Postpartum Health Disparities During the Birth Hospitalization in the United States: A Scoping Review

Despite over 50% of maternal deaths occurring during the postpartum period, with significant disparities for structurally marginalized people, this is an understudied period in the reproductive life course. This review aims to describe the scope of the literature on postpartum health disparities during the birth hospitalization.

We searched five databases (MEDLINE®, Embase, CINAHL, Web of Science, and PsychInfo) for primary research studies in the USA in English that measured a postpartum maternal outcome during the birth hospitalization and compared the outcome across at least two groups. We excluded studies that solely examined maternal mortality or severe maternal morbidity, gray literature, and review articles. We extracted data using the National Institute for Minority Health and Health Disparities (NIMHD) Research and PROGRESS-Plus Frameworks.

We extracted data from the 22 studies that met inclusion criteria. All studies identified a disparity. The most commonly reported PROGRESS-Plus individual characteristic was race. No studies reported occupation, parental/maternity leave, disability, gender identity, sexual orientation, culture, acculturation, religion, social capital, or social support. Postpartum outcomes and variables explored for association with those outcomes were predominantly at the individual and interpersonal levels, with limited to no examination at the community, health system, and societal level.

There is a critical gap in the literature on postpartum health disparities during the birth hospitalization. Knowledge gained from this review can guide perinatal clinicians and researchers in expanding their approach to addressing postpartum health disparities using intersectional axes of identity, socioeconomic status, and structural barriers.