Improving Maternal Health Through an Adaptation of a Two-Generation Postpartum Care Model in Diverse Settings

项目总结

Project Summary In the United States, the rates of maternal mortality and severe maternal morbidity have increased since 1990 and significant racial and ethnic disparities persist. Nationally, almost 70% of pregnancy-associated deaths occur during the postpartum period. Despite the growing evidence of the importance of postpartum care to improve inequities, many women do not receive recommended care. Indeed, significant racial/ethnic disparities in receipt of postpartum care may likely be a strong contributor to maternal health disparities. Currently, most postpartum care is fragmented and limited in scope leaving many women without adequate health care, behavioral health care and social support. Our preliminary work demonstrated that women are interested in a model of care where postpartum care can be provided with pediatric care. Learning from our research, we created an integrated Two-Generation clinic where postpartum care is delivered alongside pediatric care, and families are offered social support and behavioral health services. Our care model addresses issues that contribute to maternal morbidity and mortality, including social determinants of health, underlying medical conditions, and mental health. Currently, this Integrated Two-Generation model is within a hospital-based clinic, a setting not likely to reach the vast majority of birthing persons. As such, using an implementation framework we propose to evaluate successful components of the current integrated Two-Generation model of care, understand potential barriers and facilitators to implementation of this care model among a national sample of diverse community health centers, and refine the model of care to meet the needs of community health centers that are caring for women who experience persistent disparities.