VCU’s Heartbeats program races for better maternal health outcomes | Richmond Free Press

For the last several months, a new program at Virginia Commonwealth University has been working to prevent sometimes fatal complications such as domestic violence, racial inequality and medical bias that come with pregnancy.

With the support of a $1.5 million grant from the U.S. Department of Health and Human Services, VCU’s Heartbeats program is providing support for many issues that can arise before, during and after pregnancies.

Heartbeats began last October as one of 12 grants awarded in the United States to fund research and address the risks experienced by pregnant and postpartum survivors of intimate partner violence. The program also will address certain challenges African-Americans face during pregnancy. The grant is spread out over five years.

For Weluna Finley, a licensed professional counselor with 20 years of experience in mental health and three years in birth work, the chance to work with Heartbeats as a doula and consultant has allowed her to support a new initiative that’s bringing welcome services to the community.

“I believe the program has great potential,” Ms. Finley said. “We’re aware of the needs of the community and we step up to answer that call and fill in some gaps.”

The program is an extension of VCUHealth’s Project Empower, a hospital/community-based violence prevention and intervention program, that aids victims of sexual assault, domestic or intimate partner violence, and stalking. All Heartbeats patients have joined the program through Project Empower.

While the program is relatively new, administrators say it has been positively received by the pregnant and post-partum patients enrolled in various services.

“They love it,” said Carol Olson, a licensed professional counselor for VCU Health who works with Project Empower. “We provide them with transportation to their appointments, (and) we do bedside services. If they’re in here, in our hospital, giving birth, we can be there with them if they need us.”

Heartbeats’ work is focused on a major issue in maternal care for Virginia. According to data from the Virginia Department of Health gathered from 2004 to 2013, patient deaths accounted for as low as 35.2 percent to as high as 60 percent of every 100,000 live births in the state. Among those deaths, African-American women died at a much higher rate than white patients, 80.7 percent to 35.3 percent, with 53 percent of all deaths caused due to natural causes such as cardiac illness, cancer and infection. The majority of these deaths have tended to occur among women between 20 to 29 years old.

Heartbeats’ establishment in Central Virginia also places it in the greatest concentration of pregnancy-associated deaths statewide, with 63.3 percent of every 100,000 births ending in the patient’s death from 2004 to 2013.

The 70 patients enrolled in Heartbeats largely live in Richmond and the counties of Henrico and Chesterfield. They are scheduled to receive up to two years of pregnancy and postpartum support through Heartbeats inside and outside the medical system.

Using the Hurt, Insult, Threaten and Scream, or HITS, screening tool to assess instances of partner violence, enables Heartbeats to better assist patients. This support ranges from educational classes and support groups focused on pregnancy, to housing assistance, counseling services and employment.

The program also has partnerships with Richmond Behavioral Health, the YWCA, Safe Harbor and Hanover Safe Place to tackle issues such as legal concerns or substance abuse disorders, that may compound and hinder participants’ maternal care process.

“We have connections with our local partners to make sure that they make it to those centers,” Ms. Olson said. “We also have a strong relationship with our partners so that they can help navigate multiple systems at once.”

African-Americans are 59.4 percent of patients in Heartbeats so far, which makes the program’s focus on reducing systemic racism and bias in medicine especially important.

Partnerships with doulas trained to support and advocate for women of color dealing with issues in health care settings pre-and post-pregnancy have been particularly vital. Heartbeats also has hired a communications staff member tasked with reaching out to marginalized populations, to better respond to the needs of the clear majority of their patients.

“Because primarily we service African-American clients, we have a duty to service them the way they should be serviced, and historically, the way sometimes they haven’t been,” Ms. Finley said. “That is one of the guiding principles in what we do and how we do it.”

Even with the benefit of its grant, Heartbeats is already facing a number of challenges. According to multiple officials working with the program, client interest in Heartbeats’ services has quickly outpaced the ability to meet that interest.

Heartbeats also hopes to expand the program to VCU Health locations in Tappahannock and New Kent, as well as build partnerships with other Central Virginia hospital systems.

Ms. Olson said she is seeking additional funding and support for this expansion, partly due to the high number of patients but also to support new services and initiatives already in progress.

With less than a year since Heartbeats’ start, a clear picture of the full impact of its work to address maternal health won’t be available until for several more months.

“People stay engaged in treatment, because they have somebody dedicated to them, and they’re navigating pregnancies with more stability,” Ms. Olson said. “We’re having improved outcomes for people navigating the system and navigating the barriers that they may face.”