Grant Supports New Program to Reduce Disparities in Maternal Deaths from Domestic Violence

Toward a Healthier Virginia for All

This article is part of an ongoing series of stories highlighting VCU Health programs and initiatives aimed at addressing issues of access and equity in health care.

People who are pregnant are at higher risk of experiencing intimate partner violence (IPV) than those who are not pregnant. And Black people who are pregnant are more than twice as likely to die from pregnancy-associated complications as their white counterparts (80.7 compared to 35.3 per 100,000 live births). A new VCU program, powered by a recent $1.5 million, five-year grant awarded by the U.S. Department of Health and Human Services, aims to reverse these statistics.

“Heartbeats” is one of 12 grants awarded across the country that gives health care providers and researchers the opportunity to focus on the significant risks to safety that pregnant and postpartum survivors of intimate partner violence experience.

“The overall program will address the barriers that pregnant survivors and postpartum women face when attempting to access appropriate medical care, forensic evidence collection, mental health services and community support,” said Carol Olson, assistant director of VCU Health’s injury and violence prevention - gender violence and IPV initiatives and counseling programming. “The goal is to reduce maternal deaths due to suicide, homicide and domestic violence. We want to be able to intervene earlier in order to identify domestic violence and provide enhanced services — whether it's emergency shelter, counseling or additional support.”

The program is an extension of Project Empower, a hospital/community-based violence prevention and intervention program, dedicated to serving victims of sexual assault, domestic violence, intimate partner violence and stalking.

Once individuals are enrolled, the program provides support through pregnancy and postpartum for up to two years. Pregnancy support can include doula support, pregnancy educational classes and pregnancy support groups. Each participant is assigned an advocate to help them leave the violent relationship and get the resources they need.

“We usually start out by providing crisis intervention, and this part is important because we're not only helping them stabilize, we also are establishing trust,” said Leann Ragland, lead advocate for Heartbeats. “That initial interaction is key because we’re providing a sense of safety and stability which is absolutely critical for survivors of IPV, especially those who are pregnant and newly postpartum.”

VCU Health’s Injury and Violence Prevention Program integrates all prevention programs the health system offers as part of operating a Level I trauma center. Heartbeats participants receive screening and advocacy support from Project Empower, and then are connected to VCU Health’s counseling program for additional support.

One aim of Heartbeats is to improve prenatal care for Black women in general, even if they do not need any other violence prevention-related services.

“We know that health inequities happen at a higher rate for Black women,” Olson said. “We're trying to reduce maternal deaths for all people, but we are paying close attention to Black women because their mortality rates are higher and they are battling obstacles — like racism and prejudice — that not everyone else has to battle.”

Heartbeats is partnering with doulas trained to understand the barriers women of color may face in a health care setting and can support and advocate for them pre-and post-pregnancy.

Discussions are also underway about ways to increase access to underserved and rural communities. Program staff are hoping to expand Heartbeats to VCU Health locations in Tappahannock, New Kent and South Hill in the coming year, in addition to partnering with other hospital systems in Central Virginia.

If you are interested learning more about VCU Health’s efforts to address health disparities, read more of our Healthier Virginia for All coverage at https://www.mcvfoundation.org/news/tags/health-equity.