Expanding Perinatal Care Beyond Obstetrics: The National Veterans Affairs Maternity Care Coordinator Program

Pregnant and postpartum individuals in the United States experience high rates of adverse pregnancy outcomes, despite multiple obstetric initiatives to address this public health crisis. Perinatal care that meaningfully addresses long-term factors that impact pregnancy outcomes, such as chronic mental and physical conditions, adverse social and environmental factors, structural racism, birth-related morbidity and trauma, and transitions to parenting, must go beyond obstetric care sites to include health care providers who deliver care across the lifespan. Veteran's Health Administration (VHA), the nation's largest integrated health care system, has reimagined the integration of individualized pregnancy-related care coordination within a health care system that does not directly provide obstetric care. The VHA Maternity Care Coordinator Program provides a feasible, effective, and replicable model that is relevant to other integrated health care systems.