Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light to this nationwide health crisis, but to test solutions to that will fill the gap between our postpartum mothers and the high-quality care that should be available and provided to all.
The change project in this report addresses continuity of care in the postpartum period. Specifically, post-partum follow up recommendations for mothers diagnosed with a hypertensive disorder of pregnancy and mothers who screen positive on their post-partum depression screen prior to discharge. The American College of Obstetrician and Gynecologists (ACOG), recommends that women who experience any hypertensive diagnosis in pregnancy, should follow up for a blood pressure visit no later than 7-10 days after discharge (2018). ACOG also recommends that mothers who experience a severe hypertensive episode during their admission, should follow up for a blood pressure visit no later than 2-3 days post discharge. Appointments will also be scheduled with a local psychiatric mental health nurse practitioner, PMHNP, within 2 weeks of discharge for mothers who screen positive on their Edinburgh Postnatal Depression Scale, EPDS. These efforts are focused on improving continuity of care in the postpartum period and decreasing maternal morbidity and mortality cases related to hypertension and mental health disorders. Improving quality of care in the postpartum period should also reveal a decrease in postpartum readmissions.
In review of data collected during the 6-week project period, it is evident that tailoring post-partum visits to the specific needs of postpartum patients is a successful and proactive approach to improving outcomes for this population. During these visits, if findings weren’t within expected limits, providers were able to either initiate treatment or alter treatment for hypertensive patients and patients with mental health disorders. Although findings revealed improved continuity of care, there needs to be a larger population and more time spent to determine if these interventions will decrease the maternal mortality and morbidity rates.
Date of publication
MSN Capstone Project
Masters of Science in Nursing
Quezada, Ashley, "Continuity of Care in the Post-Partum Period" (2023). MSN Capstone Projects. Paper 309.