Presentations

Abstract

Introduction:

The postpartum period is an important period to diagnose and treat both physical and mental health conditions. The initial postpartum appointment is vital to diagnose postpartum mood and anxiety disorders (PMADs) as they are the most common obstetric complication, with maternal suicide being the number one cause of death within the first year postpartum. However, due to insurance guidelines, women are only seen 1-2 times postpartum, with most not being seen until 6 weeks after delivery. Lack of postpartum follow up is dangerous, especially for women of color, because it can lead to higher rates of untreated mental and physical health issues, leading to higher rates of maternal morbidity and mortality.

Methods:

We surveyed moms when they brought their baby into the General Academic Pediatrics Clinic at CHKD for well child checks from 2-6 months of age. We collected information about their birthing experience and barriers to attendance of postpartum visits.

Results:

Forty percent of mothers did not attend a postpartum visit (71.4% Black/AA, 35.7% Hispanic). Over 21% of mothers did not have a postpartum visit scheduled before they left the hospital after delivery. Reasons for not attending the initial postpartum visits included: postpartum visit was not important (36%), no active concerns (29%), forgot to attend appointment (21%), work/school schedule (21%), lack of insurance coverage (14%).

Conclusion:

When mothers do not attend their postpartum visit, it is a missed opportunity to screen, diagnose and address health issues. Topics such as contraception, breastfeeding, and PMADs can be addressed. Education on these topics has been shown to improve birth spacing and reduce risk of preterm birth and birthing complications, which disproportionately affect women of color. Having systems in place where barriers are reduced for mothers to receive the postpartum care they need is essential in reducing maternal morbidity and mortality.