About Maternal Violent Deaths

The significance of violence is often overlooked as a contributor to maternal mortality. 

The U.S. Department of Health and Human Services (HHS) Office on Women’s Health provides the Tennessee Department of Heath with funding to reduce Maternal Deaths Due to Violence. This is a 5 year grant that promotes initiatives that 1) implement and improve the data collection and reporting system that identifies and reviews maternal death, 2. Implement evidence-based strategies to reduce maternal deaths due to violence and 3. Implement a process and outcome evaluation and develop a plan to sustain efforts to reduce maternal deaths due to violence.

Tennessee Department of Health has been reviewing pregnancy-associated deaths since 2017. From 2017- 2019, 222 deaths were reviewed. Of those, 37 were intentional violent deaths with 27 being homicides and 10 suicide. The majority were determined by the review team to be preventable. This data highlights the importance of prevention initiatives around risk factors identified during the reviews. Key risk factors to be addressed include domestic violence and postpartum depression. 

During this funding period, the Tennessee Department of Health will focus on domestic violence through training home visiting, care coordinators and healthcare providers. Home visitors and care coordinators will be provided a three-part training with part one to recognize domestic violence, part two to understand the complexities of leaving the situation, and part three on resources and referral. The training for healthcare providers will be on the use of the danger assessment tool.

Another focus for this project will address post-partum depression through training of healthcare providers on utilizing the Edinburgh postnatal depression scale. In addition, training will be offered through post-partum support international on perinatal mental health and mood disorders. We have also incorporated a training called Mothers and Babies that focuses on Maternal Depression.

As part of this grant project an evaluation plan has been developed. The evaluation will utilize a mixed methods approach consisting primarily of quantitative and qualitative data that can be measured over time to assess change. The goal of the evaluation is to assess the impact of programmatic activities by examining a series of process and outcome measures. By examining both process and outcome measures, the program will determine changes needed in implementation and sustainability of the activities to improve the outcomes of maternal mortality.