Changing Maternity Care for Women Veterans

The Center for Health Equity Research and Promotion (CHERP) study at VA Pittsburgh Healthcare System looked at pregnancies nationwide among veterans who used VA maternity benefits between fiscal years 2010 and 2017. It found that Black veterans had higher odds than their white peers of serious complications during pregnancy or within a year of the end of pregnancy. The study, led by CHERP’s Dr. Deirdre Quinn, also found a high rate of death within one year of the end of pregnancy among veterans using VA maternity benefits.

Previous research suggests that more than 60% of the pregnancy-related deaths and near deaths are preventable. The key may be improving women’s health before pregnancy. Women veterans have high rates of chronic medical and mental health conditions, and many fall into vulnerable groups at a greater risk for pregnancy-related complications. Forty-eight percent identify as non-white, and 25% live in rural areas.

Quinn, who has a doctorate in family science, is expanding her pilot study into new CHERP research. She will begin by reviewing more than 30,000 pregnancies of women veterans nationally to gather numerical data on possible pre-pregnancy health risks and the connection between vulnerable groups and adverse maternal outcomes.

Nicole McCune, VA Pittsburgh Women Veterans Program manager, said Quinn’s research aligns with the facility’s goal to prioritize women’s reproductive health care — especially as growing numbers of women veterans of childbearing age turn to VA for health care.

“It’s important for enhancing medical and mental health services, and for examining racial and ethnic disparities to optimize maternal and fetal outcomes,” said McCune.

Women veterans number over 2 million in the U.S. and are the fastest growing group among veterans. By 2040, VA estimates they will comprise 18% of the Veteran population, versus just 4% in 2000. Between fiscal years 2020 and 2021, VA Pittsburgh saw a 29% increase in the number of expecting moms who received maternity care.

VA Pittsburgh already has resources in place to improve maternal outcomes, including a reproductive health clinic for pregnant women or those in need of preconception counseling. A physician with specialized experience in women’s health leads the clinic. Last spring, the clinic implemented an emergency protocol for severe maternal hypertension.

Other reproductive health services at VA Pittsburgh include maternity care coordination, lactation consultation, gender-specific dietitian services, obstetric intrapartum support, and reproductive mental health services.

Quinn’s pilot study also helped legislators to draft The Protecting Moms Who Served Act of 2021, which President Biden signed into law in November 2021. It includes:

• $15 million for maternity care coordination at VA facilities. 
• Continuing study of the maternal health crisis among veterans, with a focus on racial and ethnic disparities.
• Identifying mental and behavioral risk factors throughout the prenatal and postpartum periods.

 

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ABOUT VA PITTSBURGH HEALTHCARE SYSTEM

VA Pittsburgh Healthcare System (VAPHS) is one of the largest and most progressive VA health care systems in the nation. More than 4,000 employees serve nearly 80,000 veterans every year, providing a range of services from complex transplant medicine to routine primary care. VAPHS is a leader in virtual care delivery through telehealth technology; a center of research and learning with 130 research investigators and $14.8 million in funding; and a provider of state-of-the-art health care training to some 1,500 student trainees annually. VAPHS provides care at medical centers in Oakland and O’Hara Township in Pennsylvania and five outpatient clinics in Belmont County, Ohio, and Beaver, Fayette, Washington and Westmoreland counties in Pennsylvania. Veterans can call 412-360-6162 to check eligibility or enrollment. Stay up to date at pittsburgh.va.gov, Facebook and Twitter.

Kimberly Graham, Visual Information Specialist