614 provider perspectives on barriers and facilitators to postpartum care for Low-income individuals

Ruderman, Rachel; Dahl, Emma C.; Williams, Brittney R.; Feinglass, Joe; Kominiarek, Michelle A.; Grobman, William A.; Yee, Lynn M.

doi:10.1016/j.ajog.2020.12.635

Cited by 2 publications

(2 citation statements)

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“…Interestingly, many reproductive-aged people consider their Ob–Gyn to be their PCP and do not have a PCP to easily transition to after delivery, further evidence to support innovation in this space. 25 26…”

Section: How Can Obstetricians and Primary Care Physicians Redesign P...mentioning

confidence: 99%

Redesigning Care for the Management of Postpartum Hypertension: How Can Ob–Gyns and Primary Care Physicians Partner in Caring for Patients after a Hypertensive Pregnancy?

et al. 2023

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The standard care model in the postpartum period is ripe for disruption and attention. Hypertensive disorders of pregnancy (HDPs) can continue to be a challenge for the postpartum person in the immediate postpartum period and is a harbinger of future health risks. The current care approach is inadequate to address the needs of these women. We propose a model for a multidisciplinary clinic and collaboration between internal medicine specialists and obstetric specialists to shepherd patients through this high-risk time and provide a bridge for lifelong care to mitigate the risks of a HDP. Key Points

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Section: How Can Obstetricians and Primary Care Physicians Redesign P...mentioning

confidence: 99%

Redesigning Care for the Management of Postpartum Hypertension: How Can Ob–Gyns and Primary Care Physicians Partner in Caring for Patients after a Hypertensive Pregnancy?

et al. 2023

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“…6 Numerous barriers to postpartum follow-up exist, including transportation, return to work, caregiver burden, and lack of understanding of the importance of preventative health care maintenance. 7 8…”

mentioning

confidence: 99%

Implementation of In-Hospital Postpartum Glucose Tolerance Testing for People with Gestational Diabetes

Ayala,

Fain,

Smith

et al. 2024

Am J Perinatol

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Objective We aimed to evaluate uptake of the glucose tolerance test performed during delivery hospitalization as part of routine clinical care. Study Design This is a retrospective cohort study of people with GDM at a tertiary center. We collected 9 months of postimplementation data after the in-hospital (“early”) glucose tolerance test was adopted as a routine screening option. Adherence was compared between those who elected early glucose tolerance testing versus those who deferred testing to the standard postpartum period. Bivariable statistics including demographics, care team, and postpartum testing/visit attendance were compared between those who received early testing and those who did not using chi-square, Fisher's exact, and t-tests. Results A total of 681 patients with GDM delivered during the study period. Of those who had an early glucose tolerance test ordered (n = 408), 340 (83.3%) completed the test. Among those who did not complete an early glucose tolerance test (ordered and not completed or never ordered), only 104/341 (30.5%) completed any postpartum glucose testing in the first 12 months of postpartum. There were significant differences in characteristics in terms of race/ethnicity, insurance, type of gestational diabetes (A1GDM vs. A2GDM), diabetes medications, obstetric care provider, and delivery mode. Among those who completed early testing, 43.7% of participants had impaired glucose metabolism and 6.5% had values concerning for overt diabetes mellitus. Among those who deferred testing to the standard 6- to 12-week period, 24.0% had impaired glucose metabolism and none had overt diabetes. Those who completed an early glucose tolerance test had a lower rate of postpartum visit attendance compared with those who deferred (75.6 vs. 91.5%, p < 0.01). Conclusion In this cohort, when the early glucose tolerance test is offered in clinical practice, adherence rates are higher than when the test is deferred until the postpartum visit. Key Points

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614 provider perspectives on barriers and facilitators to postpartum care for Low-income individuals

Cited by 2 publications

References 0 publications

Redesigning Care for the Management of Postpartum Hypertension: How Can Ob–Gyns and Primary Care Physicians Partner in Caring for Patients after a Hypertensive Pregnancy?

Redesigning Care for the Management of Postpartum Hypertension: How Can Ob–Gyns and Primary Care Physicians Partner in Caring for Patients after a Hypertensive Pregnancy?

Implementation of In-Hospital Postpartum Glucose Tolerance Testing for People with Gestational Diabetes

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