Welcoming a new child is an exciting time for a family, but it can also come with challenges. It is currently estimated that 40 percent of women who have given birth do not go back for their postpartum visit with their provider.¹

Dr. Luis Torres, Medical Director, Evernorth^® Behavioral Care Group, shares some insights on this important topic, and the role primary care providers can play to support postpartum care for women.

Question: Why is postpartum care such an important aspect post-delivery?

Answer: Postpartum checkups are crucial for ensuring new moms stay healthy and well. Mothers are encouraged to schedule their postpartum visit between one to twelve weeks post-discharge. These visits help navigate the ups and downs of motherhood. Beyond the physical aspects, it is also important to get a full picture how the patient is doing mentally and emotionally. This is a key time to screen for postpartum depression (PPD), which affects one out of eight women after giving birth.² Alarmingly, untreated PPD can lead to long-term consequences for both the mother and child, including developmental delays and attachment issues.

Question: With postpartum depression on the rise, what can providers do to help address this?

Answer: Providers need to prioritize screening for depression. Currently, only 22 percent of those who screen positive for depression receive treatment and care.³ Ensuring effective depression treatment, which may include a combination of medication, counseling, and referrals, is essential to achieve full recovery. Recent studies show that integrated care models, where mental health services are incorporated into routine postpartum visits, significantly improve treatment adherence and outcomes.⁴

Question: What is the difference between the term “baby blues” and postpartum depression?

Answer: Most women experience “baby blues” within a few days of giving birth, which often includes mood swings, sadness, feeling overwhelmed, crying spells, loss of appetite, and trouble sleeping. These symptoms usually resolve within three to five days. However, postpartum depression lasts longer and is more severe, typically beginning within the first month after childbirth. However, it can also start during pregnancy or for up to a year after birth. Unlike “baby blues,” PPD can severely affect a mother’s ability to function and care for their newborn.⁵

Question: What factors are driving disparities in maternal health and what can providers do to address this issue?

Answer: Disparities in maternal health are driven by factors that include limited access to providers and hospitals, and a lack of access to culturally and linguistically appropriate care. Providers can help by increasing access to a broader array of services that support maternal and infant health, diversifying the health care workforce, and enhancing data collection and reporting.⁶ The use of telehealth has been shown to bridge gaps in access, especially in underserved areas.

Question: Lastly, what can providers do to make sure their patients go to their postpartum visit?

Answer: As much as possible, preschedule postpartum visits ahead of time, making it easier and more likely for the patients to attend. Also, using text reminder calls to communicate with patients can be helpful. As health care providers, it starts with us to help keep our patients healthy and well. Additionally, research indicates that establishing a strong provider-patient relationship during pregnancy can increase the likelihood of postpartum follow up.

Resources

Evernorth Behavioral Care Group is a community of trained therapists specializing in maternal health, including treating postpartum depression. For more information, visit the Evernorth Behavioral Care Group webpage.

1. Cohen JL, Daw JR. Postpartum Cliffs—Missed Opportunities to Promote Maternal Health in the United States. JAMA Health Forum. 2021;2(12): e214164. doi:10.1001/jamahealthforum.2021.4164
2. acog.org/womens-health/experts-and-stories/the-latest/what-to-expect-at-a-postpartum-checkup-and-why-the-visit-matters
3. policycentermmh.org/u-s-maternal-depression-screening-rates-released-for-the-first-time-through-hedis
4. Tachibana, Y., Koizumi, N., Akanuma, C., Tarui, H., Ishii, E., Hoshina, T., Suzuki, A., Asano, A., Sekino, S., & Ito, H. (2019). Integrated mental health care in a multidisciplinary maternal and child health service in the community: the findings from the Suzaka trial. BMC pregnancy and childbirth, 19(1), 58. bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2179-9
5. womenshealth.gov/a-z-topics/depression-during-and-after-pregnancy
6. Dagher, R. K., Pérez-Stable, E. J., & James, R. S. (2021). Socioeconomic and racial/ethnic disparities in postpartum consultation for mental health concerns among US mothers. Archives of women’s mental health, 24(5), 781–791. doi.org/10.1007/s00737-021-01132-5