much to be done to advance the midwifery profession and expand access to midwifery care, said Julie Blumenfeld, clinical assistant professor and midwifery program director at Rutgers School of Nursing.

“I came to this program with very specific goals,” said Blumenfeld. “One was to provide excellent education for aspiring nurse-midwives, another was to grow and further diversify the midwifery workforce in New Jersey.”

New Jersey has close to 400 midwives practicing today and midwives attend 10 percent of all births in the state. Growing these numbers is a critical part of the state government’s strategy for improving pregnancy and birth outcomes and reducing racial disparities.

In recent years there’s been a heightened awareness of the maternal health inequities in New Jersey, which is ranked 27^th according to America’s Health Rankings. Many of those deaths are Black women, who are nearly seven times more likely to die from pregnancy or childbirth compared with white women.

State leaders are working to address these issues, in part by expanding access to midwifery care – and its proven positive outcomes. Data demonstrates that the model of care provided by midwives results in lower rates of cesarean births, preterm births and low-birth-weight infants and higher rates of spontaneous vaginal deliveries, vaginal births after cesarean birth, breastfeeding and patient satisfaction with the birthing process.

In 2019, First Lady Tammy Murphy launched the Nurture New Jersey Strategic Plan, designed to improve health outcomes for mothers and babies – especially mothers and babies of color. Among its goals: expanding the practice of midwifery by “building a more robust workforce pipeline.”

To achieve this objective, Blumenfeld founded the New Jersey Midwifery Education Project with state funding backed by Gov. Phil Murphy and the First Lady, and in collaboration with the New Jersey Department of Health.

The project has established several initiatives, including compensation and support for midwifery preceptors training midwifery students in clinical settings, research projects related to midwifery education, a state-of-the-art simulation center at Rutgers School of Nursing and a student midwife scholarship fund.

“We know that in states with more midwives there are improved maternal health outcomes,” Blumenfeld added. “State-level funding for midwifery education is a part of the innovative strategies being realized here in New Jersey to dismantle inequities affecting many women and birthing people. Rutgers is proud to be part of this impactful work.”

To kick off the commemoration of its 50^th anniversary, Rutgers’ midwifery program hosted a celebratory reception that recognized Marsico’s leadership, highlighted outstanding alumni, and launched a fundraising campaign for new scholarships for Rutgers student midwives.

Eight Rutgers midwifery graduates were honored with Distinguished Alumni awards: Elaine Diegmann, ’76, retired professor and former director of the program; Shirley White Walker, ’76, recipient of the Dorthea Lang Pioneer Award from the American College of Nurse-Midwives Foundation; Kathy Gater, ’83, vice president of the New Jersey Board of Medical Examiners; Dawn Durain, ’84, former associate program director of the University of Pennsylvania’s midwifery program; Susan Rutledge Stapleton, ’83, founder of the Reading Birth and Women’s Center in Reading, Pa.; Frances Ganges, ’86, senior maternal newborn adviser of Jhpiego, Johns Hopkins University; Viola Berkeyheiser, ’92, former lead midwife in Capital Health’s collaborative midwifery practice in Trenton; MaryAnne Markowski, ‘08, director of midwifery at Newark Beth Israel Medical Center; and Catherine McCabe, ‘10, lead midwife, All Women’s Healthcare in Flemington, N.J.

Scholarships for midwifery students are critical to expand the workforce pipeline, Blumenfeld told reception attendees. Midwifery student Ashley Hannon, who received a scholarship for this school year, agreed.

“I was concerned that tuition payments might push me to find something outside my current job and volunteer positions caring for communities of underserved women, birthing people, and families, but these funds have lifted a huge burden,” Hannon said. “Being able to choose to do work I love because it feels meaningful, and not just for a paycheck, is such an honor and a privilege.”