AMHERST — Most women are receiving fewer than half the services recommended during their comprehensive postpartum medical checkup, according to a study by UMass Amherst researchers.
“These findings underscore the importance of efforts to reconceptualize postpartum care to ensure women have access to a range of supports to manage their health during this sensitive period,” according to the study, published Nov. 10 in JAMA Network Open. “There is substantial room to improve the delivery of postpartum care.”
Authors Kimberley Geissler and Laura Attanasio, both assistant professors of Health Policy and Management in the School of Public Health and Health Sciences, were joined in the study by graduate student Brittany Ranchoff and undergraduate Michael Cooper. The study received funding from the National Heart, Lung and Blood Institute and the Agency for Healthcare Research and Quality.
“This research is very important because we were able to look at care that was actually provided and really understand what happened during healthcare visits, not just that the visits are happening. This information is critical for improving the quality of care,” Geissler said.
The medical visits averaged about 17 minutes, the researchers found, which may help explain the incomplete postpartum care. “Is that enough time to provide these services? I don’t know,” Geissler went on. “The pressure to see more patients in an increasingly short time is a known issue in the U.S. healthcare system, so it’s not surprising we see that here, too.”
In one of the most startling findings, despite an increased awareness of perinatal depression, only one in 11 patients received a screening for depression, part of the assessment of physical, social, and psychological well-being recommended by the American College of Obstetricians and Gynecologists.
“We need to look at why depression screening is not happening,” Attanasio said. “This is an important factor in women’s health for the rest of their lives. Even if you’re missing some of the recommended services, this one should be universal among this population.”
Previous studies have shown that women with Medicaid insurance receive fewer preventive services than women with private insurance, leading the UMass Amherst team to examine insurance type in their review. “We hypothesized recommended services would be less frequently provided during postpartum visits for women with Medicaid insurance compared to women with other coverage types,” they noted.
However, Attanasio said, “we found that there were not significant differences in the services received between women with Medicaid coverage and private insurance. That could reflect the fact that a lot of these services were not provided to most of the women.”