“We need to find ways to take advantage of this prime opportunity when we have a captive audience of people who are already in the doctor’s office, talking about their health at a critical juncture in life,” said corresponding author Dr. Sadiya Khan, assistant professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. “It is hard to create new opportunities. The fourth-trimester visit is an already-ready moment to prioritize maternal heart health.”
“Our data show that reports of overall counseling are low. For people who have risk factors, lifestyle counseling during this critical time is a first step to reducing long-term risk of heart disease,” said lead author Dr. Natalie Cameron, instructor of general internal medicine at Feinberg and a Northwestern Medicine physician.
“While the postpartum visit represents an opportunity to reach a large number of women, it is only the start,” Cameron said. “Health care systems must improve continuity of care after pregnancy and help women find clinicians who can provide preventive care. These can be obstetricians/gynecologists, primary care clinicians or cardiologists, depending on the patient’s needs and the clinician’s expertise.”
Counseling Discrepancy: Remembering Heart Health Guidance in Postpartum Care
It is important to note that more women may have received counseling but only 60% of women reported remembering that they received counseling on how to optimize their heart health, Khan said.
“I think it’s important that we also prioritize implementation science research that identifies the best strategies for counseling to improve heart health, particularly in the first year after pregnancy,” Khan said. “If counseling is provided but they don’t remember it or it does not translate into improvements in heart health, it’s not very effective.”
From a structural level, systems and policies must support these health care transitions from pregnancy to postpartum and ensure women can access care throughout the first-year postpartum and beyond. Continuing to expand postpartum Medicaid coverage from 60 days to 12-months postpartum is a critical first step to improving access to care for the more than 40% of U.S. women who are insured by Medicaid during pregnancy, Cameron said.
“In the midst of the growing public health crisis around maternal health, we also need to continue to increase awareness of the importance of long-term cardiovascular health monitoring and optimization among women with adverse pregnancy outcomes,” she said.
- Trends in Cardiovascular Health Counseling Among Postpartum Individuals – (https://jamanetwork.com/journals/jama/article-abstract/2807566)
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