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Postpartum Visit Attendance in the United States: A Systematic Review

Published:March 15, 2022DOI:https://doi.org/10.1016/j.whi.2022.02.002

      Abstract

      Introduction

      Adequate postpartum care, including the comprehensive postpartum visit, is critical for long-term maternal health and the reduction of maternal mortality, particularly for people who may lose insurance coverage postpartum. However, variation in previous estimates of postpartum visit attendance in the United States makes it difficult to assess rates of attendance and associated characteristics.

      Methods

      We conducted a systematic review of estimates of postpartum visit attendance. We searched PubMed, CINAHL, PsycInfo, and Web of Science for articles published in English from 1995 to 2020 using search terms to capture postpartum visit attendance and use in the United States.

      Results

      Eighty-eight studies were included in this analysis. Postpartum visit attendance rates varied substantially, from 24.9% to 96.5%, with a mean of 72.1%. Postpartum visit attendance rates were higher in studies using patient self-report than those using administrative data. The number of articles including an estimate of postpartum visit attendance increased considerably over the study period; the majority were published in 2015 or later.

      Conclusions

      Our findings suggest that increased systematic data collection efforts aligned with postpartum care guidelines and attention to postpartum visit attendance rates may help to target policies to improve maternal wellbeing. Most estimates indicate that a substantial proportion of women do not attend at least one postpartum visit, potentially contributing to maternal morbidity as well as preventing a smooth transition to future well-woman care. Estimates of current postpartum visit attendance are important for informing efforts that seek to increase postpartum visit attendance rates and to improve the quality of care.
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      Biography

      Laura B. Attanasio, PhD, is an Assistant Professor in Health Policy and Management, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research examines issues of quality, equity, and decision making in perinatal health care.

      Biography

      Brittany L. Ranchoff, MPH, is a doctoral student in Health Policy and Management, University of Massachusetts Amherst. Her research interests include access to care, perinatal experiences, and health outcomes and utilization in the perinatal period.

      Biography

      Michael I. Cooper, BBA, is a medical student at Tufts University School of Medicine and a Departmental Assistant in the Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. His research interests include health care quality, delivery, and policy.

      Biography

      Kimberley H. Geissler, PhD, is an Associate Professor in Health Policy and Management, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research examines factors affecting access to and coordination of health care.