Bridging the Postpartum Gap: A Randomized Controlled Trial to Improve Postpartum Visit Attendance Among Low-Income...

Background: Rates of postpartum visit attendance are low among all women, and particularly for low-income women. Experts in obstetrics, women's health, and health disparities are calling for novel, holistic approaches to postpartum care to better meet the needs of women and that respond to existing health care disparities. Materials and Methods: We conducted a single-site parallel-arm randomized controlled trial to determine the feasibility and effect of a co-located, co-timed 4-6 weeks postpartum obstetrics visit and well-newborn pediatric visit (i.e., "mommy-baby visit") compared with an enhanced usual postpartum visit, that is, staff scheduled the postpartum visit for the patient before hospital discharge. Results: One hundred sixteen women, of whom 76.7% (n = 89) were Latina immigrants, were enrolled postdelivery and randomized to a mommy-baby visit (n = 58, 49.5%) or to enhanced usual care (n = 58, 50.4%). Almost all study participants attended their postpartum visit (n = 109, 94.0%). There was no significant difference in postpartum visit attendance rate by randomization assignment (91.4% of mommy-baby vs. 96.6% of enhanced usual care participants). Study participants, mommy-baby intervention and enhanced usual care arms combined, were significantly more likely to attend the postpartum visit than historical controls (94.0% vs. 69.7%, respectively, p < 0.001). Conclusions: In a randomized controlled trial, we showed postpartum visit attendance rates were high for participants in both the mommy-baby and enhanced usual care arms. Postpartum visit scheduling assistance was provided to all participants and may have increased postpartum visit attendance and thereby attenuated the effect of the intervention. It is encouraging that a low-cost, low-tech, low-touch intervention, that is, postpartum appointment scheduling before hospital discharge, could increase postpartum visit attendance.