Prenatal and Postpartum Care—Postpartum Care
The Prenatal and Postpartum Care—Postpartum Care measure reports the percentage of women who delivered a live birth who completed a postpartum visit between 21 days and 56 days after delivery.
Postpartum care is an important determinant of quality health care outcomes for women giving birth. Since medical complications can occur after a woman has given birth, postpartum visits can address any adverse effects that giving birth had on a woman’s body, such as persistent bleeding, inadequate iron levels, blood pressure, pain, emotional changes, and infections. For example, heavy bleeding can be an indicator of a retained placenta, uterine atony, lacerations, hematoma, or coagulation disorders. However, socioeconomic factors that present barriers to consistent care are common in the Medicaid populations. In 2008, almost 82 percent of members enrolled in commercial health plans received timely postpartum care; however, only 63 percent of Medicaid members received timely postpartum care.Postpartum depression is one of the most prevalent complications that can occur after delivery. Approximately 30 to 70 percent of women experience postpartum sadness immediately after delivery (i.e., within the first week). An estimated 10 percent of these women suffer from postpartum depression for which a postpartum care visit is needed.124 This figure increases to 25 percent if the woman has a history of postpartum depression. Postpartum depression has been associated with marital happiness, mother-child relationship, and infant behavior. If untreated, postpartum depressed usually lasts around seven months. Receiving appropriate postpartum care can address these emotional issues. In addition to emotional issues, there are physical issues associated with pregnancy that should be closely monitored during the postpartum period. For example, 1 to 3 percent of vaginal deliveries result in postpartum endometritis. Urinary incontinence is prevalent in 3 to 23 percent of pregnancies after the first year of delivery. Approximately 4 to 7 percent of pregnancies result in a thyroid disorder during the first year of pregnancy. Women at risk for any of these risks should be tested and treated during the postpartum period. Postpartum visits also provide an opportunity for women to be instructed on certain health care guidelines, such as contraceptive use.
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