{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:26:46Z","timestamp":1790699206912,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Wallace Center for Maternal, Child, and Adolescent Health"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Professional societies such as the American College of Obstetricians and Gynecologists (ACOG) promote the idea that postpartum care is an ongoing process where there is adequate opportunity to provide services and support. Nonetheless, in practice, the guidelines ask clinicians to perform more clinical responsibilities than they might be able to do with limited time and resources.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted an online survey among practicing obstetric clinicians (obstetrician\/gynecologists (OB\/GYNs), midwives, and family medicine doctors) in California about their priorities and care practices for the first postpartum visit and explored how they prioritize multiple clinical responsibilities within existing time and resources. Between September 2023 and February 2024, 174 out of 229 eligible participants completed the survey, a 76% response rate. From a list of care components, we used descriptive statistics to identify those that were highly prioritized by most clinicians and those that were considered a priority by very few and examined the alignment between prioritized components and recommended care practices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Clinicians were highly invested in the care components that they rated as most important, indicating that they always check these components or assess them when they perceive patient need. <jats:italic>Depression and anxiety<\/jats:italic>,<jats:italic> breast health\/breast feeding issues<\/jats:italic>,<jats:italic> vaginal birth complications and family planning counseling<\/jats:italic> were highly ranked components by all clinicians. In contrast, clinicians more often did not assess those care components that infrequently ranked highly among the priority listing, consisting mainly of social drivers of health such as screening and counseling for <jats:italic>intimate partner violence<\/jats:italic>,<jats:italic> working conditions and food\/housing insecurity<\/jats:italic>. In both instances, we found little discordance between priorities and care practices. However, OB\/GYNs and midwives differed in some care components that they prioritized highly.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>While there is growing understanding of how important professional society recommendations are for maternal-infant health, clinicians face barriers completing all recommendations, especially those components related to social drivers of health. However, what the clinicians do prioritize highly, they are likely to perform. Now that Medi-Cal (Medicaid) insurance is available in California for up to 12 months postpartum, there is a need to understand what care clinicians provide and what gaps remain.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12884-024-06705-7","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T15:23:11Z","timestamp":1721920991000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinician care priorities and practices in the fourth trimester: perspective from a California survey"],"prefix":"10.1186","volume":"24","author":[{"given":"Sylvia","family":"Guendelman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena Xinzi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Lahiff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Lurvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley E.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"6705_CR1","doi-asserted-by":"crossref","unstructured":"Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Major Survey Findings of Listening to Mothers(SM) III: New Mothers Speak Out: Report of National Surveys of Women\u2019s Childbearing Experiences Conducted October-December 2012 and January-April 2013. J Perinat Educ. 2014 Winter;23(1):17\u201324.","DOI":"10.1891\/1058-1243.23.1.17"},{"issue":"10","key":"6705_CR2","doi-asserted-by":"publisher","first-page":"e223292","DOI":"10.1001\/jamahealthforum.2022.3292","volume":"3","author":"JD Interrante","year":"2022","unstructured":"Interrante JD, Admon LK, Carroll C, Henning-Smith C, Chastain P, Kozhimannil KB. Association of Health Insurance, Geography, and race and ethnicity with disparities in receipt of recommended Postpartum Care in the US. JAMA Health Forum. 2022;3(10):e223292.","journal-title":"JAMA Health Forum"},{"key":"6705_CR3","unstructured":"Postpartum Depression Screening and Follow-Up. National Committee for Quality Assurance. https:\/\/www.ncqa.org\/hedis\/measures\/postpartum-depression-screening-and-follow-up\/. Accessed 25 Apr 2024."},{"issue":"5","key":"6705_CR4","doi-asserted-by":"publisher","first-page":"e140","DOI":"10.1097\/AOG.0000000000002633","volume":"131","author":"Presidential Task Force on Redefining the Postpartum Visit Committee on Obstetric Practice","year":"2018","unstructured":"Presidential Task Force on Redefining the Postpartum Visit Committee on Obstetric Practice. ACOG Committee Opinion 736: optimizing Postpartum Care. Obstet Gynecol. 2018;131(5):e140\u201350.","journal-title":"Obstet Gynecol"},{"key":"6705_CR5","unstructured":"California Health Care Almanac. Maternity Care in California, 2023: Delivering the Data. California Health Care Foundation. www.chcf.org. Accessed 19 Apr 2024."},{"key":"6705_CR6","unstructured":"Kaiser Family Foundation. Medicaid Postpartum Coverage Extension Tracker. 2024. https:\/\/www.kff.org\/medicaid\/issue-brief\/medicaid-postpartum-coverage-extension-tracker\/. Accessed 1 May 2024."},{"issue":"5","key":"6705_CR7","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1097\/AOG.0000000000003731","volume":"135","author":"AF Peahl","year":"2020","unstructured":"Peahl AF, Novara A, Heisler M, Dalton VK, Moniz MH, Smith RD. Patient preferences for prenatal and Postpartum Care Delivery: a Survey of Postpartum Women. Obstet Gynecol. 2020;135(5):1038\u201346.","journal-title":"Obstet Gynecol"},{"key":"6705_CR8","doi-asserted-by":"crossref","unstructured":"Cheng CY, Fowles ER, Walker LO. Continuing education module: postpartum maternal health care in the United States: a critical review. J Perinat Educ. 2006 Summer;15(3):34\u201342.","DOI":"10.1624\/105812406X119002"},{"key":"6705_CR9","unstructured":"ACOG Postpartum Toolkit. www.ACOG.org. Accessed 3 Apr 2024."},{"issue":"1","key":"6705_CR10","doi-asserted-by":"publisher","first-page":"e43","DOI":"10.1097\/AOG.0000000000002459","volume":"131","author":"Committee on Health Care for Underserved Women. ACOG Committee Opinion No","year":"2018","unstructured":"Committee on Health Care for Underserved Women. ACOG Committee Opinion No. 729: Importance of Social Determinants of Health and Cultural Awareness in the delivery of Reproductive Health Care. Obstet Gynecol. 2018;131(1):e43\u20138.","journal-title":"Obstet Gynecol"},{"issue":"1","key":"6705_CR11","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s12913-020-05144-2","volume":"20","author":"T Krishnamurti","year":"2020","unstructured":"Krishnamurti T, Simhan HN, Borrero S. Competing demands in postpartum care: a national survey of U.S. providers\u2019 priorities and practice. BMC Health Serv Res. 2020;20(1):284.","journal-title":"BMC Health Serv Res"},{"key":"6705_CR12","unstructured":"Sakala C, Declercq ER, Turon JM, Corry MP. Listening to mothers in California: a Population-based survey of women\u2019s childbearing experiences. Full Survey Report; 2018."},{"key":"6705_CR13","unstructured":"Kwong C, Brooks M, Dau KQ, Spetz J. October. California Midwives: How Scope of Practice Laws Impact Care. California Health Care Foundation, 2019. www.chcf.org. Accessed July 2, 2024."},{"key":"6705_CR14","doi-asserted-by":"crossref","unstructured":"Thompson-Lastad A, Harrison JM, Taiwo TK, Williams C, Parimi M, Wilborn B, Chao MT. Postpartum care for parent-infant dyads: a community midwifery model. Birth. 2024 Apr 8.","DOI":"10.1111\/birt.12822"},{"issue":"6","key":"6705_CR15","doi-asserted-by":"publisher","first-page":"e2316536","DOI":"10.1001\/jamanetworkopen.2023.16536","volume":"6","author":"IJ Saldanha","year":"2023","unstructured":"Saldanha IJ, Adam GP, Kanaan G, Zahradnik ML, Steele DW, Chen KK, Peahl AF, Danilack-Fekete VA, Stuebe AM, Balk EM. Health Insurance Coverage and Postpartum Outcomes in the US: a systematic review. JAMA Netw Open. 2023;6(6):e2316536.","journal-title":"JAMA Netw Open"},{"issue":"6","key":"6705_CR16","doi-asserted-by":"publisher","first-page":"e2316542","DOI":"10.1001\/jamanetworkopen.2023.16542","volume":"6","author":"JR Daw","year":"2023","unstructured":"Daw JR, Howell EA. Defining goals and investing in data to Improve Postpartum Health and Health Equity. JAMA Netw Open. 2023;6(6):e2316542.","journal-title":"JAMA Netw Open"},{"issue":"2","key":"6705_CR17","doi-asserted-by":"publisher","first-page":"B2","DOI":"10.1016\/j.ajog.2023.10.013","volume":"230","author":"Society for Maternal-Fetal Medicine","year":"2024","unstructured":"Society for Maternal-Fetal Medicine. Social determinants of health and obstetric outcomes: a report and recommendations of the workshop of the Society for maternal-fetal medicine. Am J Obstet Gynecol. 2024;230(2):B2\u201316.","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"6705_CR18","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1377\/hlthaff.2023.00541","volume":"42","author":"JR Daw","year":"2023","unstructured":"Daw JR, Underhill K, Liu C, Allen HL. The Health and Social needs of Medicaid beneficiaries in the Postpartum Year: evidence from a Multistate Survey. Health Aff (Millwood). 2023;42(11):1575\u201385.","journal-title":"Health Aff (Millwood)"},{"key":"6705_CR19","volume-title":"Encyclopedia of Social Measurement","author":"KK Leonard","year":"2005","unstructured":"Leonard KK. Encyclopedia of Social Measurement. Volume 2. Amsterdam: Academic; 2005."}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06705-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-06705-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06705-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T15:23:46Z","timestamp":1721921026000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-06705-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,25]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["6705"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-06705-7","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,25]]},"assertion":[{"value":"27 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Boards of the University of California, Berkeley (Protocol No. 2023-01-15992) and Stanford University (Protocol No. 71687).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"502"}}