How COVID-19 Exacerbated Health Inequalities in Postpartum Care

A new study by Brown University researchers found that attendance at postpartum health care visits declined by almost six percentage points during the COVID-19 pandemic — with uninsured women, Black women, and women under age 19 facing the sharpest decreases in visits. Thus, the pandemic magnified existing health disparities in postpartum care.

Bellerose

Meghan Bellerose, a Ph.D. student at the School of Public Health and co-author Maria Steenland, an assistant professor of health services, policy, and practice at Brown University used Pregnancy Risk Assessment Monitoring System data from 2016 to 2020 — information maintained by the U.S. Centers for Disease Control and Prevention aggregating annual surveys of people with a live birth in 45 states, Washington, D.C., and New York City. They determined that during the first nine months of the COVID-19 pandemic, overall postpartum visit attendance declined by 5.8 percentage points. The steepest decline was shown by individuals without postpartum insurance, among whom visit attendance dropped by 11.4 percentage points. Visit attendance among Black women and women under age 19 each dropped by 9.9 percentage points.

“These are the same groups who experience higher rates of postpartum complications and maternal mortality, so it’s imperative that we understand the factors preventing them from receiving important pregnancy care,” Bellerose said.

Streenland

“To reduce ongoing disparities in postpartum care, clinical practices must ensure that care is provided in a way that accommodates the preferences and needs of all patients — including postpartum people who don’t have broadband access at home or who face ongoing barriers due to transportation, child care and work schedules,” Dr. Steenland said.

Bellerose is a graduate of Bowdoin College in Brunswick, Maine. She earned a master of public health degree at Columbia University. Dr. Steenland is a graduate of Emory University in Atlanta, where she majored in Latin American studies and French. She holds a master of public health degree from the University of Michigan and a doctorate from the School of Public Health at Harvard University.

The full study, “Association Between the Coronavirus Disease 2019 (COVID-19) Pandemic and National Disparities in Postpartum Visit Attendance,” was published in the journal Obstetrics & Gynecology. It may be accessed here.