Postpartum, Pregnancy Related
Conditions
Keywords
Breastfeeding, Contraception, Emergency, Department
Brief summary
The purpose of this study is to determine if shortening the time to initial postpartum visit from six weeks to two weeks can improve clinic visit attendance and decrease usage of the emergency department.
Detailed description
Postpartum care is an integral component to completing the maternal peripartum experience and transitioning the patient to well-women care. The American Congress of Obstetrics and Gynecology has recently highlighted the importance of this fourth stage of pregnancy suggesting earlier and more comprehensive visits compared to the standard 6-week postpartum visit. Specifically they describe that all women should ideally have contact with a maternal care provider within the first three weeks postpartum however this is largely derived from expect opinion and retrospective data. The current rate of postpartum visit attendance is as low as 66%, especially in women with scant prenatal care. In the investigators government-funded clinic, the postpartum clinic attendance in 2017 was 69% and many of the patients have co-morbidities, notably a 25% rate of psychiatric illness. Additionally, in this population, the investigators have identified a high rate of Emergency Department (ED) usage (8.7%) within 30 days of delivery suggesting that perhaps an earlier routine visit is ideal and can prevent the use of the ED. The aim therefore is to evaluate the utility of an early postpartum visit at two weeks in addition to a standard six-week visit with a randomized control trial.
Interventions
BEHAVIORALPostpartum Visit at 6 Weeks
The patient will be scheduled for a routine postpartum visit at the standard time interval. Each postpartum visit will consist of the standard interview and physical examination. The purpose of this visit is for routine postpartum care. If she has a medical complication during delivery, she may be recommended to schedule an additional earlier visit.
BEHAVIORALPostpartum Visit at 2 Weeks
The patient will be scheduled for an earlier postpartum visit in addition to the standard time interval. Each postpartum visit will consist of the standard interview and physical examination. The purpose of this visit is for routine postpartum care. If she has a medical complication during delivery, she may be recommended to schedule an additional earlier visit.
Sponsors
University of California, Los Angeles
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* At least 18 years of age * Receives antepartum, intrapartum and postpartum care at UCLA * Speaks English or Spanish * Provides informed consent for study participation * Vaginal, cesarean delivery or operative vaginal delivery
Exclusion criteria
* Cognitive impairment, psychiatric instability, or language barriers that limit her ability to provide informed consent * Plans to received postpartum care at other institution
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Attendance at one or more routine postpartum visits | 8 weeks postpartum | The primary outcome will be the attendance at one or more scheduled postpartum visits at the clinic where the patient received her prenatal care. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Emergency Department usage within 30 days of delivery | 30 days postpartum | The secondary outcome will be the presentation and usage of an Emergency Department during the 30 days since delivery of the baby. |
Countries
United States
Outcome results
None listed