For many mothers, the postpartum period may be the most medically complex stage of pregnancy. More than half of maternal deaths occur during the postpartum period defined as one day to one year after delivery. There are even more near misses — new mothers who experience pregnancy-related complications that may be avoidable. As with so many other adverse health outcomes, these complications and deaths disproportionately affect low-income families and rural areas with diminished access to high-quality medical care.
As a doula, I see firsthand how hard it can be for mothers to care for a newborn while also trying to meet their own needs. And yet, many complications can be avoided through a combination of increased access to routine postpartum care visits and addressing the socioeconomic determinants of health.
Recently, I’ve had the opportunity to be a part of an important project that could have a long-lasting impact on the health of new mothers. Using information from the Oregon Data Collaborative, Comagine Health investigated how many insured Oregonians were accessing crucial postpartum visits. The results are compelling and are featured in our Postpartum Care Data Byte.
In 2017, only 37% of Oregon mothers received routine postpartum care visits within three weeks of hospital discharge, while 64% of women received a visit within eight weeks. It’s during this timeframe that postpartum mothers are more susceptible to dangerous maternal health conditions, such as postpartum hemorrhage, infection or postpartum depression. The American College of Obstetricians and Gynecologists recommends that all women have contact with their OB-GYN or other obstetric care providers within the first three weeks postpartum. And yet less than half of commercially insured Oregon women had a postpartum doctor visit during the crucial period 21-56 days after delivery — much lower than the national average of 71%.
In partnership with the other members of the Oregon Perinatal Collaborative, Comagine Health is supporting a quality improvement project aimed at decreasing the incidence of one of the leading causes of maternal morbidity and morbidity: obstetric hemorrhage. Using national guidelines set by the Alliance for Innovation on Maternal Health, Comagine Health is contributing to the development of an obstetric hemorrhage toolkit and data measurement strategy for Oregon providers to improve maternal health care.
Working with families to ease their transition to parenthood is gratifying, but I am aware that for every family with support, there are dozens more who don’t have access to care. By focusing on policies that affect the larger community, we can transform the experience of postpartum care and positively impact health.
To see a more complete picture of the state of postpartum care in Oregon, download our Postpartum Care Data Byte.