Many women who experienced gestational hypertension, gestational diabetes, or preeclampsia during pregnancy are not receiving appropriate postpartum care to reduce their future risk of cardiovascular disease, according to a recent study conducted at Allina Health hospitals in Minnesota and western Wisconsin.
These conditions can significantly increase the risk of heart disease, and it’s crucial to address them through proper postpartum care.
Inadequate Follow-up Care
The American College of Obstetricians and Gynecologists recommends that new mothers, especially those who had high blood pressure during pregnancy, should have several checkups during the 12 weeks after childbirth.
The study found that while 64% of women overall saw an OB-GYN at least once within six months of delivery, only 29% of those who had gestational diabetes received blood glucose screening, and about 25% of them still had elevated blood glucose levels.
Among women with gestational hypertension, 90% had their blood pressure measured postpartum, but more than a third still had elevated blood pressure. For women with preeclampsia, 41% still had elevated blood pressure after childbirth.
Lack of Evidence-Based Follow-up
Despite the increased risk associated with these conditions, many women did not receive evidence-based follow-up care to adequately reduce their long-term risk.
The study also highlighted disparities, with American Indian and Black women, as well as those insured by Medicaid, being disproportionately affected.
This lack of postpartum care may have serious implications for maternal health, as cardiovascular disease is the leading cause of maternal death in the U.S. and accounts for over a third of all pregnancy-related deaths.
Closing the Gap with Extended Medicaid Coverage
To address this gap in postpartum care, some states have extended Medicaid coverage from 60 days to 12 months after childbirth.
This extension aims to provide more comprehensive care and support for women during the critical postpartum period. Currently, 41 states have implemented extended coverage, with five more planning to do so.
Raising Awareness and Implementing Systemic Change
Experts emphasize the urgent need to increase awareness about the importance of long-term follow-up care for patients with pregnancy complications. This education should target both healthcare providers and patients to improve health equity.
Cardiovascular disease remains a significant risk for women who have experienced complications during pregnancy, making it crucial to identify barriers to postpartum care completion and work towards improving access to care.
Healthcare systems should offer flexible appointment times and convenient locations to support women who may face various social barriers to accessing heart health care.
In conclusion, inadequate postpartum care for women with pregnancy complications poses a significant risk to their long-term cardiovascular health.
Addressing this issue requires a multi-faceted approach, including raising awareness, implementing systemic changes, and extending Medicaid coverage to provide comprehensive care during the postpartum period.
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The research findings can be found in Circulation: Cardiovascular Quality and Outcomes.
