Utah first lady Abby Cox and New Jersey first lady Tammy Snyder Murphy sat quietly in a talking circle Wednesday morning at a Sacred Circle Healthcare Center in downtown Salt Lake City as providers passed a talking stick while describing barriers they climb over daily to provide maternal and infant health care.

The gathering was part of the two-day National Governors Association roundtable in Salt Lake this week, the first of four this year. New Jersey Gov. Phil Murphy, the association’s chairman this year, chose youth mental health as his area of concern, while his wife has a companion initiative being addressed in the meetings: maternal and infant health. At the end of the year, Tammy Murphy said, they will issue reports with recommendations addressing both issues.

At Sacred Circle Healthcare, Cox and Murphy both spoke about the bipartisan nature of the NGA, and how the association focuses on finding and sharing solutions for state-level policy problems, rather than providing a forum for partisan bickering. The final reports will include the best practices they’ve seen as they look at how states address these issues, and what challenges are shared.

In the talking circle, the list of worries and challenges around maternal and infant care was long.

One woman spoke of the introduction of baby formula right after birth in hospitals, which can interfere with breastfeeding and the benefits thst provides babies.

Another talked about different rules from one state to another on what’s paid for by Medicaid. States should collaborate, the first ladies were told. It could be “very, very, very beneficial to have unity and agree upon a set of maternal and infant services.”

The providers from different agencies described how hard it is to provide the mental health services some clients need and how inadequate housing and poor nutrition have serious impacts on pregnancies and the development of babies.

Lorena Horse, executive officer at Sacred Circle Healthcare, second from right, tears up while speaking to community health care officials and providers during a National Governors Association event at Sacred Circle Healthcare in Salt Lake City on Wednesday, Oct. 19, 2022. | Laura Seitz, Deseret News

Lorena Horse, the executive officer at Sacred Circle, said care coordinators are “maxed out” because they’re asked to do so many things to serve clients that they sometimes don’t have time even to apply for grants that would ease the financial burden and help them meet more needs.

Many of the patients have related issues that impact their lives and health, including historic trauma issues, she noted, adding it’s hard to meet those needs “when we’re always in response mode.”

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Sacred Circle Healthcare is an entity of the Confederated Tribes of the Goshute Reservation and has four centers, three in the Salt Lake area and one on tribal land, Horse told the Deseret News.

Sacred Circle Healthcare provides everything from substance use disorder treatment to pharmacy and dental services, physical therapy, primary care, radiology, mental health and more, said medical director Dr. Carissa Monroy as she gave the first ladies a tour. The centers serve a broad group of underserved populations, including anyone eligible for Medicaid, those without insurance and people of different ethnicities, not just Native Americans.

U.S. lags behind on maternal health

After the discussion, Murphy told the Deseret News the U.S. is “not where it needs to be in terms of maternal and infant health. We are 55th in the world in terms of maternal mortality rates. Speaking for myself — and probably Abby as well, each of us being mothers of four — I can’t imagine some of the challenges that some people face across our country, because I didn’t personally have those same challenges.”

Her goal, she said, is to “take whatever space I find and either leave it exactly the same or hopefully a little bit better. And this is one where I feel we have the ability to prevent 60% of the deaths and the complications that happen to our mothers. We have that. They’re preventable.”

The listening tour was created to understand the barriers faced by people of different races and circumstances, “because those are the communities that are being disproportionately impacted,” Murphy said.

The National Governors Association has provided the opportunity, she added “to take these scourges on the road and have convenings around the country. ... I really believe that the National Governors Association is the one area that’s not partisan. We all want to lean in and work together. And these are two topics that we’re all struggling with across the country right now.”

In the talking circle, the women listened as Goshute chairman Rupert Steele spoke of his childhood. He was placed in a boarding school at a young age, away from his parents, and missed that crucial contact and found himself reluctant to have his own children as an adult because of that. On the other hand, he knew his tribe’s survival depends on future generations, he said.

Bipartisan civility is key

Utah Gov. Spencer Cox is the association’s vice chair and his wife is actively involved with the association and its initiatives.

“Both initiatives are really personal to us as well,” Abby Cox said. “But also this idea of bipartisanship, and not just civility, but dignity and seeing the dignity in each other, seeing the dignity in these populations that have been underserved, seeing all these things and then putting it together as leaders of the country.”

She said while anger, vitriol and contempt have “infiltrated a lot of the public discourse, we’re here to say as NGA representatives that we can tackle these huge issues in the country together, and we need to because it’s the only way that we’re going to get it done.”

Cox believes youth mental health is the biggest issue when it comes to the future of the country, “and if we do not take care of our mothers and our babies in this country, we will not have a future.”

She added, “The preventative aspect of this — I mean, it’s just a no-brainer. If we can do something preventative, let’s just do it. So working together, we’re going to make it happen.”

Utah first lady Abby Cox, center, and New Jersey first lady Tammy Snyder Murphy, to the right of Cox, visit with community health care officials and providers during a National Governors Association event at Sacred Circle Healthcare in Salt Lake City on Wednesday, Oct. 19, 2022. | Laura Seitz, Deseret News