Evaluation of effectiveness of postpartum preparedness interventions in current obstetric care paradigm among patients with significant risk factors and socioeconomic vulnerabilities

Name: Kateri Donahoe
School: Vagelos College of Physicians and Surgeons, Class of 2025, 
Mentor: Devon Rupley, MD and J.L. Stewart, PhD

Abstract

The postpartum period is one of marked vulnerability to perinatal mood and anxiety disorders (PMADs)1, lingering risk of pregnancy-related morbidity and mortality2, intense physiological changes3, and shifting identities4 and/or strained relationships with social supports5. However, postpartum preparedness and care systems have a protective effect against PMADs when mobilized during pregnancy5. We hypothesize that current models of antenatal care are suboptimal for adequately preparing birth parents with risk factors in the domain of social determinants of health for the transition to the postpartum period, contributing to PMADs and poor peripartum and perinatal health outcomes. This mixed-method study describes postpartum preparedness and associated roles of social support, healthcare information delivery, planning procedures, and mental/emotional health prior to and after giving birth among obstetrical patients in NYP’s Ambulatory Care Network. This cross-sectional study utilizes two qualitative interviews, in the third trimester of pregnancy and between two and 12 weeks postpartum, as well as surveys exploring demographic features, health experiences, and self-assessed preparedness for the postpartum period. While data collection is ongoing, preliminary impressions suggest that prenatal participants receive little information regarding expected physical and mental/emotional changes after giving birth, although expectant mothers report moderately high confidence in their ability to cope with the postpartum period, regardless of nulliparous/multiparous status. Having a better understanding of how current obstetric care prepares patients for the postpartum period and identifying outcomes of existing planning and preparedness interventions are critical for enhancing interventional opportunities and improving maternal health outcomes.