Postpartum Care Timing: A Randomized Trial

Not Applicable

Completed

• Conditions: Pregnancy Related; Postpartum
• Interventions: Behavioral: Postpartum Visit at 6 Weeks; Behavioral: Postpartum Visit at 2 Weeks

• Registration Number: NCT03733405
• Lead Sponsor: University of California, Los Angeles

Brief Summary

The purpose of this study is to determine if shortening the time to initial postpartum visit from six weeks to two weeks can improve clinic visit attendance and decrease usage of the emergency department.

Detailed Description

Postpartum care is an integral component to completing the maternal peripartum experience and transitioning the patient to well-women care. The American Congress of Obstetrics and Gynecology has recently highlighted the importance of this "fourth stage" of pregnancy suggesting earlier and more comprehensive visits compared to the standard 6-week postpartum visit. Specifically they describe that "all women should ideally have contact with a maternal care provider within the first three weeks postpartum" however this is largely derived from expect opinion and retrospective data. The current rate of postpartum visit attendance is as low as 66%, especially in women with scant prenatal care. In the investigators government-funded clinic, the postpartum clinic attendance in 2017 was 69% and many of the patients have co-morbidities, notably a 25% rate of psychiatric illness. Additionally, in this population, the investigators have identified a high rate of Emergency Department (ED) usage (8.7%) within 30 days of delivery suggesting that perhaps an earlier routine visit is ideal and can prevent the use of the ED. The aim therefore is to evaluate the utility of an early postpartum visit at two weeks in addition to a standard six-week visit with a randomized control trial.

Study Timeline

• Study Start: 2018-10-31
• Study First Submitted: 2018-11-05
• Study First Submitted QC: 2018-11-06
• Study First Posted: 2018-11-07
• Primary Completion: 2020-07-01
• Study Completion: 2020-07-01
• Status Verified: 2020-11
• Last Update Submitted: 2020-11-02
• Last Update Posted: 2020-11-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 256

Inclusion Criteria

• At least 18 years of age
• Receives antepartum, intrapartum and postpartum care at UCLA
• Speaks English or Spanish
• Provides informed consent for study participation
• Vaginal, cesarean delivery or operative vaginal delivery

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Exclusion Criteria

• Cognitive impairment, psychiatric instability, or language barriers that limit her ability to provide informed consent
• Plans to received postpartum care at other institution

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Postpartum Visit 6 Weeks	Postpartum Visit at 6 Weeks	Participants will have a postpartum visit scheduled 6 weeks after birth
Postpartum Visit 2 and 6 Weeks	Postpartum Visit at 6 Weeks	Participants will have postpartum visits scheduled 2 and 6 weeks after birth
Postpartum Visit 2 and 6 Weeks	Postpartum Visit at 2 Weeks	Participants will have postpartum visits scheduled 2 and 6 weeks after birth

Primary Outcome Measures

Name	Time	Method
Attendance at one or more routine postpartum visits	8 weeks postpartum	The primary outcome will be the attendance at one or more scheduled postpartum visits at the clinic where the patient received her prenatal care.

Secondary Outcome Measures

Name	Time	Method
Rate of Emergency Department usage within 30 days of delivery	30 days postpartum	The secondary outcome will be the presentation and usage of an Emergency Department during the 30 days since delivery of the baby.

Trial Locations

Locations (1)

University of California Los Angeles; 🇺🇸 Los Angeles, California, United States