Postpartum Visit

Postpartum Visit in United States

United States

The days and weeks after childbirth are a critical time for the care of both mother and newborn. During this time period, new mothers experience many physical, social and psychological changes. Because of this, it is important that women who recently gave birth receive postpartum checkups. 

At a postpartum visit, health care providers and patients may discuss: 

• Pregnancy complications.
• Mental health, including postpartum depression.
• Concerns about infant care.
• Care referrals for preexisting or developing medical conditions, such as diabetes, obesity and hypertension.
• The transition to well-woman care. 
• Sexual health and relationship development.

Postpartum visits are less common among:

• Women younger than 20 compared with women older than 30.
• Women who identified as Hispanic or Latino.
• Uninsured women and women with public insurance.
• Women who do not have stable housing and those with transportation barriers.
• Women who have a hard time communicating with their providers.

The American College of Obstetricians and Gynecologists (ACOG) suggests an initial assessment within the first three weeks of birth, followed by individualized, ongoing care and concluding with a comprehensive well-woman visit no later than 12 weeks after birth. Additional and earlier postpartum visits are recommended for women who experienced complications during pregnancy and/or delivery. 

Strategies to increase postpartum visits include:

• Discussing postpartum visits during prenatal care appointments.
• Scheduling postpartum visits during prenatal visits or prior to hospital discharge.
• Using technology to remind women of scheduled postpartum visits.
• Providing incentives for women who complete a postpartum visit. 

The content of postpartum visits can be improved by providing postpartum depression screening guidelines to health care providers and using the visit to connect women with community resources. The Centers for Medicare & Medicaid Services’ Maternal & Child Health Initiative provides states with resources to improve the rate and content of postpartum visits among Medicaid and Children’s Health Insurance Program (CHIP) populations.

Expanding Medicaid coverage during the postpartum period would allow for the most vulnerable women to receive the recommended ACOG postpartum care. Medicaid pays for almost half of all births in the United States and is required to cover women for the first 60 days of the postpartum period. Many states have expanded coverage beyond the first 60 days, but some have not.

Increasing the proportion of mothers screened for postpartum depression during a postpartum visit is a Healthy People 2030 objective.

“ACOG Committee Opinion No. 736: Optimizing Postpartum Care.” Obstetrics & Gynecology 131, no. 5 (May 2018): e140–50. https://doi.org/10.1097/AOG.0000000000002633.

Bryant, Allison S., Jennifer S. Haas, Thomas F. McElrath, and Marie C. McCormick. “Predictors of Compliance with the Postpartum Visit among Women Living in Healthy Start Project Areas.” Maternal and Child Health Journal 10 (June 2006): 511–16. https://doi.org/10.1007/s10995-006-0128-5.

Ranji, Usha, Ivette Gomez, and Alina Salganicoff. “Expanding Postpartum Medicaid Coverage.” Issue Brief. KFF, March 9, 2021. https://www.kff.org/womens-health-policy/issue-brief/expanding-postpartum-medicaid-coverage/.

Shaw, Elizabeth, Cheryl Levitt, Sharon Wong, and Janusz Kaczorowski. “Systematic Review of the Literature on Postpartum Care: Effectiveness of Postpartum Support to Improve Maternal Parenting, Mental Health, Quality of Life, and Physical Health.” Birth 33, no. 3 (2006): 210–20. https://doi.org/10.1111/j.1523-536X.2006.00106.x.

Stumbras, Katrina, Kristin Rankin, Rachel Caskey, Sadia Haider, and Arden Handler. “Guidelines and Interventions Related to the Postpartum Visit for Low-Risk Postpartum Women in High and Upper Middle Income Countries.” Maternal and Child Health Journal 20, no. Suppl 1 (November 2016): 103–16. https://doi.org/10.1007/s10995-016-2053-6.

Wilcox, Annemieke, Erika E. Levi, and Joanne M. Garrett. “Predictors of Non-Attendance to the Postpartum Follow-up Visit.” Maternal and Child Health Journal 20, no. Suppl 1 (November 2016): 22–27. https://doi.org/10.1007/s10995-016-2184-9.