WOMEN/MATERNAL HEALTH DOMAIN 

FY25 APPLICATION YEAR

STRATEGIES:

1. Work with stakeholders to increase access to doula services among women of color

In order to expand access to doula services among women of color in Virginia, VDH intends to continue managing the State Doula Certification Program and providing administrative support to the Virginia Doula Task Force during the upcoming funding period. The task force will meet quarterly and guide the Doula Certification Program, Medicaid reimbursement of doulas, and promote doula access among vulnerable populations.

Title V will continue to work with Fairfax County Health Department to expand doula training opportunities throughout the Northern Virginia area as well as opportunities for clients seeking prenatal services through Fairfax’s community partners to receive doula services.

Title V will continue to work with Germanna Community College and Rappahannock Health District to implement doula certification classes as part of their curriculum.

2. Maintain Title V representation on the Virginia Neonatal Perinatal Collaborative (VNPC) Steering and Executive committees, and Title V representation in selected workgroups

VDH staff, including DCFH Director, Title V/MCH Director, Maternal/Infant Consultant, and MCH Epi team members will maintain active representation on VNPC’s Board of Directors and steering committees, as well as participate in monthly data meetings with VNPC staff.   

VNPC, in collaboration with Urban Baby Beginnings, are Virginia’s recipients of HRSA’s 2023 State Maternal Health Innovation Program grant, awarded in September 2023. As outlined in the grant requirements, Virginia’s Title V Director and State SSDI Director will participate in the Maternal Health Task Force, provide subject matter expertise towards the development of a strategic plan, and ensure that the MHI grant efforts are in alignment with, and enhancement of, Virginia’s Title V State Action Plan. Title V will continue to provide technical assistance and data support as requested by the grantees.

3. Local Health District (LHD) Strategy: Develop, mobilize, and participate in strong interagency, multisector, and community partnerships to address disparities in maternal and infant mortality rates

Beginning October 2023, all 35 Local Health Districts were required to participate in at least one of five work groups designed to collectively identify strategies and activities to impact priorities areas outlined in the State Action Plan. The Doula Work Group, consisting of MCH leaders from 11 of 35 LHDs, will continue to meet monthly through June 2025, and the work will inform activities in the new State Action Plan.

4. Partnership with CDC Innovative Cardiovascular Health Initiative grantees to implement evidence-based strategies to improve cardiovascular health in pregnant and postpartum women

In September 2023, VDH Division of Prevention and Health Promotion in the Office of Family Health Services was one of only 13 states to receive the highly-competitive CDC Innovative Cardiovascular Health Initiative grant (CDC DP23-0005). This five-year grant focuses on census tracts across Virginia whose population has a high rate of hypertension. Pregnant and postpartum women comprise a subset of this target population. Title V will partner with the grantees, assuring local-level collaboration through MCH teams in targeted areas of focus in Crater, Portsmouth, and Roanoke health districts. The local teams will advance the grant’s community-based partner, Huddle Up Moms, and their Moms Under Pressure project, which supports the distribution of blood pressure kits and education to pregnant mothers who are diagnosed with preeclampsia, HELLP syndrome, gestational hypertension, or are at risk for hypertensive disorders. 

STRATEGIES:

1. Sustain state maternal mortality and child fatality review programs, engaging with cross-sector partners and addressing social determinants of health in development of MMRT and CFRT recommendations

The Maternal Mortality Review Program staff will continue to conduct informant interviews for the maternal mortality review program. This protocol will allow for family members of maternal death cases to provide information that will help to bolster the review of maternal death cases. The Maternal Mortality Review team will continue to be a diverse, multidisciplinary team that conducts comprehensive reviews of each pregnancy-associated death in the Commonwealth. This includes addressing social determinants of health throughout the review process. The Team then makes recommendations for the development of interventions and the implementation of policy changes that support health equity, improve maternal outcomes and reduce racial disparities in pregnancy-associated deaths in the Commonwealth of Virginia.

2. Re-convene the Maternal Health Data and Quality Measures Task Force to evaluate maternal health data

Virginia House Bill 2111 (2021 General Assembly) established the Maternal Health Data and Quality Measures Task Force for the purpose of evaluating maternal health data collection to guide policies in the Commonwealth to improve maternal care, quality, and outcomes for all birthing people in the Commonwealth. Although the work culminated in a final report in FY24, efforts are underway to re-establish the Task Force to continue the work of the previously established Task Force under the State Health Commissioner. As such, FY25 will see the reconvening of the multidisciplinary task force with representation from multiple sectors in order to improve maternal health data in the Commonwealth.

STRATEGIES:

1. Work with stakeholders to remove policy, financial, and training barriers to contraceptive access

During FY25, VDH’s Reproductive Health Unit intends to continue its work supporting the Contraceptive Access Network and the Contraceptive Access Initiative.

STRATEGIES:

1. Explore opportunities for providing support to families seeking fertility services and families experiencing miscarriage

VDH intends to continue the Pregnancy Loss Support program in FY25. VDH will continue evaluation of program data to determine immediate program impact and insight about additional needs among this population. VDH will additionally identify opportunities for system-level initiatives through this project.

2. Local Health District (LHD): Strengthen early identification, supports, and referrals for women’s mental and behavioral health needs

Beginning October 2023, all 35 Local Health Districts were required to participate in at least one of five work groups designed to collectively identify strategies and activities to impact priorities areas outlined in the State Action Plan. The Maternal Mental Health Work Group, consisting of MCH leaders from 15 of 35 LHDs, will continue to meet monthly through June 2025, and the work will inform activities in the new State Action Plan.

3. Update the maternal guidelines for VDH’s five prenatal care clinics to include guidelines on maternal substance use and maternal mental health

Write guidelines for maternal substance use and maternal mental health for clinical providers working in VDH’s prenatal care clinics. Ensure that guidelines are useful and easy to follow for providers and in line with recommendations from the relevant professional organizations such as the American College for Obstetricians and Gynecologists.

In FY25, VDH Dental Health Program will continue to partner with Virginia Health Catalyst to influence changes to the system that promote more equitable and easier access to oral health services for pregnant and parenting people and their children.

STRATEGIES:

1. Maintain and expand existing MCH-focused dental education programs to improve oral health for individuals across the lifespan, to include advising on oral health integration in primary care settings, education for home visitors, school-aged oral health education, and emerging needs of adolescents

2. Continue to facilitate and support regional efforts to improve oral health for all Virginians, with emphasis on pregnant people and their infants

3. Convene statewide groups focused on issues that impact oral health and facilitate collaboration and work plan development and provide leadership and oversight to guide initiatives