Addressing Women's Health Care Needs During Pediatric Care

Abstract

Objective: To determine if the use of a simple self-administered Postpartum Questionnaire for Mothers (PQM) at the well-baby visit (WBV) increased the proportion of women who received health care and contraception by 6 months postpartum (PP). Methods: This was a single-site, system-level, intervention. Women were recruited from the pediatric clinic when presenting with their infants for a 2-month WBV. During phase 1 of the study, a control group was enrolled, followed by an 8-week washout period; then enrollment of the intervention group (phase 2). During phase 2, the PQM was administered and reviewed by the pediatrician during the infant's visit; the tool prompted the pediatrician to make a referral for the mother's primary or contraceptive care as needed. Data were collected at baseline and at 6 months PP, and additional data were extracted from the electronic medical record. Results: We found that PP women exposed to the PQM during their infant's WBV were more likely to have had a health care visit for themselves between 2 and 6 months PP, compared with the control group (relative risk [RR] 1.66, [confidence interval (CI) 0.91-3.03]). In addition, at 6 months PP, women in the intervention group were more likely to identify a primary care provider (RR 1.84,), and more likely to report use of long-acting reversible contraception (LARC) (RR 1.24, [CI 0.99-1.58]), compared with women in the control group. Conclusion: A simple self-administered PQM resulted in an increase in women's receipt of health care and use of LARC by 6 months PP. Clinical Trial Registration: Use of a reproductive life planning tool at the pediatric well-baby visit with postpartum women, NCT03448289.

Maintaining A Long‐Term Practice of Daily Pelvic Floor Muscle Exercises: What Do Childbearing Women Think?

“…The present US social system is insufficient to correct this inadequacy and injustice to women following birth. Some US legislative work is in process that focuses on paid family leave, 35 postpartum Medicaid extension, 36,37 and postbirth care plans 38 . Associations for women's health care providers need to be actively working on guidelines that will improve the US perinatal health care system by reframing PFMT as a preventive strategy.…”

“…Two-generation postpartum care is an alternative for women to receive health care at the well-baby visit. 41,42 The US health care system lacks a smooth course for two-generation care postpartum, 41,42 specialty education on pelvic floor muscles and exercise, 11 and referrals for women who need additional guidance. Adequate PFMT education and instruction should be part of routine postpartum care.…”

“…Have pediatricians and primary care providers use well-baby visits (2-generational care) as an opportunity to meet the postpartum needs of the dyad 41 by connecting birthing persons with the health care services they need 42 for UI or PFMT assessment and education postbirth.…”