Optimizing women's health after pregnancy holds potential to beneficially impact subsequent pregnancy outcomes. We compare postpartum care utilization for women at an academic medical center and affiliated community health centers.METHODS:
Administrative encounter data were examined for women who received prenatal care and delivered from 2006–2010 to identify health care encounters within 2 months after delivery, and among women who enrolled in hospital-affiliated primary care practices prior to delivery to examine utilization in the 2 years after delivery. Univariate and multivariate models were built to identify predictors of care utilization.RESULTS:
Among 8,749 and 4,439 women receiving prenatal care at the academic center and affiliated health centers, respectively, most returned for an obstetric postpartum visit (86% vs 79%, P<.0001), and additionally some had encounters with primary care (7% vs 12%, P<.0001), other outpatient clinics (13% vs 14%, P=.094), the emergency department (2% vs 3%, P<.0001), or hospital admissions (1.7% vs 1.9%, P=.41) during the initial 2 months postpartum. Among the 3,743 and 2,034 women with previously established primary care, the majority sought primary care (79% vs. 84%, P<.0001) and other outpatient services (71% vs 74%, P=.019) in the 2 years after delivery—with increasing age, having a chronic health condition, and accessing care at a community health center increasing the odds of utilizing postpartum primary care.CONCLUSION:
After pregnancy most women utilize the obstetric postpartum visit and primary care, emphasizing the opportunity to optimize preconception health care at these encounters. A community-based care delivery model may facilitate primary care utilization after pregnancy.