By Sylvia Kim

There is a building on Bergen Hill with marble corridors and an Art Deco lobby. It is called The Hague. Two hundred forty-one apartments. What it sells you now is the ceiling height and the view across the river.

The former Jersey City Medical Center complex on Bergen Hill, restored as residences and marketed as The Beacon. Photo: King of Hearts / Wikimedia Commons, CC BY-SA 4.0

Between 1931 and 1979, more than three hundred fifty thousand people were born inside it.

I came to Hudson County at fifteen, in the late 1980s, when the immigrants were still arriving in waves. High school here, college here. Then Brooklyn, then a commute into midtown, then thirty years in Bergen County.

I came back to a different city. That part I expected. What I did not expect was the other thing: at fifteen I had not been old enough to see the place I was living in. It took being past fifty.

The Jersey City waterfront today, seen from the Hudson River. Photo: Jakub Halun / Wikimedia Commons, CC BY-SA 4.0

So I started reading this city again, the way you reread a letter you were too young for the first time. What I kept finding was not what the city had written down about itself. It was what it had not.

In the early 1920s, somebody in Hudson County was counting dead infants and writing the number in a ledger. The rates recorded here in that decade were among the worst in the state. That number exists because a government bothered to write it. It changed something because a woman picked it up and carried it into a budget meeting.

Mary T. Norton was the first woman seated on the Hudson County Board of Chosen Freeholders. She kept after her colleagues until they funded a maternity hospital. She would go on to serve thirteen consecutive terms in the United States House, one of the first women ever to sit there. Her papers are at Rutgers, including a memoir she never published.

Rep. Mary T. Norton of New Jersey, photographed in Washington on July 26, 1939. Photo: Harris & Ewing / Library of Congress, LCCN 2016876001

Eight years after she walked that number into that room, the building opened.

First someone counted. Then someone built. Hold on to that order, because everything after it is a departure from it.

The Margaret Hague Maternity Hospital opened on October 12, 1931. Ten stories, Art Deco, room for four hundred mothers. Mayor Frank Hague had proposed it in 1921, the year his mother died, and he gave it her name. There is a story that he lost her in childbirth as a boy and swore then to bring the death rate down. It is a lovely story. It is also not true — he was in his mid-forties and had been mayor four years.

The Margaret Hague Maternity Hospital in The Jersey Journal, May 22, 1946, on a paid page marking the hospital’s fifteenth anniversary: “Margaret Hague Hospital Leads Nation in Births. Prime Factor In Reducing Infant Maternal Mortality Here.” Photo: The Jersey Journal

A stainless steel chandelier hung over the delivery room.

There was a roof garden. There was a nursery named for Eleanor Roosevelt, who came to see it herself. Visiting hours ran late so a father coming off a shift could still get upstairs. And if a mother had other children at home and nobody to watch them, the hospital watched them.

James McGreevey was born there. So were Martha Stewart and two of Frank Sinatra's children. In 1936, 5,088 babies were born in that building, quite possibly more than in any hospital in the country that year. Of the 6,096 mothers admitted, twenty died. Accounts from that time report maternal and infant outcomes well under the national averages — though those figures were kept under definitions that do not line up with ours, so I pass them along as the institution's own record and nothing more.

Care was free at the point of use for anyone who lived in Jersey City. Not by accident. On purpose, and on a scale that got the city laughed at nationally. Critics at the end of the 1930s called the place a costly experiment in socialized medicine and a financial white elephant. Their arithmetic was fine. They had simply misread what the arithmetic was for.

And the city did not do it alone. New Deal money finished the job — federal public works funds paid for a two-million-dollar extension completed around 1940 — and on October 2, 1936, Franklin Roosevelt came through the Holland Tunnel to dedicate the complex, telling the crowd he was glad to take part in dedicating “the third largest medical institutional group in the whole of the United States.” The federal government helped build the largest free maternity service in America, in a city run by a machine, and said so out loud, from a podium.

None of which was generosity. Frank Hague left school in the sixth grade and ended up deciding who governed New Jersey, and this hospital was one of the instruments. Public money, public debt, jobs handed to the faithful, and everyone involved understood that the care was buying loyalty along with everything else.

Jersey City, November 1912: boys outside a nickel movie house on a weekday afternoon. Photographed by Lewis Hine for the National Child Labor Committee. Library of Congress; no known copyright restrictions.

It is worth being honest about why that trade worked here of all places. Jersey City was a port of first arrival. People came off the boats and off the trains and needed everything at once, and a family three years into a new country has very little to negotiate with except a vote. The machine understood that better than anyone. It gave people what they could not otherwise get, and took the one thing they had. I do not think there is much use calling that a contradiction. It was an exchange, and one side set the terms. Inside the nurses' residence he built himself an office paneled in mahogany. Decades later a film crew borrowed that room to play Rockefeller Center. They did not have to change a thing.

He sent no bills. He collected something else. In 1937 he won a sixth term, 110,743 votes to 6,798, which is 94.2 percent.

The hospital worked. Both ways.

I am not asking anyone to go soft about the medicine of 1931 or the politics behind it. The thing worth carrying forward is smaller and harder than either. This city had decided that maternity care was public infrastructure, the way a fire department is — a debt the city owed. That idea can be separated from the man who used it, and it has to be, because he is long gone and the idea is what we lost.

Here is what I could not find.

I could find how many babies were born in that building, and which of them grew up famous. I could find the staffing, the operating scale, the chandelier, the visiting hours, the roof garden. All of it is there.

I could not find who was kept out.

Dr. Lena Frances Edwards opened her practice in Jersey City in 1925 and was granted admitting privileges at the Margaret Hague, but was not admitted to its obstetrics and gynecology residency until 1945. Photo: Schlesinger Library, Radcliffe Institute, Harvard University

There is no publicly accessible Margaret Hague admission or maternity record broken down by race — not one I could reach. Whether Black mothers were admitted, separated, sent elsewhere or refused, the surviving material does not say.

That silence is ordinary, and it is not innocent. New Jersey never wrote segregation into its statutes the way the South did. Northern hospitals did their sorting quietly instead, through which neighborhoods people lived in and who got hired and who was admitted and who was told to try somewhere else, and none of it was dragged into the open until the Civil Rights Act and Medicare in the mid-1960s. Newark had Kenney Memorial Hospital, opened in 1927 by a Black physician and staffed by Black doctors and nurses, because Black patients in Newark needed a place that would take them. Jersey City had nothing like it. Whatever the Margaret Hague did or did not do, there was no second door in this city.

One record does survive, just to the side of the question.

Florence Gaynor was born in Jersey City in 1920 and finished Lincoln High School at fifteen. She applied to the nursing school at Jersey City Medical Center and was turned away; her obituaries say the school did not admit Black students then. She trained at Lincoln Hospital in the Bronx instead. In 1971 she took over Sydenham Hospital in Harlem, and the year after that Newark's Martland, six hundred beds — the first Black woman in the country to run a teaching hospital that size.

That tells us about the nursing school. It does not tell us what happened in the maternity ward, and I am not going to stretch it that far.

But think about where it points. If women were turned away from those wards, they are not in the institution's numbers at all. Not in the 350,000. Not in the mortality rate. A hospital that never writes down who it refuses will, given enough years, end up with a spotless record.

The gap in that archive was not hidden. It was never made. And you cannot hold a city to account for something it decided in advance not to measure.

Look at what happened to the hospital stay.

In 1970 the average stay after an uncomplicated delivery is commonly given as four days. Federal health statistics show the average for childbirth dropping from 3.8 days in 1980 to 2.1 by 1995. By the middle of that decade some insurers had stopped paying past twenty-four hours. The stays got shorter while the evidence, the follow-up systems and the standards for a safe discharge were all still being worked out.

So in 1996 Congress passed the Newborns' and Mothers' Health Protection Act, requiring group health plans to cover at least forty-eight hours after a vaginal delivery and ninety-six after a cesarean, unless the mother and her doctor agree to leave sooner. Most states wrote the same minimums into their own law around the same time.

I want to stay on that sentence a moment. The United States needed an act of Congress to give a woman two days in a hospital bed after giving birth. The law exists because the opposite was already happening to people.

There are plenty of lines in this story separating who got what from who did not, and I will not pretend otherwise. But the floor is the same for every one of us. Nine months of work does not end at the delivery. The delivery is only the part the country schedules. Forty-eight hours, and nothing in that number is conditional on anything.

In 1931, in this city, a woman got a roof garden and someone to mind her other children, and nobody sent her a bill.

Leaving the Margaret Hague Maternity Hospital with a newborn daughter, 1965. Photo: Burnett Peter Van Deusen / Wikimedia Commons, CC BY-SA 4.0

I do not think we lost a building. I think we lost a category.

Nobody ever asked the Jersey City Medical Center to recover its costs, for the same reason nobody asks it of a fire department. It was not charity and it was not a business. It was infrastructure — and infrastructure is allowed a roof garden, because what it earns was never the question. Then birth got reclassified. It became a discrete, billable episode with codes and negotiated rates and a length of stay you defend line by line.

You cannot itemize a roof garden. You cannot itemize the ninth day, either.

The Margaret Hague closed in 1979. The medical center around it filed for bankruptcy at the end of 1982 — first under Chapter 11, which the court threw out because a municipal hospital could not use it, then under Chapter 9 in February 1983 — and became a private nonprofit in 1988. No single decision ended the free hospital. The city could not carry it, the model had no way to pay for itself the moment anyone asked it to, and by then nobody was asking the older question anymore — whether a city owes a mother a bed the way it owes her a fire truck.

But there is a second lesson in the ending, and it is the one I keep coming back to. That hospital rested on one man’s arithmetic. When his arithmetic changed, it went. Nothing underneath it could stand on its own — no independent midwives, no neighborhood clinics, no small organizations with their own revenue and their own reason to survive the next election. The city had built a magnificent single point of failure. Being publicly owned did not make it permanent. It only made it dependent on a different kind of luck.

The building is apartments now. Two million square feet of the old complex became somewhere between twelve and fifteen hundred units marketed as The Beacon, one of the larger adaptive reuse projects in the country. The marble was kept. The Art Deco was kept. What was not kept was the reason any of it was laid down.

We kept the finishes and threw away the purpose.

In 2024, 649 women in this country died of maternal causes, a rate of 17.9 per 100,000 live births — which the National Center for Health Statistics reported as not meaningfully lower than 2023’s 18.6. The pandemic spike has come down. The distance between women has not: Black mothers die at roughly three times the rate of white mothers, and that ratio does not move. The United States still has the highest maternal mortality of any wealthy country. And on a separate count, kept on a wider definition and an earlier stretch of years, maternal mortality review committees in thirty-six states found that more than eighty percent of pregnancy-related deaths between 2017 and 2019 were preventable.

Preventable. That is the word I keep stopping on.

New Jersey is worse where it matters most. The state's own Nurture NJ initiative reports that a Black mother here is almost seven times more likely than a white mother to die of maternity-related complications. New Jersey publishes that about itself, which is more than most states are willing to do.

In Washington, the Momnibus came back in March, reintroduced by Representatives Alma Adams and Lauren Underwood and by New Jersey's own Senator Cory Booker — fourteen bills covering social determinants, the perinatal workforce, data, veterans, incarcerated mothers, postpartum WIC, maternal mental health, environmental risk. Pieces of it have become law over the years; the Protecting Moms Who Served Act was signed in November 2021. The package itself never has.

A building is going up at Pennington Avenue and North Warren Street in Trenton, across from the Battle Monument. Eighty-six point seven million dollars of state and federal money. Ground broke in July 2025. It opens in 2027.

Inside: an OB/GYN clinic run by Capital Health, the lead clinical partner. A social services hub run by Trenton Health Team. Research and workforce space anchored by Rutgers School of Nursing, alongside Mercer County Community College, The College of New Jersey, Thomas Edison State University and Stockton. An innovation floor with Rowan University, the Cooper Institute and Plug and Play. Running the place day to day will be the New Jersey Maternal and Infant Health Innovation Authority, a state agency created by law in 2023, whose president and chief executive is Lisa Asare.

The state's economic development authority has put its twelfth Strategic Innovation Center in the building — five thousand square feet, branded New Baby New Jersey. Its board approved $12.55 million in January 2026 covering that center and a medtech center in South Jersey, with Plug and Play running two cohorts a year of at least twenty companies each, a fifth of every cohort required to be New Jersey firms.

New Jersey calls it a first-of-its-kind statewide hub, and I could not find a state-run counterpart anywhere else.

It would be easy to write this up as a ribbon-cutting, and just as easy to write it as a takedown. Both would be wrong, and the second would be lazy.

Since December 1, 2025, the authority has been running free rides. A pregnant or postpartum resident — or someone in the perinatal workforce that serves her — books a zero-emission car off a QR code and gets to a prenatal appointment or a social service office. More than 1,600 rides for over 2,100 passengers in the first six months. In May 2026 it extended into Hamilton and Ewing. Under the current partnership the rides are funded through December 30, 2026.

They have been building the workforce ahead of the building, too. The community-based doula program launched in September 2025, an eight-week, seventy-hour course that leaves graduates eligible to enroll as Medicaid providers. The published counts do not agree with each other — thirty graduates and twenty-two facilitators across four cohorts in one accounting, fifty doulas trained according to the authority’s president this July. Either way the number is small, and honestly the plumbing matters more than the number. Medicaid paid for about three in ten births in this state in 2024. Getting a doula credentialed and registered is the whole difference between a trained woman existing somewhere and a trained woman being reachable by someone who needs her.

In February 2026 the agency opened grants of up to fifty thousand dollars for small businesses and community organizations working in women's health and birth services, and built a second program alongside it to teach the winners how to manage the money and report on it.

I want to point at that last part, because it is easy to skim past and I think it is the most important thing in this article. The state did not open a clinic. It gave money to people already doing the work, and then taught them how to keep books so they could go get more money from somewhere else next year. Same with the doulas: nobody hired them. The state made it possible for them to bill. That is a different kind of act than building a building. It leaves something standing that does not need the state to keep standing.

The agency is not large. Its second annual report, out in March, lists $5.2 million in state appropriations, agreements with other agencies worth more than $670,000, and $475,000 in philanthropy. That is a small budget for the office carrying an entire state's maternal health, and worth remembering before anyone insists it should also have built a hospital.

Assemblywoman Verlina Reynolds-Jackson, who represents the district and sponsored the law creating the authority, has said the rides sound like a small thing right up until you are the mother who missed the appointment. She is right. She also represents a city where the median household income is under fifty-three thousand dollars.

And the biggest piece of all is not in Trenton at all. It is at people’s front doors. Family Connects NJ sends a trained registered nurse to the home of a new parent within about two weeks of a birth or the adoption of a newborn. It is free. It does not ask about income or insurance or immigration status. It is offered to families who lose a baby, too. It started in January 2024 in five counties — Cumberland, Essex, Gloucester, Mercer and Middlesex — and by January 2026 more than ten thousand families had used it. The Murphy administration put at least fifty million dollars into it across several budgets, and Governor Sherrill’s first budget proposal adds $12.8 million to finish the map, bringing Hunterdon, Morris, Union and Warren online in January 2027 — which would make New Jersey the first state in the country where that visit is available everywhere.

I want to be exact about why that matters, because it cuts against the argument I am about to make and it belongs here anyway. When the Commonwealth Fund compared wealthy countries on maternal health, the United States came out as the only one guaranteeing neither a postpartum home visit nor paid leave. The others guarantee at least fourteen weeks of leave. Here, roughly a quarter of private-sector workers have access to paid family leave at all. New Jersey has been closing both halves of that gap on its own — its own paid family leave insurance, and soon universal nurse home visiting. It is the most underreported maternal health fact in this state, and somebody should say it more often.

Now read the state's description of the clinical program. It promises continuity of care for women “before conception, during pregnancy, and after birth,” and lists reproductive and gynecological services, pre- and post-natal obstetric care, behavioral health, newborn and pediatric care.

Before. And after.

Birth is the one word in that sentence that shows up only as a marker of time. Labor and delivery is not in the state's published description of the Center — not in the 2024 version, not in 2025, not in the one posted this July.

Capital Health moved obstetrics out of the city to its Hopewell campus in 2011. Most Trenton women deliver there now, about fifteen minutes away. Reporting in 2022 put the number of pregnant Trenton residents leaving the city to give birth at roughly a thousand a year. Then in June 2025 the East Trenton hospital, the old St. Francis, closed over building-safety problems, and the city was down to one hospital.

The agencies did not draw any of this alone. They ran two rounds of community engagement in Trenton first, and residents used both of them to ask for accessible delivery services and for a freestanding birth center. Coverage in 2022 and 2023 talked about birthing rooms and a birth center for Trenton. That language is not in what the state publishes today.

There is an answer to the question. It is across the street.

The Greater Mount Zion Trenton Community Development Corporation, a faith-based nonprofit, is building an independent birthing center on the other side of Pennington Avenue. It is called Back in Our Hands. It will do prenatal and postpartum care as well, plus lactation support, fitness classes, programs for fathers and children. Diana Rogers, the corporation's executive director, has said it should open in the fall and will be the first birthing option Trenton has had in more than a decade. Crystal Charley directs the center. Asare has said low-risk mothers who would rather avoid a hospital birth can be referred there.

The two efforts are hardly strangers to each other. Rosalee Boyer, First Lady of the Greater Mount Zion A.M.E. Church and a co-founder of Salvation and Social Justice, sits on the authority's board. This is a small city and that overlap is a feature, not a scandal.

Washington has been by as well. In late August, Senator Cory Booker toured the planned birthing center with Mayor Reed Gusciora, walking through a building that stands across the street from the state's construction site.

So the answer is real, the collaboration is real, and the people building it have earned every word of the credit. It is still worth saying plainly what the arrangement is. The state built the building. A church nonprofit is building the birth. And a referral across a street is not the same thing as a service under a roof.

These belong to NJMIHIA, NJEDA, Capital Health and Mount Zion, and every one of them has an answer.

Will labor and delivery, or licensed birth-center services, be available at the Center itself, or only by referral? If by referral, who performs the delivery, and what is the formal clinical and legal handoff between the prenatal provider and that institution? Who transmits the record? Who follows the patient when a complication surfaces after discharge? Who counts the woman who could not get the ride? And what happens to the rides after December 30, 2026, when the funding runs out?

None of that is rhetorical. The answers decide whether this building is infrastructure or a very good program.

Specialization is progress. Fragmentation is not. Modern maternity care may well need a network instead of a single tower — the 1931 model was expensive, paternalistic, and built by a man nobody should admire. But a network only becomes infrastructure when the handoffs and the transportation and the accountability are guaranteed. Short of that, what you have is a map.

Ninety-five years ago one building held all of it, and the woman stayed where she was while the care moved around her. Today the care is spread across two municipalities, several institutions and a set of programs, and the person who has to move between them is the one who just gave birth.

We are handing her the map.

Every part of this story runs through the same ground and through wildly different kinds of government. A machine boss built a hospital to hold on to power, and it delivered 350,000 babies anyway. A New Deal president came to dedicate it. A Democratic president signed the forty-eight-hour law a Republican Congress passed. A Democratic governor created the Trenton authority, and a new administration is finishing the building and paying for the nurse who knocks on the door.

Ninety years of that, and no American government has been willing to stand up and say that mothers are on their own. We are losing anyway. Which tells me the problem is not what anyone believes. It is what we have agreed to be responsible for, and what we have agreed to count.

So I want to be careful about what I am asking for, because the obvious thing to ask for is another Margaret Hague, and I do not think that is right. Policies change. Governors change. The people running the agencies change. Hanging something this important on any of that is how you get a magnificent building full of apartments ninety years later.

What I want is the other thing, the quieter thing the state is already doing in Trenton without much fanfare. Make it possible for the people who would do this work anyway to survive doing it. Let a doula bill Medicaid. Let a church nonprofit build a birthing center and stand next to it when it does. Give a small organization fifty thousand dollars and then teach it to keep books, so that next year it can go find the money somewhere else. That is not a program. That is an ecosystem, and an ecosystem outlives an administration, because no single person’s arithmetic holds it up.

Public money is not the risk. Public money as the only leg is the risk.

We already know how to count births. That number is exact, published every year, broken out by race and county and hospital. The harder question is whether we still count what surrounds a birth — the ride that never came, the record that never transferred, the visit that got missed, the complication that showed up on day nine, the woman who never made it into the building's official total in the first place.

The Margaret Hague has a perfect record of everyone it admitted. It has no record at all of anyone it turned away. Ninety-five years on, we are still deciding which of those two numbers a public institution owes the public.

The building is still standing on Bergen Hill.

Somebody just has to count again.

The hospital: contemporary accounts in The Jersey Journal; the Third Circuit opinion in In the Matter of Jersey City Medical Center, 817 F.2d 1055 (1987), for the December 1982 Chapter 11 petition the court dismissed and the Chapter 9 petition of February 10, 1983; Jersey City Medical Center’s own published history for the 1988 conversion to a private nonprofit. Mary T. Norton’s papers, including the unpublished memoir, are at Rutgers. Figures the hospital reported in its own era are given here as the institution’s record, not as measurements comparable to ours.

Maternal mortality: National Center for Health Statistics, maternal mortality in the United States, 2024. The preventability figure is a different measure from a different period — the CDC 2022 report on 2017 to 2019 findings from maternal mortality review committees in thirty-six states, which counts pregnancy-related deaths within a year of pregnancy rather than the narrower maternal-death definition NCHS uses. The two do not share a denominator and should not be read as one number. New Jersey’s racial disparity figure is the state’s own, published through Nurture NJ.

Medicaid share of births: March of Dimes PeriStats, drawn from NCHS final natality data — 29.6 percent of New Jersey births in 2024. The four-in-ten figure often quoted is the national one.

Family Connects NJ: the New Jersey Department of Children and Families, which reports the program launched in January 2024 in Cumberland, Essex, Gloucester, Mercer and Middlesex counties and expanded to six more in January 2025.

The Trenton center: the New Jersey Maternal and Infant Health Innovation Authority and the New Jersey Economic Development Authority, including the authority’s second annual report and the state’s published description of the Center’s clinical program, read in its 2024, 2025 and July 2026 versions. New Jersey calls the Center first-of-its-kind. That is the state’s characterization; I have not found a comparable state-run facility elsewhere, which is not the same as proving there is none.

Where the record is silent — admissions by race at the Margaret Hague — I have said so rather than inferred.

Sylvia Kim is the publisher of KORISE/Mom&I, founded in 1999. She lives in Jersey City.

Disclosure, for republication outside KORISE/Mom&I: the author is also president of KCED Foundation Inc., an IRS-approved 501(c)(3) public-interest newsroom based in Fort Lee, New Jersey.