In Newark, a city with some of the worst birth outcomes in the state, a small group of trained doulas is on the front lines working to improve the lives of black women and their babies there.

They start with some basic questions.

"We sit down and make a birth plan with the mom," explained Elizabeth Taylor, 31, one of the doulas with Sister to Sister Community Doulas of Essex County, a group started last fall with a grant from the state's health department. "What do you see when you're in the birthing room? What do you smell? Is there a taste? Music. Who's around you? What pajamas are you in? All of that, things that people don't even think that they have options to think about."

Doulas act as counselors before, during and after birth; they provide insight and knowledge, help women follow through with doctor's checkups, advocate for the mother's interests at the hospital, and provide comfort and encouragement during the delivery itself. The job can entail small things, Taylor described, like spraying a vanilla perfume during birth, negotiating a private room in the hospital, or tracking down a birthing bar, which can help a woman squat during labor.

But it's often big things too.

Juliza Garcia, 38, is another doula in Sister to Sister and a mother of two. During her first pregnancy, she didn't have a doula, and she got a Cesarean section, though she'd been determined to have a vaginal birth.

"Emotionally I caved," she said. "I needed that gentle loving touch."

For her second birth, she had two doulas at her side, and credits them with having a successful vaginal birth.

"It really mattered," she explained. "It made a different impact in my life."

The doula pilot is one program funded by the state to improve birth outcomes for black women and their babies. First Lady Tammy Murphy has made the issue one of her priorities. 

"We are targeting hotspots around the state," Murphy said. "Hotspots being areas where the pre-term births infant mortality maternal mortality teenage births—where those numbers are at alarming levels and Newark is clearly one of those areas."

Higher rates of poverty, crime, smoking, less timely pre-natal care, are some factors at play in Newark, according to Dr. Barbara Ostfeld, a professor at Rutger's Robert Wood Johnson Medical School.

Doulas can help mitigate some of those things, by encouraging healthy habits, helping encourage regular pre-natal care, she said. A 2017 study of nearly 500 births in New York City found that doula care decreased chances of pre-term birth and low-birth weight by half. 

"That's a very powerful finding," she said. "Whenever you find something that can sustain a pregnancy longer you have protected that baby from so many adverse outcomes."

Newark's doula pilot is slated to grow to cover 200 women over the next fiscal year.