The 4th Trimester Project aims to improve maternal and infant health outcomes
October 06, 2022
Female doctor talks with pregnant patient in exam room

    A $1.3M CDC grant will expand perinatal quality collaborative statewide

    A project led by the Virginia Neonatal Perinatal Collaborative, which includes CHoR, aims to improve maternal and infant health outcomes throughout the commonwealth with the support of a $1.3 million grant from the Centers for Disease Control and Prevention.

    According to national data from the CDC, nearly two-thirds of maternal deaths are preventable. The 4th Trimester Project, originally piloted in 15 hospitals, will expand to all 51 birth hospitals and communities in the commonwealth with the support of this grant, more than tripling access to perinatal care.

    Founded in 2017 and led by executive director Shannon Pursell, the VNPC is a statewide perinatal quality collaborative that was created to ensure every mother has the best possible perinatal care and every infant cared for in Virginia has the best possible start to life. The VNPC includes members from throughout the state, including researchers and practitioners from Virginia Commonwealth University, Virginia Tech, University of Virginia, Virginia Department of Health and Virginia Hospital & Healthcare Association.

    A multi-pronged approach for supporting the health of new mothers

    In the 2019 Virginia Maternal Mortality Review Team report, women with a chronic condition were more likely to die after the traditional six-week postpartum period with 62.3% of deaths occurring 43 days or more following their index pregnancy.

    "The 4th Trimester Project was designed specifically as a result of the findings in the MMRT report," said Joseph Khoury, M.D., associate professor in the Division of Neonatal-Perinatal Medicine at CHoR  and co-chair of the VNPC. "We are thrilled that VNPC has been awarded this grant and look forward to expanding this work and improving maternal outcomes for people across the commonwealth."

    The 4th Trimester Project aims to reduce maternal mortality and improve maternal and infant health by focusing on five core areas:

    • Increasing access and education about reproductive health.
    • Providing training opportunities to all providers who see women of child-bearing age in mental health, substance use, and domestic violence, screening and management.
    • Increasing provider and specialist training in the management of specific chronic conditions in pregnant and postpartum care.
    • Supporting pregnant persons’ goals for human milk feeding.
    • Providing education and awareness about well-person and preventive care.

    "Knowing that two-thirds of maternal deaths are preventable, the ways to remedy this in Virginia are best determined by the expertise we have in the commonwealth," said Arthur Ollendorff, M.D., professor in the departments of OB/GYN and Health Systems and Implementation Science at Virginia Tech Carilion School of Medicine and co-chair of the VNPC. "This grant will allow VNPC to gather medical experts with members of the community and other collaborators to find the best ways to protect those giving birth in our state."

    "This grant will afford the VNPC the opportunity to grow and to provide more assistance to birth hospitals and communities across Virginia," Khoury said. "Understanding each community's unique challenges will allow for the VNPC to adapt education, awareness and best inform birth hospitals on the needs and wants of communities in the maternal and infant health space to ultimately drive change with maternal and infant health outcomes."

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