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Report: Fewer Than Half of Women Attend Recommended Doctor Visits After Childbirth

Visits considered 'window of opportunity' to ensure preventive care (February 5)

Medical associations widely recommend that women visit their obstetricians and primary care doctors shortly after giving birth, but slightly fewer than half make or keep those postpartum appointments, according to a new study by Johns Hopkins researchers.

The investigators found that women with pregnancy complications were more likely to see a doctor post-delivery, but overall, visit rates were low.

For the study, the researchers collected data from one commercial health insurance plan and multiple Medicaid insurance plans in Maryland. The aims were to determine different predictors of receiving post-delivery primary and obstetric care in women with and without pregnancy complications, including gestational or pregestational diabetes mellitus and hypertensive disorders, such as preeclampsia. Women with these conditions are much more likely to develop long-term health problems, such as type 2 diabetes and cardiovascular disease.

Among women with tax-supported Medicaid insurance, 56.6% of those with a complicated pregnancy and 51.7% of those without a complicated pregnancy visited a primary care doctor within 1 year. Among women with commercial health insurance, 60% of those with a complicated pregnancy and 49.6% of those without a complicated pregnancy did so.

Caucasian patients, older patients, and patients with depression or preeclampsia were also more likely to visit their primary care doctor.

Of the women on Medicaid, 65.0% of those with complicated pregnancies and 61.5% of those without complicated pregnancies had a postpartum obstetric visit within 3 months. The numbers were slightly lower for those with commercial insurance, at 50.8% of those with complicated pregnancies and 44.6% of those without complicated pregnancies.

According to lead investigator Wendy Bennett, MD, the new findings add to evidence that access to health care alone — having insurance and a physician — is not enough to assure proper care. All study participants had insurance for at least 6 weeks after delivery.

Source: EurekAlert; February 5, 2014.

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