Shannon Lenze, an associate professor of psychiatry at Washington University School of Medicine in St. Louis, is aware of the disturbing statistics that demonstrate how gun violence, discrimination, poverty, and lack of access to transportation and healthy food can negatively impact mental and physical well-being during pregnancy, especially among Black individuals who face disproportionately greater challenges compared to other racial groups.

Nonetheless, Lenze pointed out that numerous obstetricians are reluctant to inquire about the trauma associated with their pregnant patients’ life experiences, fearing it may distress them. In collaboration with Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE), a consortium of academic medical professionals and clinics in St. Louis, Lenze experienced an enlightening realization—an insight that has significantly influenced her research on the prenatal health of both the expectant mother and her child.

“Just because you don’t inquire about our trauma doesn’t mean it hasn’t occurred,” a postpartum woman shared during a 2018 gathering with EleVATE, which comprises community-based health organizations, practicing obstetricians, research scientists, and women who have experienced pregnancy as community representatives.

“And when you do ask us,” the expectant mother added, “we feel secure because we understand that you genuinely care about our well-being.”

This insight has prompted research and initiatives surrounding pregnancy that are anchored in trauma-informed care. One such initiative involves a prenatal group where participants develop healthy routines, connect with each other, and share their experiences with ongoing hardships.

For their endeavors in enhancing maternal and infant health outcomes, Lenze and her collaborators from EleVATE were honored with WashU’s William H. Danforth St. Louis Confluence Award, which acknowledges researchers and community collaborators who unite to tackle regional challenges.

The accolade is named in honor of former WashU Chancellor William H. Danforth, who is recognized for fortifying connections between the university and St. Louis during his leadership from the 1970s to the 1990s.

“Engaging deeply with individuals in the St. Louis community and appreciating their needs and viewpoints is vital to all our actions at WashU, be it in education, research, or patient care,” remarked Beverly Wendland, provost and executive vice chancellor for academic affairs. “Fusing the expertise of our researchers with the lived experiences of St. Louis residents can yield significant benefits in addressing society’s most pressing issues.”

Maternal and infant health metrics in both St. Louis and St. Louis County rank among the poorest in U.S. metropolitan areas, as indicated by federal statistics. The national preterm birth rate—denoting infants born prior to 37 weeks of gestation—stands at 10.4% of live births. In contrast, St. Louis’ preterm birth rate is 13.5%, while St. Louis County’s is nearly 12%. Prematurely born infants face heightened risks of health complications, including developmental delays, disabilities, and death.

A pilot study, co-directed by Lenze and released last year in the journal Health Equity, revealed that the prenatal care group can assist in decreasing preterm births and enhancing mental health, which is the leading cause of pregnancy-related fatalities in the St. Louis area. This care model is presently undergoing assessment in a randomized, controlled clinical trial.

Lenze also mentioned a recent investigation from another institution that discovered a 140% increase in postpartum depression rates among non-Hispanic Black women over the last decade. Furthermore, Black pregnant individuals—regardless of socioeconomic or educational background—are at a higher risk for adverse pregnancy outcomes compared to other racial or ethnic demographics. They are also three times more likely to die during childbirth than white patients.

While various risk factors exist, mental health, racism, and daily stressors can contribute to premature births. “Year after year, preterm birth rates in the St. Louis area have been abysmal,” Lenze stated. “EleVATE’s focus on community engagement has enabled us to engage in serious, candid discussions about the challenges facing pregnant patients and how healthcare providers can assist them. Receiving the Confluence Award would not be possible without the contributions of EleVATE’s community collaborators. Together, we aspire to influence healthcare teams and systems throughout the St. Louis area.”

Sharing the award is Cheron Phillips, a community partner with EleVATE who was involved in the pilot study during her pregnancy. “I used to wonder if anyone truly cared enough to listen to the community’s perspective,” she expressed. “This award signifies that my voice, along with those of many birthing families, is being acknowledged.”

Lenze, Phillips, and additional EleVATE collaborators accepted the honor at the William H. Danforth St. Louis Confluence Award Showcase on April 16 at Hillman Hall, located on the Danforth Campus.

The ceremony was organized by the Confluence Collaborative for Community-Engaged Research, Teaching, and Practice, which was established in 2024 to support the St. Louis community and promote community-engaged research.

Alongside a presentation regarding the EleVATE research, the event also recognized the 2025 Provost Impact Award recipients. They are:

• “Empowering Young Women Through Breast Health Education: A Partnership with Siteman Cancer Center and Hazelwood School District” (Faculty lead: Lannis Hall, WashU Medicine; Community lead: Nettie Collins-Hart, Hazelwood School District)
• “Improving Postpartum Mental Health for NICU Families: Developing and Piloting ‘The Fathers First Initiative’ in Neonatal Healthcare Systems” (Faculty lead: Tyriesa Howard, Brown School; Community lead: Jessie A. Davis, Integrated Health Network)
• “Segregation By Design” (Faculty lead: Catalina Freixas, Sam Fox School of Design & Visual Arts; Community lead: St. Louis Association of Community Organizations)
• “STL Solid Waste and Alley Condition Project” (Faculty lead: Scott Krummenacher, Arts & Sciences; Community lead: Karisa Gilman-Hernandez, Dutchtown South Community Corp.)
• “The Importance of Cost Transparency During Cancer Care” (Faculty lead: Mary Politi, School of Public Health; Community lead: Center for Collaborative Care Decisions community advisory board)

2025 honorable mentions

• “A Community Partnership to Enhance Sexual Health Care” (Faculty lead: Hilary Reno, WashU Medicine; Community lead: St. Louis Sexual Health Community Member Advisory Board)
• “Building Bridges: Advancing Refugee Integration in St. Louis” (Faculty lead: Mitra Naseh, Brown School; Community leads: Monarch Immigrant Services and International Institute of St. Louis)
• “CHEST: A Collaboration with Community Health Centers to Implement SMART for Asthma” (Faculty lead: James Krings, WashU Medicine; Community lead: Andwele Jolly, Integrated Health Network)
• “Developing a Community-Based Interdisciplinary Collaborative Team to Support School-Aged Youth with Asthma” (Faculty lead: Kelly Harris, WashU Medicine; Community lead: Veronica Macklin, Hazelwood School District)
• “Financial Burden Among Black Men Making Prostate Cancer Treatment Choices” (Faculty lead: Ashley Housten, WashU Medicine; Community lead: the Empowerment Network)

At the Confluence Award ceremony, attendees Becky Hassler (left), Richelle Smith, Cheron Phillips, Shannon Lenze and Bettina Drake celebrate.

Originally published on the WashU Medicine website

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