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Strengthen the Evidence for Maternal and Child Health Programs

Evidence Tools
Postpartum Visit

Introduction

Postpartum Visit is one of two Universal Measures. This toolkit summarizes content from the Postpartum Visit Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

Postpartum Visit is related to the following topics; see these Accelerators for additional information: Postpartum Contraception Use and Postpartum Mental Health Screening.

From the MCH Block Grant Guidance. The postpartum period is an important time for maternal health and well-being. Untreated chronic conditions and pregnancy-related complications increase the risk of adverse health outcomes in the weeks and months following delivery. Data from Maternal Mortality Review Committees in 36 states suggest that more than half of pregnancy-related deaths occur from 7 to 365 days postpartum.1 A comprehensive postpartum visit is an opportunity to improve maternal health by providing recommended clinical services, including screening, counseling, and management of health issues.2 Anticipatory guidance and screening for mental health conditions and contraceptive counseling are key components of postpartum care that are recommended by national quality standards and professional organizations.2,3,4 The American College of Obstetricians and Gynecologists (ACOG) recommends that all women have contact with their obstetrician-gynecologists or other obstetric providers within the first three weeks postpartum followed by a comprehensive postpartum visit within 12 weeks after birth.2

Goal. To increase the percent of women who have a postpartum visit within 12 weeks after giving birth and received recommended care components.

Note. Access other related measures in this Population Domain through the Toolkits page.

Overview: Read a summary of the issue related to Title V

The postpartum period is a critical time for parents and infants, setting the stage for a lifetime of health and well-being.1  Untreated chronic conditions and pregnancy-related complications increase the risk of severe maternal morbidity and mortality.2,3 Data from Maternal Mortality Review Committees in 36 U.S. states show that more than half of pregnancy-related deaths occur between one week and one year postpartum; the majority of pregnancy-related deaths are preventable.4 For this reason, it is important that those who have recently given birth receive a health checkup that allows a provider to assess their physical recovery; evaluate their mental health status; diagnose and treat any acute pregnancy-related issues; and manage chronic conditions, such as diabetes or hypertension.5 A positive postnatal experience—where new parents receive the support, reassurance, and information they need within a culturally respectful context6—will increase the likelihood that they will continue to seek recommended health care in the future.

The American College of Obstetricians and Gynecologists (ACOG) recommends that everyone have contact with their maternal health provider within the first three weeks postpartum, followed by a comprehensive postpartum visit within 12 weeks after birth.1 The follow-up appointment provides an opportunity to improve maternal health by offering screening, counseling, and health care services management that adheres to professional guidelines and national quality standards.1,7,8 Family planning services, including contraceptive counseling, and preliminary screening for anxiety and depression are among the key components recommended.1,7,9

Optimizing care and support for postpartum women requires policy changes that view postpartum care as an ongoing process rather than an isolated checkup.1 Systematic data collection efforts aligned with new guidelines for postpartum care are also needed to determine if a comprehensive postpartum visit has occurred and whether recommended services and counseling were received.10

Detail Sheet: Start with the MCH Block Grant Guidance

DEFINITION

Numerators:

A) Number of women who reported attending a postpartum checkup within 12 weeks after giving birth
B) Number of women who reported attending a postpartum checkup within 12 weeks after giving birth and that a healthcare provider talked to them about birth control methods and what to do if they felt depressed or anxious

Denominators:

A) Number of women with a recent live birth
B) Number of women with a recent live birth who reported attending a postpartum checkup within 12 weeks after giving birth

Units: 100

Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE

Related to Pregnancy and Childbirth (MICH) Objective D01: Increase the proportion of women who get screened for postpartum depression (Developmental)

DATA SOURCES

Pregnancy Risk Assessment Monitoring System (PRAMS)

MCH POPULATION DOMAIN

Women/Maternal Health

MEASURE DOMAIN

Clinical Health Systems

Data Sources: Learn more about the issue and access the data directly

This NPM is measured through data collected from the Pregnancy Risk Assessment Monitoring System (PRAMS). In 2020, approximately 88% of mothers surveyed said they had received a postpartum health checkup.11 These self-reported rates are higher than those gathered by health administrators, with those rates ranging anywhere from 24.9% to 96.5%, depending on the clinical setting, sociodemographic factors, and insurance status.10 Postpartum care attendance among Medicaid recipients also varies widely, depending on the state.12 Regardless of insurance status, the majority of postpartum women do not receive all recommended components of care, including contraception counseling and depression screening.8,13

1. Accelerate with EvidenceStart with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools

Evidence-Informed

Evidence-Based

Mixed Evidence

Emerging Evidence

Expert Opinion

Moderate Evidence

Scientifically Rigorous

 

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Key Findings and Emerging Issues: Read more from the literature

KEY FINDINGS

The following are key findings emerging from the literature:

  1. Appointment scheduling before hospital discharge can increase postpartum visit attendance, particularly for women with low incomes and limited English proficiency35,36 After discharge, appointment reminders via text, email, or telephone are also effective.37
  2. Community health workers (CHWs) can address SDOH and help reduce barriers by enhancing access to postpartum care, childcare support, transportation, and other community-support services.38,39
  3. State policies that expand emergency Medicaid to include postpartum care or extend Medicaid to pregnant people beyond 60 days postpartum are likely to improve attendance rates.40,42 A more generous state paid family and medical leave policy also resulted in an increase in postpartum visit attendance, an increase in postpartum care among all women and women from underrepresented racial groups, and lower likelihood of postpartum depression symptoms.43,44
  4. Home visiting programs—whether provided by a nurse, caseload midwife, or community health worker—increase the likelihood that new mothers will receive postpartum care.39,45,46
  5. Adherence to postpartum care guidelines—including contraceptive counseling and screening for depression and anxiety—can be improved when providers use note templates and tools based on ACOG’s Clinical Practice Guideline for Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum.47,48
  6. Effective strategies that emerged during the pandemic include telehealth interventions, mobile medical clinics, and remote monitoring of postpartum patients diagnosed with hypertensive disorders of pregnancy.49-54

RESEARCH

The following strategies are emerging as potential approaches to advance this NPM, but they have not been studied with enough rigor to be included in the evidence continuum, and more research is needed to verify outcomes:

  • Better data can inform policy and align postpartum care with a new standard, helping to normalize concerns, address SDOH, and disaggregate health outcomes by race, ethnicity, and rurality.27,55,56
  • Redesigning perinatal payment strategies in Medicaid can provide incentives for providers to perform postpartum checkups.57

Research Gaps: Learn where more study is needed

Topical Area Knowledge Gaps. Lack of studies on:

  • Making postpartum visits more relevant and valuable to women's overall health and well-being.
  • Identifying predictors of non-attendance at postpartum follow-up visits.
  • Addressing barriers to health care access for low-income minority women to avoid perpetuating or exacerbating health and health care disparities.

Specific Intervention Research Gaps. Lack of studies on:

  • Implementing new postpartum care standards (i.e., care should be ongoing and comprehensive; not just one postpartum visit, but at least 2)
  • Identifying solutions to modifiable barriers to postpartum care, such as enhancing health care teams with community health workers. 
  • Redesigning perinatal payment strategies in Medicaid to provide incentives for providers.

Methodological Gaps. Lack of studies on:

  • Providing postpartum care in populations at a higher risk of having multiple medical and psychosocial stressors. 
  • Using data to inform policy, align postpartum care with a new standard, help to normalize concerns, address SDOH, and disaggregate health outcomes by race, ethnicity, and rurality.

Strategy Video: Watch a summary of evidence-based/informed strategies

Watch a short video discussing state-of-the-art, evidence-based/informed strategies that can be used or adapted as ESMs. Experts in the field discuss approaches, the science, and specific ways that Title V agencies can implement and measure these approaches.

2. Think Upstream with Planning ToolsLead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

A. Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

B. Align with the Needs of the Population

Consider the following findings related to this performance measure.

The Role of Title V: Get ideas on how to implement strategies

Title V agencies can support postpartum visits through:

Home Visiting Programs. Title V can support the expansion of home visiting programs that reach out to underserved pregnant and postpartum women. Home visitors can provide culturally-sensitive education to support the needs of mothers and emphasize the importance of postpartum care.31-33

Community Outreach. Title V can collaborate with community-based organizations to connect postpartum women to local support services, such as childcare and transportation, to reduce care gaps.15

Statewide Programs. Title V can partner with Medicaid to simplify enrollment, unbundle postpartum visits, and advocate to expand eligibility and extend Medicaid coverage beyond 60 days postpartum.15,27,34

SDOH and Health Equity Considerations: Identify ways to advance health for all

Social Determinants of Health (SDOH)

Access to adequate perinatal and postpartum care varies as a result of the social, economic, and environmental conditions that influence individual health care experiences and outcomes. Factors such as low socioeconomic status, racial discrimination, cultural differences, lack of social support, lack of adequate health insurance, and poor anticipatory guidance contribute to disparities in postpartum visits and health outcomes.9,14 Strategies to address SDOH and enhance postpartum care include:

  • Training providers to deliver respectful, culturally appropriate care for a diverse population.15,16
  • Supporting maternal care models that are person-centered, coordinated, and integrated.15
  • Adopting statewide policies to improve access to health coverage during the postnatal period.15,16

HEALTH EQUITY

There are significant differences in the number of postpartum women who seek preventive care after giving birth. Those with limited resources,17,18,19,20,21 those who do not attend prenatal care visits,20,21,22 and those who perceived discrimination during childbirth23 are also less likely to attend a postpartum visit.13 The comprehensiveness of the visit also varies, with Medicaid-insured patients, rural residents, and racial minority groups less likely to receive contraception counseling and depression screening than urban white people with private insurance.7

Universal screening and standardized forms for postpartum care may counteract clinician and policy biases that affect perception and clinical care.7 Payment incentives to allow providers the time to deliver comprehensive care and expanded use of telehealth to help overcome logistical barriers may also improve access to postpartum care and address disparities in the receipt of recommended care.7,15

Special Considerations: Tease out ways to zoom in on populations of focus

Comprehensive Postpartum Care

In studies, women have noted that there is an intense focus on women’s health prenatally but care during the postpartum period is infrequent and late.1,24 ACOG states that the timing of postpartum visits should be individualized and woman centered.1 An initial postpartum visit can occur within the first three weeks after birth or earlier for women with comorbidities and/or complications.1,25 During the early postpartum period, providers were primarily concerned about complications such as infection and bleeding while women tended to be most concerned with issues such as pain and discomfort, fatigue, and emotional lability.24,26 The most commonly provided components of postpartum care—depression screening and contraceptive counseling—have existing national quality standards, which are often tied to financial incentives.7,8,27,28 Comprehensive postpartum care should also include discussions about physical recovery from birth; mood and emotional well-being; sexuality and birth spacing; sleep and fatigue; chronic disease management; health maintenance; and infant care and feeding.1 With half of women reporting not receiving all the care they wanted and 30% reporting feeling rushed,7,29,30 new mothers have multiple unmet clinical needs during the “fourth trimester.”124 A team-based approach among providers may improve the focus of clinical interactions to address the interrelated health issues most important to women as they recover physiologically and psychologically from birth.24,25

3. Work Together with Implementation ToolsMove from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are movable within the realities of Title V programs and lead to health equity for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Implementation Resources: Use these field-generated resources to affect change

PRACTICE. The following tools can be used to translate evidence to action to advance this NPM:

PARTNERSHIP. The following organizations focus efforts on increasing postpartum visits:


References

Introductory References: From the MCH Block Grant Guidance

1 Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022.

2 ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018 Sept; 132(3): 784-785. doi: 10.1097/AOG.0000000000002849.

3 Interrante JD, Admon LK, Caroll C, et al. Association of health insurance, geography, and race and ethnicity with disparities in receipt of recommended postpartum care in the US. JAMA Health Forum. 2022; 3(10): e223292. doi:10.1001/jamahealthforum.2022.3292

4 Centers for Medicare & Medicaid Services. 2023 and 2024 Core Set of Maternal and Perinatal Health Measures for Medicaid and CHIP (Maternity Core Set). 2023.

Toolkit References: From the Evidence Accelerator

  1. ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018 Sept; 132(3): 784-785.
  2. Declercq, E., Zephyrin, L. C. (2021). Severe maternal morbidity in the United States: A Primer. The Commonwealth Fund.
  3. Declercq, E., Zephyrin, L. C. (2020). Maternal mortality in the United States: A Primer. The Commonwealth Fund.
  4. Retrieved from https://www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.html?CDC_AAref_Val=https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html [October 30, 2023]
  5. Centers for Medicare and Medicaid Service. (2019). Improving postpartum care: State projects conducted through the Postpartum Care Action Learning Series and Adult Medicaid Quality Grant Program.  
  6. Retrieved from  https://www.who.int/publications/i/item/9789240045989 [October 30, 3023]
  7. Interrante, J. D., Admon, L. K., Carroll, C., Henning-Smith, C., Chastain, P., & Kozhimannil, K. B. (2022). Association of Health Insurance, Geography, and Race and Ethnicity with Disparities in Receipt of Recommended Postpartum Care in the US. JAMA health forum, 3(10), e223292.
  8. Centers for Medicare & Medicaid Services. 2023 and 2024 Core Set of Maternal and Perinatal Health Measures for Medicaid and CHIP (Maternity Core Set). 2023.
  9. Lopez-Gonzalez, D. M., & Kopparapu, A. K. (2020). Postpartum care of the new mother.
  10. Attanasio, L. B., Ranchoff, B. L., Cooper, M. I., & Geissler, K. H. (2022). Postpartum Visit Attendance in the United States: A Systematic Review. Women's health issues: official publication of the Jacobs Institute of Women's Health, 32(4), 369–375.
  11. Retrieved from https://www.cdc.gov/prams/prams-data/mch-indicators/states/pdf/2020/All-Sites-PRAMS-MCH-Indicators-508.pdf (October 30, 2023)
  12. Bigby, J. A., Anthony, J., Hsu, R., Fiorentini, C., and Rosenbach, M. (2020) Recommendations for Maternal Health and Infant Health Quality Improvement in Medicaid and the Children’s Health Insurance Program. Center for Medicare & Medicaid Services.
  13. Geissler, K., Ranchoff, B. L., Cooper, M. I., and Attanasio, L. B. (2020). Association of Insurance Status With Provision of Recommended Services During Comprehensive Postpartum Visits. JAMA network open, 3(11), e2025095.
  14. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality (October 31, 2023)
  15. Centers for Medicare & Medicaid Services. Increasing Access, Quality, and Equity in Postpartum Care in Medicaid and CHIP: A Toolkit for State Medicaid and CHIP Agencies. August 2023.
  16. Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M. R., Neilson, E., & Wallace, M. (2021). Social and structural determinants of health inequities in maternal health. Journal of women's health, 30(2), 230-235.
  17. Bennett WL, Chang HY, Levine DM, et al. Utilization of primary and obstetric care after medically complicated pregnancies: an analysis of medical claims data. J Gen Intern Med. 2014;29(4):636-645
  18. Bryant AS, Haas JS, McElrath TF, McCormick MC. Predictors of compliance with the postpartum visit among women living in Healthy Start Project areas. Matern Child Health J. 2006;10(6):511-516.
  19. Wilcox A, Levi EE, Garrett JM. Predictors of non-attendance to the postpartum follow-up visit. Matern Child Health J. 2016;20(suppl 1):22-27.
  20. Danilack VA, Brousseau EC, Paulo BA, Matteson KA, Clark MA. Characteristics of women without a postpartum checkup among PRAMS participants, 2009-2011. Matern Child Health J. 2019;23(7):903-909.
  21. DiBari JN, Yu SM, Chao SM, Lu MC. Use of postpartum care: predictors and barriers. J Pregnancy. 2014:530769.
  22. Masho SW, Cha S, Karjane N, et al. Correlates of postpartum visits among Medicaid recipients: an analysis using claims data from a managed care organization. J Womens Health (Larchmt). 2018;27(6):836-843.
  23. Attanasio L, Kozhimannil KB. Health care engagement and follow-up after perceived discrimination in maternity care. Med Care. 2017;55(9):830-833.
  24. Tully KP, Stuebe AM, Verbiest SB. The fourth trimester: a critical transition period with unmet maternal health needs. Am J Obstet Gynecol. 2017 Jul;217(1):37-41. doi: 10.1016/j.ajog.2017.03.032. Epub 2017 Apr 5. PMID: 28390671.
  25. Walker, K. C., Arbour, M. W., & Wika, J. C. (2019). Consolidation of guidelines of postpartum care recommendations to address maternal morbidity and mortality. Nursing for women's health, 23(6), 508-517.
  26. Martin, A., Horowitz, C., Balbierz, A., & Howell, E. A. (2014). Views of women and clinicians on postpartum preparation and recovery. Maternal and child health journal, 18, 707-713.
  27. Interrante JD, Admon LK, Stuebe AM, Kozhimannil KB. After childbirth: better data can help align postpartum needs with a new standard of care. Womens Health Issues. Published online January 11, 2022:S1049-3867(21)00187-0.
  28. National Committee for Quality Assurance. Postpartum Depression Screening and Follow-Up. Retrieved from https://www.ncqa.org/hedis/measures/postpartum-depression-screening-and-follow-up/
  29. Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Listening to Mothers III: New Mothers Speak Out. Childbirth Connection; 2013. Accessed July 27, 2022.
  30. Krishnamurti T, Simhan HN, Borrero S. Competing demands in postpartum care: a national survey of U.S. providers’ priorities and practice. BMC Health Serv Res. 2020;20(1):284.
  31. Retrieved from https://homvee.acf.hhs.gov/ (October 30, 2023)
  32. Phung B. (2023). Policy measures to expand home visiting programs in the postpartum period. Frontiers in global women's health, 3, 1029226.
  33. Rudick, S., Fields, E., Finnerty, P., Voelker, S., Fitzgerald Lewis, E., & Elliott, K. (2020). How Home Visiting Can Support Postpartum Care. Home Visiting Impacts & Insights Brief Series, 1(2). Waltham, MA: EDC.
  34. Retrieved from  https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/ (October 2023)
  35. Polk, S., Edwardson, J., Lawson, S., Valenzuela, D., Hobbins, E., Prichett, L., & Bennett, W. L. (2021). Bridging the Postpartum Gap: A Randomized Controlled Trial to Improve Postpartum Visit Attendance Among Low-Income Women with Limited English Proficiency. Women's health reports (New Rochelle, N.Y.), 2(1), 381–388.
  36. Centers for Medicare and Medicaid Services (CMS). (2019). Improving postpartum care: State projects conducted through the Postpartum Care Action Learning Series and Adult Medicaid Quality Grant Program. CMS Issue Brief August 2019. https://www.medicaid.gov/sites/default/files/2020-03/postpartum-als-state-projects
  37. Yee, L. M., Martinez, N. G., Nguyen, A. T., Hajjar, N., Chen, M. J., & Simon, M. A. (2017). Using a Patient Navigator to Improve Postpartum Care in an Urban Women's Health Clinic. Obstetrics and gynecology, 129(5), 925–933.
  38. Nelson, D. B., Martin, R., Duryea, E. L., Lafferty, A. K., McIntire, D. D., Pruszynski, J., Rochin, E., & Spong, C. Y. (2023). Extending Maternal Care After Pregnancy: An Initiative to Address Health Care Disparities and Enhance Access to Care After Delivery. Joint Commission journal on quality and patient safety, 49(5), 274–279.
  39. Pan, Z., Veazie, P., Sandler, M., Dozier, A., Molongo, M., Pulcino, T., Parisi, W., & Eisenberg, K. W. (2020). Perinatal Health Outcomes Following a Community Health Worker-Supported Home-Visiting Program in Rochester, New York, 2015-2018. American journal of public health, 110(7), 1031–1033.
  40. Rodriguez, M. I., Skye, M., Lindner, S., Caughey, A. B., Lopez-DeFede, A., Darney, B. G., & McConnell, K. J. (2021). Analysis of Contraceptive Use Among Immigrant Women Following Expansion of Medicaid Coverage for Postpartum Care. JAMA network open, 4(12), e2138983.
  41. Wang, X., Pengetnze, Y. M., Eckert, E., Keever, G., & Chowdhry, V. (2022). Extending Postpartum Medicaid Beyond 60 Days Improves Care Access and Uncovers Unmet Needs in a Texas Medicaid Health Maintenance Organization. Frontiers in public health, 10, 841832.
  42. DeSisto, C. L., Rohan, A., Handler, A., Awadalla, S. S., Johnson, T., & Rankin, K. (2020). The Effect of Continuous Versus Pregnancy-Only Medicaid Eligibility on Routine Postpartum Care in Wisconsin, 2011-2015. Maternal and child health journal, 24(9), 1138–1150.
  43. Steenland, M. W., Short, S. E., & Galarraga, O. (2021). Association Between Rhode Island's Paid Family Leave Policy and Postpartum Care Use. Obstetrics and gynecology, 137(4), 728–730.
  44. Perry, M. F., Bui, L., Yee, L. M., & Feinglass, J. (2024). Association Between State Paid Family and Medical Leave and Breastfeeding, Depression, and Postpartum Visits. Obstetrics and gynecology, 143(1), 14–22.
  45. Raffo, J. E., Titcombe, C., Henning, S., Meghea, C. I., Strutz, K. L., & Roman, L. A. (2021). Clinical-Community Linkages: The Impact of Standard Care Processes that Engage Medicaid-Eligible Pregnant Women in Home Visiting. Women's health issues : official publication of the Jacobs Institute of Women's Health, 31(6), 532–539.
  46. Adelson, P., Fleet, J. A., & McKellar, L. (2023). Evaluation of a regional midwifery caseload model of care integrated across five birthing sites in South Australia: Women's experiences and birth outcomes. Women and birth: journal of the Australian College of Midwives, 36(1), 80–88.
  47. Grotell, L. A., Bryson, L., Florence, A. M., & Fogel, J. (2021). Postpartum Note Template Implementation Demonstrates Adherence to Recommended Counseling Guidelines. Journal of medical systems, 45(1), 14
  48. Jones-Beatty, K., Jolles, D., Burd, I., & Thomas, O. (2022). Increasing effective postpartum care in an obstetric clinic using ACOG's postpartum toolkit. Nursing forum, 57(6), 1614–1620.
  49. Rosenberg, J., Sude, L., Budge, M., León-Martínez, D., Fenick, A., Altice, F. L., & Sharifi, M. (2022). Rapid Deployment of a Mobile Medical Clinic During the COVID-19 Pandemic: Assessment of Dyadic Maternal-Child Care. Maternal and child health journal, 26(9), 1762–1778.
  50. McGuinness, C., Mottl-Santiago, J., Nass, M., Siegel, L., Onyekwu, O. C., Cruikshank, A., Forman, R., & Weir, G. (2022). Dyadic Care Mobile Units: A Collaborative Midwifery and Pediatric Response to the COVID-19 Pandemic. Journal of midwifery & women's health, 67(6), 714–719.
  51. Kumar, N. R., Arias, M. P., Leitner, K., Wang, E., Clement, E. G., & Hamm, R. F. (2023). Assessing the impact of telehealth implementation on postpartum outcomes for Black birthing people. American journal of obstetrics & gynecology MFM, 5(2), 100831.
  52. Arias, M. P., Wang, E., Leitner, K., Sannah, T., Keegan, M., Delferro, J., Iluore, C., Arimoro, F., Streaty, T., & Hamm, R. F. (2022). The impact on postpartum care by telehealth: a retrospective cohort study. American journal of obstetrics & gynecology MFM, 4(3), 100611.
  53. Janssen, M. K., Demers, S., Srinivas, S. K., Bailey, S. C., Boggess, K. A., You, W., Grobman, W., & Hirshberg, A. (2021). Implementation of a text-based postpartum blood pressure monitoring program at 3 different academic sites. American journal of obstetrics & gynecology MFM, 3(6), 100446.
  54. Hoppe, K. K., Thomas, N., Zernick, M., Zella, J. B., Havighurst, T., Kim, K., Williams, M., Niu, B., Lohr, A., & Johnson, H. M. (2020). Telehealth with remote blood pressure monitoring compared with standard care for postpartum hypertension. American journal of obstetrics and gynecology, 223(4), 585–588.
  55. Chappel, A., DeLew, N., Grigorescu, V., & Smith, S. R. (2021). Addressing the maternal health crisis through improved data infrastructure: Guiding principles for progress. Health Affairs Blog.
  56. Holzer, J., Fiedler, G., & Londhe, S. (2023). Maternal Centric Measurement and Data Gaps in Addressing Maternal Morbidities: A Scoping Review. Maternal and child health journal, 27(2), 367–374.
  57. Centers for Medicare and Medicaid Services (CMS). (2019). Lessons Learned About Payment Strategies to Improve Postpartum Care in Medicaid and CHIP. CMS Issue Brief August 2019.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.