Postpartum Concerns after Discharge: Who has Them, and What are They? [19P]

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Abstract

INTRODUCTION:

To identify the prevalence of concerns among postpartum women and the factors associated with them

METHODS:

All postpartum women from March to June 2017 were contacted after discharge via an automated call. A call was successful if the woman engaged with the automated system, and those with concerns were contacted by a nurse. We compared call success and presence of concerns by mode of delivery, insurance type (public or private), parity, pregnancy complication (diabetes, hypertension, hemorrhage), and neonatal intensive care (ICN) admission using univariate analyses and multivariable logistic regression.

RESULTS:

881 women were called and 730 (83%) successfully contacted; 224 (29%) reported a concern. Women with operative vaginal delivery were more likely to report an issue than spontaneous vaginal and cesarean delivery (42% vs 28% p=0.04). Women with public insurance were less likely to be successfully contacted (68% vs 84% p=0.003), but the frequency of concerns were equivalent (28% vs 29%). Nulliparous women were more likely to answer the call (86% vs 79% p=0.004) and to report an issue (32% vs 25% p=0.05). Women with neonates in the ICN were less likely to be successfully contacted. When controlling for confounders, nulliparity (OR 1.5, 95% CI 1.1- 2.2) and private insurance (OR 1.9, 95% CI 1.1 - 3.8) were independently associated with successful contact.

CONCLUSION:

The majority of postpartum women responded to a call, and one third had concerns. The system was less effective in contacting women with public insurance. Nulliparous women and women with operative vaginal deliveries may benefit from additional discharge support.

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