Postpartum Repository

Current, practice-based literature from trusted organizations in the field provide thematic saturation on the following topics related to postpartum standards of care:

• Behavioral/Mental Health Services and Substance Use. The literature highlights a critical focus on system integration, universal screening, and equity. A dominant theme is the necessity of universal screening for both substance use disorders, such as opioid use disorder (OUD), and perinatal mental health conditions, like depression and anxiety, often utilizing a two-generational approach in both pediatric and obstetric primary care settings. Policy recommendations and numerous toolkits advocate for the integration of these behavioral health services into existing clinical workflows to improve access, with guidance on system-level changes like leveraging Medicaid policies and implementing patient safety bundles. A significant area of focus is on addressing differences in screening and treatment outcomes across various community groups, necessitating policy solutions that include provider training on uneven perspectives and culturally responsive care to address structural inequities.
• Chronic Health Conditions/Mortality and Morbidity Drivers. The literature identifies chronic physiological conditions (e.g., hypertensive disorders, cardiovascular diseases) as primary clinical drivers of maternal morbidity and mortality, necessitating targeted clinical interventions such as patient safety bundles to manage these risks. Beyond physical health, reports from Maternal Mortality Review Committees (MMRCs) emphasize the rising impact of mental health conditions and substance use disorders as critical, yet preventable, contributors to pregnancy-related deaths. Crucially, these clinical drivers are inextricably linked to social and structural determinants, with data consistently showing that specific population groups experience higher rates of adverse outcomes due to inequities in access to care and insurance coverage.
• Clinical Consensus, Guidelines, Protocols. The literature highlights a foundational reliance on standardized clinical frameworks, exemplified by the Guidelines for Perinatal Care and Guidelines for Women's Health Care, which provide essential protocols for obstetric and neonatal service delivery across community and hospital settings. A significant shift in clinical consensus is represented by the "Optimizing Postpartum Care" opinion, which reframes the postpartum period as an ongoing, comprehensive process requiring earlier contact and tailored management of chronic conditions rather than a single isolated visit. These guidelines increasingly intersect with policy-level recommendations to address structural drivers of mortality, calling for coordinated system-wide changes to eliminate racial inequities and expand insurance access.
• Community Outreach and Engagement. The literature identifies community-based models (e.g., integration of community health workers (CHWs) and doulas) as essential strategies for redressing maternal health disparities and "re-centering" care around the unique needs of underserved populations. These community-led interventions are shown to improve outcomes by bridging the gap between clinical systems and social determinants, offering culturally congruent support that addresses barriers such as racism and lack of trust. The literature also emphasizes that for these engagement strategies to be sustainable, they must be supported by structural policy changes, including Medicaid reimbursement for doula services and the formal integration of community wisdom into hospital quality improvement protocols.
• Data Collection, Measurement, Analysis. The literature emphasizes the critical role of Maternal Mortality Review Committees (MMRCs) and standardized surveillance systems in transforming raw vital statistics into actionable clinical and public health intelligence. By rigorously collecting and analyzing data on pregnancy-associated deaths and severe maternal morbidity, these bodies are able to determine preventability and identify specific clinical and non-clinical contributing factors. A recurring theme is the urgent need for high-quality, disaggregated data (e.g., by race, ethnicity, insurance status) to accurately measure inequities and drive policy changes that address structural racism. The scope of measurement is expanding beyond mortality to include patient experience surveys and "journey mapping," ensuring that quality improvement efforts are informed by the voices of birthing people themselves.
• Dyadic, Culturally Congruent, Family-Centered Care. The literature advocates for a paradigm shift towards viewing the mother-infant dyad as a single unit to ensure that critical opportunities for maternal intervention (e.g., mental health screening during pediatric visits) are not missed. This approach is inextricably linked to the need for culturally congruent practice, with reports calling for a diverse workforce and anti-bias training to dismantle the structural racism that drives disparities in Black and Indigenous communities. The documents emphasize that sustainable success relies on policy mechanisms, specifically Medicaid reforms that reimburse for community-based support roles like doulas and mandate coverage for two-generational screening protocols.
• Health Equity and Access to Care. The literature underscores that eliminating maternal health disparities requires dismantling structural barriers such as racism and inadequate insurance coverage, which disproportionately affect Black and Indigenous communities. Key strategies include "maternity care deserts" analysis to identify geographic gaps in access, and supporting the extension of Medicaid coverage from 60 days to 12 months postpartum to ensure continuity of care for chronic conditions and mental health needs. In addition, the literature advocates for a "birth justice" framework that integrates community-based models into the standard of care, supported by equitable reimbursement policies and workforce diversity initiatives. Finally, achieving equity is framed not just as a clinical goal but as a systemic one, requiring hospitals and policymakers to co-design solutions with the communities they serve through patient journey mapping and respectful care assessments.
• Infrastructure Development, Financing, and Expansion of Services. The literature identifies Medicaid transformation as the central mechanism for infrastructure development, urging states to adopt value-based payment models and extend postpartum coverage to 12 months to ensure continuity of care. A critical theme is the financing of a broadened workforce, specifically through the reimbursement of community-based doulas and community health workers, which serves to integrate social support directly into the clinical delivery system. The documents emphasize the urgent need to expand service footprints into "maternity care deserts" via rural health investments and equitable telehealth policies. Ultimately, these financial and structural reforms are framed not merely as administrative updates, but as vital strategies for closing racial disparity gaps and advancing health equity.
• Legislation and Policy Development. The literature positions legislative policy as a primary mechanism for redressing maternal health disparities, with a dominant focus on Medicaid transformation. Central to this is supporting the extension of Medicaid postpartum coverage from 60 days to 12 months, which is cited as a critical step for ensuring continuity of care for chronic conditions and mental health needs. Beyond coverage extension, the literature highlights the need for value-based payment models that reward equitable outcomes and specific reimbursement policies for community-based workforce roles, such as doulas and midwives, to integrate social support into the clinical system. The literature emphasizes the importance of "family-friendly" structural policies (e.g., paid parental leave, workplace protections for breastfeeding) as essential components of a holistic approach to improving maternal and infant health across generations.
• Nonclinical Postpartum Care. The literature redefines postpartum care beyond the clinical setting, positioning community-based birth workers as vital providers who address social determinants of health and bridge the gap between families and medical systems. These models are explicitly framed as equity interventions, with evidence suggesting that culturally congruent, continuous social support is essential for mitigating the impacts of structural racism and improving outcomes for Black and Indigenous communities. The documents stress that the scalability of these services hinges on policy integration, calling for robust Medicaid reimbursement structures and organizational strategies to formally embed non-clinical support into the standard perinatal workforce.
• Promising Models of Care and Best Practices. The literature highlights comprehensive state-level initiatives, such as "Nurture NJ" and California's Medi-Cal reforms, as leading models for integrating clinical quality improvement with health equity goals. A central theme is the adoption of "whole-person" care frameworks that bridge the gap between hospital and community, specifically through the formal integration of doulas and midwifery care into the standard hospital setting to reduce primary cesareans and support vaginal birth. These best practices emphasize that successful outcomes depend on systemic changes, including the development of maternal care quality collaboratives and the expansion of reproductive health access to ensure safer, more equitable birthing experiences for all populations.
• Quality, Performance, And Outcome Indicators. The literature emphasizes the use of standardized, evidence-based metrics to drive systems-level improvement and patient safety, explicitly moving beyond volume-based measures to focus on value and equity. A key strategy is the rigorous assessment of facility capabilities through "Levels of Maternal Care" verifications, which ensure that patients receive risk-appropriate treatment based on objective capacity standards rather than geography. Concurrently, quality improvement initiatives (e.g., toolkits targeting the reduction of primary cesareans) demonstrate a shift toward actionable, data-driven clinical protocols designed to optimize birth outcomes and support vaginal delivery. The integration of systematic reviews on perinatal pharmacotherapy and health equity resource hubs reflects a broadening definition of quality, one that now includes long-term psychosocial outcomes and the specific measurement of disparity reduction efforts.
• Resources For Consumers/New Mothers. The literature highlights a shift towards empowering consumers with accessible, actionable tools that support self-advocacy and continuity of care. Resources emphasize patient-centered safety through comprehensive guides on postpartum planning and contraceptive choices, enabling individuals to actively participate in their own clinical decision-making. Crucially, the literature highlights the need for mental health support via supports such as the National Maternal Mental Health Hotline, which provides immediate, culturally and linguistically appropriate counseling for anxiety and depression. There is also a strong focus on mitigating socioeconomic barriers, with literature linking clinical care to vital safety-net programs like WIC and SNAP to ensure families have the nutritional and financial stability required for recovery.
• Universal Screening Tools and Billing Codes. The literature advocates for using validated, culturally adaptable instruments like the Edinburgh Postnatal Depression Scale (EPDS) to identify the most common complications of pregnancy, including depression, anxiety, and PTSD. While obstetric providers are positioned as the primary screeners, the literature underscores that clinical identification must be supported by structural mechanisms, explicitly identifying reimbursement challenges and the bifurcated mental health system as critical barriers that prevent screening from translating into effective treatment. Consequently, the field is moving toward standardized quality metrics, such as HEDIS measures, to track screening rates and drive the policy changes needed to ensure these essential services are both billable and sustainable within the obstetric setting.
• Workforce Training and Development. The literature identifies the expansion and diversification of the perinatal workforce as a critical lever for advancing health equity, explicitly calling for federal investments to grow the pipeline of doulas, midwives, and community health workers who reflect the communities they serve. A major focus is placed on training and education, with recommendations to implement standardized, anti-bias and culturally congruent care curricula across clinical and non-clinical training programs to dismantle systemic racism within the delivery system. The documents emphasize the need for interdisciplinary collaboration, urging states to adopt team-based care models that integrate these community-based roles into the maternity care team through established reimbursement pathways and professional support structures.

The MCH Library has collected the gray literature related to mothers and children from the founding of the Children’s Bureau in 1912 to the present. You can expand your postpartum searching with related resources from the library, including these highlighted resource guides:

• Adolescent Pregnancy and Parenting
• Depression During and After Pregnancy
• Diabetes
• Infant Mortality Toolkit
• Maternal Distress in the Perinatal Period and Child Outcomes
• Maternal Health Toolkit
• Nutrition During Preconception and Pregnancy
• Preconception and Pregnancy
• Racial and Ethnic Disparities in Health
• Tobacco, Alcohol, and Substance Use During Preconception and Pregnancy
• Women's Health

A full list of adjacent topical Resource Guides can also be accessed:

• Assisted Reproductive Technologies
• Breastfeeding
• Childbirth
• Community Services Locator
• Culturally Competent Services
• Family Health History
• Fatherhood
• Home Visiting
• Intimate Partner Violence
• Racial and Ethnic Disparities in Health
• Sleep
• SUID/SIDS Gateway

The Library also has a Single Search that finds resources across over 50,000 cataloged items.

The MCH Evidence Center has collected the evidence base for the Maternal and Child Health National Performance Measures, including:

•  Postpartum Visit (Universal)
•  Postpartum Mental Health Screening
•  Postpartum Contraception Use
•  Perinatal Care Discrimination
•  Risk-Appropriate Perinatal Care
•  Breastfeeding
•  Safe Sleep

The Evidence Center also maintains the MCHbest database of evidence-based interventions, as well as information on understanding the evidence base, using results-based accountability to plan; and implementation tools to move from knowledge to practice.

The peer-reviewed literature can be summarized by the general types of articles identified by the Postpartum Repository:

• Clinical Health. Current clinical research emphasizes the need for managing severe maternal morbidities through standardized protocols and quantitative blood loss measurement to reduce mortality rates. There is a significant focus on the longitudinal management of chronic conditions, such as cardiovascular disease and diabetes, suggesting that the postpartum period offers a vital window for risk screening and lifestyle interventions to prevent long-term health sequelae. In addition, the literature highlights the complexity of integrating mental health care, linking physiological factors like inflammation and cortisol reactivity to postpartum depression and anxiety, while advocating for multidisciplinary approaches to support high-risk populations.
• Clinical Procedures. The clinical literature prioritizes the optimization of cesarean delivery through evidence-based intraoperative techniques and Enhanced Recovery After Cesarean (ERAS) protocols that emphasize multimodal pain management and standardized postoperative care to reduce maternal morbidity. A significant portion of the resources focuses on the management of postpartum hemorrhage, evaluating the efficacy of mechanical interventions like intrauterine balloon tamponade and compression sutures, as well as pharmacological adjuncts like tranexamic acid, while exploring novel diagnostic tools such as portable ultrasound and digital phenotyping. The literature also highlights the evolution of inclusive and specialized clinical pathways, specifically detailing hormonal and mechanical protocols for induced lactation in transgender women and the establishment of multidisciplinary clinics for peripartum pelvic floor disorders. Finally, there is an emerging focus on leveraging technology to improve care access and safety, demonstrated by the implementation of obstetric telemedicine services for rural hospitals and the use of electronic health record data to refine risk identification.
• Consensus Guidelines. Current consensus guidelines emphasize the implementation of standardized tool such as safety bundles to address leading causes of maternal morbidity and mortality, such as cardiac conditions, sepsis, and obstetric hemorrhage. There is a unified shift toward advocating for comprehensive care transitions that manage chronic conditions like hypertension and diabetes while integrating interconception health planning. The literature prioritizes universal screening and evidence-based management for perinatal mood and anxiety disorders, alongside targeted protocols for specific populations including those with physical disabilities and substance use disorders.
• Consumer Access. The literature identifies pervasive structural inequities, including racism and insurance coverage denials, that create significant barriers to accessing quality postpartum care for marginalized and low-income populations. Research highlights critical gaps in access to mental health services, lactation support, and contraception, often exacerbated by the "dual burden" of limited digital connectivity and geographic isolation in rural areas.  Multiple studies emphasize the unmet needs of specific groups, such as individuals with disabilities and those seeking midwifery or doula care, advocating for policy shifts in Medicaid and licensure to improve service availability and affordability.
• Data. Current literature emphasizes the need for accurate data collection and validation to improve maternal health outcomes, highlighting significant discrepancies between hospital discharge codes and electronic health records (EHRs) in identifying conditions like severe maternal morbidity and postpartum hemorrhage. Resources discuss the development and implementation of robust surveillance systems, such as the Red CLAP network in Latin America and the PRECISE database, to monitor global mortality trends and standardize data on life-saving interventions.  Multiple studies utilize large-scale population datasets (e.g., PRAMS) and economic analyses to identify risk factors for complications (e.g., substance use, sleep disorders) and to quantify the financial burden of morbidity and quality improvement programs.
• Provider Education. The reviewed literature emphasizes the role of interdisciplinary provider education in addressing maternal health crises, particularly through standardized training for obstetric emergencies, perinatal mental health screening, and lactation support. There is a significant focus on advancing health equity by integrating implicit bias training and LGBTQIA+ affirming care models into clinical curricula to reduce disparities and improve patient experiences. The resources highlight the efficacy of innovative pedagogical modalities, such as high-fidelity simulation, virtual reality, and game-based learning, in enhancing clinical competency and safety outcomes for high-risk conditions like postpartum hemorrhage.
• Quality Metrics. Recent literature on quality metrics emphasizes the implementation of standardized quality improvement initiatives and patient safety bundles to address gaps in screening and management for conditions like postpartum depression, hemorrhage, and hypertension. There is a significant focus on data integrity, highlighting the limitations of administrative discharge codes compared to electronic health records and the need for validated surveillance tools to accurately capture severe maternal morbidity. The resources advocate for the integration of patient-reported outcome measures (PROMs) to align clinical practice with patient experiences, while critically evaluating the utility of metrics like readmission rates to ensure they drive meaningful improvements in safety and equity.
• Research Community Programs. The literature highlights the implementation of culturally centered, community-led interventions (e.g., Black-led birth centers, Indigenous birth support programs) to dismantle structural racism and address persistent maternal health disparities. There is a significant focus on integrated, dyadic care models that co-locate maternal and pediatric services to improve access to mental health resources, substance use treatment, and chronic disease management for both mother and child. The resources emphasize the efficacy of community health workers and peer support specialists in navigating social determinants of health and sustaining breastfeeding continuity among vulnerable populations.
• Research: Expert Opinion. Current expert opinion advocates for a paradigm shift toward comprehensive, multidisciplinary care models that integrate pediatricians, cardio-obstetric teams, and lactation specialists to manage complex conditions and support dyadic health. There is a pervasive call to action to dismantle structural racism and health inequities by diversifying the workforce, such as through HBCU lactation training programs, and implementing antiracist clinical practices. Experts emphasize the expansion of care access through telehealth and digital innovations while urging a broader focus on emerging public health threats like climate change and the long-term management of chronic conditions beyond the immediate postpartum period.
• Research Focused on Health Services and Implementation. The literature within this topic area evaluates the impact of systemic interventions on improving postpartum access and clinical outcomes. Resources consistently highlight the persistence of racial and economic disparities in care utilization, urging the adoption of culturally responsive and multidisciplinary care models to mitigate these inequities. Studies emphasize the necessity of robust data surveillance and quality improvement initiatives to monitor severe maternal morbidity and ensure the sustainability of supportive health policies.
• Research That Describes Specific Interventions. Thise literature evaluates a diverse array of clinical and behavioral strategies aimed at optimizing postpartum outcomes and bridging gaps in care transition. A significant portion of the resources investigates the efficacy of digital health innovations, including remote blood pressure monitoring and text-based support systems, to enhance the management of hypertensive disorders and perinatal mental health. A number of studies emphasize the implementation of multidisciplinary educational programs and standardized protocols, such as simulation training and pharmacist-led counseling, to improve breastfeeding rates, contraception access, and the response to obstetric emergencies. Finally, there is a concerted focus on developing culturally responsive interventions to address structural disparities and improve health equity for marginalized populations.
• Research Focused on Patient Education. This research emphasizes a shift from passive discharge instructions to interactive, longitudinal educational models." Studies demonstrate that implementing structured pedagogical strategies, such as the "teach-back" method, significantly improves maternal health literacy, leading to higher rates of breastfeeding exclusivity and better recognition of obstetric warning signs. The literature also highlights the growing efficacy of digital health interventions (e.g., mobile apps. telehealth platforms) in bridging gaps in care access and enhancing self-efficacy, particularly for high-risk populations. Multiple articles also advocate for culturally responsive and plain-language educational materials to address disparities in health outcomes and ensure equitable understanding of postpartum recovery protocols.
• Research on Pilot Programs. The literature on research pilots evaluates the feasibility, acceptability, and preliminary efficacy of novel clinical and behavioral interventions designed to address critical gaps in postpartum care. A significant portion of these studies investigates digital health innovations, such as remote health systems monitoring and mobile mental health applications, to enhance the surveillance of hypertensive disorders and perinatal mood anxiety disorders. A large number of studies highlight the piloting of community-based and interdisciplinary care models(e.g., doula support programs, integrated clinics) aimed at addressing social determinants of health and improving engagement among high-risk and marginalized populations.
• Research: Systematic Reviews. Current systematic reviews evaluate a wide array of postpartum interventions, with a strong consensus on the efficacy of counseling and telehealth platforms for preventing and treating perinatal mental health disorders. The literature also synthesizes evidence on managing hypertensive disorders of pregnancy, highlighting the variability in pharmacological protocols while pointing to remote blood pressure monitoring as a promising strategy to reduce readmissions and long-term cardiovascular risk. A number of systematic reviews assess health service delivery models, finding that telehealth and community-based support can significantly mitigate racial disparities in postpartum visit attendance and improve access for underserved populations.

Stay current with the science by accessing the previous 12 months of peer-reviewed literature on these topics:

• Postpartum Overall: PubMed Search (access the search used for this repository)
• Postpartum Visit: PubMed Search
• Postpartum Mental Health Screening: PubMed Search
• Postpartum Contraception Use: PubMed Search

Project librarians excluded many of the population-based studies that took place during the COVID-19 pandemic because they focused on situations that no longer exist. For example, many articles focused on this time period examine the isolation that pregnant/postpartum people experienced during lock down; their extreme fear of contracting the virus; and their avoidance of in-person visits with practitioners. 

However, COVID itself still exists, and pregnant people who get COVID are more likely to have poor maternal/infant health outcomes, so librarians included relevant studies that focus on preventing/treating COVID-19 in pregnant and postpartum people, including those that focus on vaccination.  In addition, there were numerous lessons learned during the pandemic; librarians included those COVID pandemic studies that focused on lessons learned.  

In the Postpartum Repository, we use the definition of "non-clinical postpartum care" as outlined by the Postpartum Medicaid Implementation Issue Brief (Community Health Acceleration Partnership, 2024): Non-clinical postpartum care can be provided by a complex network of perinatal case managers and care managers such as social workers, and community health workers, and birth workers including doulas. Perinatal case management programs can be hospital/health system based, health department based, or community based. Many of these programs are funded by federal funds from Healthy Start or the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs. Unfortunately, access to quality programming varies greatly and depends on local and state resources. Community-based doulas have increasingly been integrated into the perinatal support model through Medicaid reimbursement, but results to date have been mixed.

Access to these support professionals is far from universal based on a myriad of social, systemic, and structural issues, including the quality and access to medical care. The current structure of postpartum services and resources require individuals to navigate the complex web of services and professionals, which assumes a moderate to high level health literacy and social agency. While innovative collaborations are underway, structural barriers typically prevent effective coordination and data sharing between professionals and organizations. This is especially true for the management of behavioral health needs.

Common themes from the interventions collected in the repository can be summarized by the following topic areas:

• Advocacy. The advocacy interventions detailed in the literature emphasize the critical need for systemic policy reforms, particularly methods to support the extension of Medicaid coverage to 12 months postpartum and the implementation of paid family leave, to ensure continuity of care and financial stability for new families. Resources advocate for dismantling structural racism within healthcare systems by integrating anti-racist training, diversifying the perinatal workforce, and codifying respectful maternity care standards to mitigate racial disparities in maternal mortality. The literature also highlights the efficacy of community-based advocacy models (e.g., reimbursable doula services, peer support networks in empowering patients and addressing the social determinants of health that drive inequitable outcomes.
• Case Management. Evidence-based interventions in case management prioritize the deployment of patient navigators and community health workers to bridge the critical gap between obstetric discharge and long-term primary care, particularly for high-risk populations managing conditions like gestational diabetes, hypertension, and substance use disorders. These resources demonstrate that personalized care coordination effectively mitigates systemic barriers (e.g., insurance fragmentation’ logistical challenges) leading to significantly improved rates of postpartum visit attendance and successful linkage to behavioral health services. The literature highlights the utility of nurse-led "bridge clinics" and integrated care models in ensuring continuity of safety surveillance and enhancing self-management efficacy.
• Collaboration. Evidence-based interventions in this area demonstrate that interdisciplinary collaboration, like that through the Collaborative Care Model (CoCM), is essential for effectively managing complex clinical issues like perinatal mental health and substance use disorders. The resources highlight that integrated teams comprising midwives, nurses, pharmacists, and physicians significantly enhance patient safety and outcomes, including improved breastfeeding rates and reduced unnecessary obstetric interventions. From a policy perspective, these studies advocate for systemic reforms in reimbursement and workforce training to sustain these team-based care models, ensuring they are scalable and accessible to diverse postpartum populations.
• Consultation. The literature on consultation interventions emphasizes the implementation of specialized access programs (e.g., perinatal psychiatry consultation lines, telelactation services) to bridge critical gaps in provider expertise and patient access. These resources demonstrate that equipping frontline obstetric and pediatric providers with real-time access to psychiatric and lactation specialists significantly enhances their capacity to screen for and manage complex conditions like postpartum depression and breastfeeding challenges. The use of multidisciplinary "heart teams" and virtual consultation platforms is highlighted as a scalable strategy to reduce maternal morbidity and overcome geographic barriers to care for high-risk populations.
• Counseling. Evidence-based interventions in this area identify a critical gap in postpartum counseling for women with hypertensive disorders of pregnancy, noting that while patients are often informed of future cardiovascular risks, they rarely receive actionable guidance on specific risk reduction strategies. A significant portion of the resources advocates for shifting contraceptive counseling away from directive methods toward person-centered, shared decision-making frameworks that protect reproductive autonomy, particularly for populations managing HIV or substance use disorders. The literature also highlights the expanding role of interdisciplinary providers, demonstrating that pharmacist-led counseling initiatives can effectively improve patient knowledge regarding severe maternal morbidity risks like preeclampsia and opioid safety.
• Direct Care. Evidence-based interventions in direct care emphasize the management of complex physiological and psychological conditions through multidisciplinary and technology-enabled models. Resources highlight the efficacy of specialized cardio-obstetrics teams and standardized anesthesia protocols in mitigating severe maternal morbidity, while also establishing consensus guidelines for safe return to postpartum physical activity. A significant portion of the literature advocates for integrating digital health tools (e.g., telemedicine for preeclampsia monitoring, mental health support) to bridge care gaps and address racial disparities. The texts underscore the importance of interventions such as sleep protection strategies and trauma-informed care for perinatal loss, to prevent long-term mental health sequelae.
• Disease. Evidence-based interventions in this area prioritize the management of complex chronic and infectious conditions, specifically Hepatitis C and Substance Use Disorders (SUD), through integrated and longitudinal care models. Resources emphasize the critical need for universal screening and robust linkage-to-care protocols for Hepatitis C to prevent vertical transmission and long-term maternal morbidity. The literature advocates for holistic, "medical home" and two-generation approaches that co-locate behavioral health, primary care, and social services to effectively support recovery and reduce health disparities among postpartum populations.
• Education. Evidence-based educational interventions are increasingly moving beyond didactic methods to incorporate immersive technologies, such as high-fidelity simulation, virtual reality, and game-based learning, which have been shown to significantly enhance clinical judgment and team response to obstetric emergencies like postpartum hemorrhage and neonatal resuscitation. The literature emphasizes the standardization of curricula for perinatal mental health and post-birth warning signs to ensure consistent screening and patient education across diverse care settings, including emergency departments and inpatient units. Resources strongly advocate for integrating structural competency frameworks (e.g., implicit bias training, LGBTQIA+ affirming care models) into professional development to address health disparities and improve the quality of care for marginalized populations.
• Epidemiology. The epidemiological literature documents a concerning rise in maternal mortality and severe maternal morbidity (SMM) in the United States, with postpartum hemorrhage, cardiovascular conditions, and infection identified as leading drivers of these adverse outcomes. A central finding across these resources is the persistence of stark racial and ethnic disparities, particularly affecting Black women, which underscores the need to address structural determinants of health alongside clinical risk factors. Research emphasizes the critical role of enhanced surveillance systems (e.g., Maternal Mortality Review Committees, standardized SMM screening) to accurately classify pregnancy-related deaths and identify opportunities for prevention. The data supports the implementation of standardized patient safety bundles to manage obstetric emergencies, as a significant proportion of maternal deaths and near-miss events are deemed preventable through timely and effective care.
• Outreach. Evidence-based outreach interventions prioritize community-embedded models, such as mobile medical clinics and nurse-led home visiting programs, to extend the continuum of care to underserved and hard-to-reach populations. The literature highlights the effectiveness of community health workers and peer support specialists in building trust-based relationships that facilitate engagement and retention in care for high-risk groups, particularly those navigating substance use disorders or homelessness. These interventions advocate for the implementation of integrated, two-generation care models that co-locate maternal and pediatric services to address social determinants of health and mitigate racial disparities in postpartum outcomes.
• Policy. Policy-level interventions described in the literature prioritize the legislative extension of Medicaid coverage from 60 days to 12 months postpartum as a critical strategy to ensure continuity of care for chronic conditions and behavioral health disorders. Research consistently supports the implementation of Paid Family Leave (PFL) policies, demonstrating that access to paid time off significantly increases breastfeeding duration and reduces the prevalence of postpartum depressive symptoms. Of note, there is a concerted advocacy for state-level Medicaid reimbursement of doula services, positioning community-based perinatal support as a vital mechanism for dismantling structural racism and narrowing racial disparities in maternal morbidity.
• Referral. Evidence-based interventions in this area prioritize the implementation of standardized screening and referral protocols (e.g., Screening, Brief Intervention, and Referral to Treatment (SBIRT)) to effectively link postpartum individuals with necessary behavioral health and substance use services. The literature emphasizes the efficacy of "warm handoff" strategies and co-located care models in reducing attrition rates and ensuring successful transitions from obstetric to specialty providers. These interventions advocate for the use of electronic health record integration and dedicated patient navigators to streamline the referral process and address structural barriers to access for high-risk populations.
• Screening. Evidence-based interventions in this area focus on implementing universal screening protocols across diverse care settings (e.g., pediatric primary care, NICUs, and emergency departments) to detect perinatal mood and anxiety disorders and substance use disorders early. Resources highlight the efficacy of integrating validated tools like the Edinburgh Postnatal Depression Scale (EPDS) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) into clinical workflows and electronic health records to prompt consistent assessment and facilitate "warm handoffs" to treatment. The literature also emphasizes the importance of culturally responsive screening practices and provider education to mitigate racial disparities in diagnosis and ensuring that positive screens lead to equitable, accessible follow-up care.
• Social Marketing. Evidence-based interventions in this area focus on the use of digital communication strategies, such as text messaging and mobile applications, to deliver targeted educational content and support to postpartum populations. Resources highlight that personalized, biomarker-based text messages and culturally tailored educational films can effectively improve breastfeeding rates, smoking cessation, and the management of maternal weight retention. The literature also demonstrates that financial incentives and "humanizing" campaigns can significantly reduce stigma and increase social support for women experiencing postpartum depression, thereby enhancing engagement in care and improving mental health outcomes.

In addition to the intervention studies found in the peer-reviewed literature, there are collections of evidence-based or informed, field-generated, and community-rooted interventions that have been collected for further adaptation or adoption. Access these resources for specific interventions and supporting research and ideas for implementation:

• MCHbest Database. Provides access to over 40 interventions related to the postpartum period, including strategies focused on the postpartum visit; postpartum mental health screening, and postpartum contraception use. The MCH Evidence Center has also developed a series of Evidence Accelerators and Toolkits to explore how to implement and measure these strategies.
• Innovation Hub. The Association of Maternal and Child Health Programs (AMCHP) provides a searchable repository of practice-based evidence in multiple MCH topics, including the perinatal period; resources includes both practices and policies.
• What Works for Health. County Health Rankins and Roadmaps, with funding from the Robert Wood Johnson Foundation, provides strategies focused specifically on postpartum topics and a full range of adjacent strategies of importance to the perinatal period. The WWFH database also includes a research-driven chatbot, Ask Evi, that taps resources from their evidence base.
• Maternal Distress in the Perinatal Period and Child Outcomes: Professional Resource Guide. The MCH Library's guide provides access to resources that address some of the sources of stress that pregnant women and new mothers experience and the impact of maternal distress on the developing fetus and young child. A section of Interventions to Reduce or Manage Maternal Distress provides direct access to current practice- and evidence-based strategies.

Several stand-alone resources also contain details about specific types of interventions:

• Improving Quality in Pregnancy and Postpartum Care: Implementation Guide. National Association of Community Health Centers. This guide provides practical strategies to leverage data from electronic clinical data systems for improved maternal health care through continuous quality improvement initiatives.
• Resources on Strategies to Improve Postpartum Care Among Medicaid and CHIP Populations. Centers for Medicare and Medicaid Services, Maternal and Infant Health Initiative. The resource includes a range of evidence-based strategies, best practices, and advice to providers. The materials cover approaches to increasing the number of women who make and keep a postpartum visit and to improving the measurement process in clinical settings. Many of the projects or programs described in the guide include multiple interventions. The guide also
  presents information on interventions that have been tested at the MCO, provider, and member level, and across the prenatal, postpartum, and interconception periods.