# Engaging Veterans in Developing an Intervention to Address Racial Disparities in Cesarean Sections

> **NIH VA I01** · NORTHAMPTON VA MEDICAL CENTER · 2022 · —

## Abstract

Background: Our recent research demonstrated racial disparities in cesarean section delivery rates
among Veterans of color utilizing VA maternity care coordination (MCC) and delivering at community-
based hospitals. Disparate birth outcomes likely result from various factors that impact the Veteran at
multiple timepoints during the perinatal period; however, an in-depth examination of the social
determinants of health that may contribute to these disparities has yet to be conducted among
Veterans. This study will conduct an in-depth examination of the social and clinical factors leading to
cesarean deliveries among Veterans of color and test the feasibility of doula services to enhance VA
MCC in an effort to mitigate disparities in childbirth delivery outcomes among Veterans of color.
Significance: This novel study intensely examines the impact of the social determinants of health on
prenatal, labor & delivery, and postpartum care among Veterans of color in effort to mitigate
disparities in childbirth outcomes. This is the first study to test the feasibility of an enhanced MCC
model that incorporates doula services to improve pregnancy outcomes. The proposed study is
directly responsive to several HSR&D priorities including health equity, women Veterans’ health,
access to care, and care coordination.
Innovation and Impact: This is the first VA study to examine social determinants of health among
Veterans of color who have delivered babies using the VA Maternity Care benefit. It is also the first
study to examine the feasibility of a doula program that complements VA MCC support for Veterans of
color, who are at an increased risk for cesarean delivery.
Specific Aim 1: Conduct an in-depth investigation with Veterans of color to better understand their
recent cesarean deliveries, using semi-structured interviews and systematic obstetrical chart reviews.
Specific Aim 2: Test the feasibility of an enhanced VA Maternity Care Coordination program which
incorporates doula care to ensure Veterans of color are receiving continuous support throughout
pregnancy, labor and delivery, and the postpartum period.
Specific Aim 3: Share our study findings (Aims 1 & 2) with VA stakeholders, including Women’s
Health Services leadership, through expert roundtable sessions. Utilize the qualitative data from these
proceedings to further inform a larger intervention that will seek to reduce childbirth delivery disparities
among Veterans of color.
Methodology: This is a mixed methods study that will utilize existing survey data and obstetrical chart
audits to augment qualitative interviews in an effort to better understand the impact of social
determinants of health and the role continuous perinatal support has on Veterans.
Next Steps/Implementation: We plan to disseminate findings among our key stakeholders through
expert roundtable discussions. The findings from these sessions will promote and inform a larger VA
intervention that will seek to further mitigate childbirth...

## Key facts

- **NIH application ID:** 10413659
- **Project number:** 1I01HX003463-01A1
- **Recipient organization:** NORTHAMPTON VA MEDICAL CENTER
- **Principal Investigator:** KRISTIN M. MATTOCKS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-05-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413659

## Citation

> US National Institutes of Health, RePORTER application 10413659, Engaging Veterans in Developing an Intervention to Address Racial Disparities in Cesarean Sections (1I01HX003463-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10413659. Licensed CC0.

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