Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital),

Intervention Description: The availability of postpartum care through telehealth, either via video and audio or audio only, starting on March 16, 2020. Before this date, all postpartum visits at our institution were performed in-person. However, after this date, outpatient obstetrics clinics recommended telehealth postpartum visits as the primary modality for visits while also offering some limited in-person postpartum visits.

Intervention Results: Subjects in the postimplementation group were at 90% increased odds of attending a postpartum visit compared with those in the preimplementation group, even when controlling for race, prenatal care provider, parity, gestational age at delivery, and insurance status. Patients in the postimplementation group were also more likely to be screened for postpartum depression (86.3% vs 65.1%; P<.001)

Conclusion: Availability of telehealth during the COVID-19 pandemic is associated with increased postpartum visit attendance and postpartum depression screening. However, telehealth was also associated with a decrease in use of long-acting reversible contraception or permanent sterilization.

Study Design: Retrospective cohort study

Setting: Department of Obstetrics & Gynecology, University of Pennsylvania

Population of Focus: Postpartum women enrolled in Medicaid

Sample Size: 1,759 (780 in preimplementation group 799 in postimplementation group(

Age Range: 25-34

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital),

Intervention Description: Postpartum home telehealth with remote blood pressure monitoring.

Intervention Results: Significantly more women in the intervention group than the control group had at least one blood pressure measured within ten days postpartum (202 [94.4%] vs. 129 [60.3%], aRR 1.59, 95% CI: 1.36–1.77). Postpartum home telehealth with remote blood pressure monitoring was associated with reduced readmissions compared to standard care. The intervention group had fewer hypertension-related readmissions compared to the control group (1 [0.5%] vs. 8 [3.7%], aRR 0.12; 95% CI: 0.01–0.96).

Conclusion: Telehealth with remote blood pressure monitoring and standardized management of postpartum hypertension was associated with reduced readmissions compared to standard care. The study suggests that telehealth with remote blood pressure monitoring offers a promising strategy for achieving higher acquisition of blood pressure measurements, early identification and treatment of uncontrolled hypertension, and ultimately reducing hospital readmissions.

Study Design: Non-randomized control trial

Setting: The UnityPoint Health-Meriter healthcare facility and the Department of Obstetrics and Gynecology at the University of Wisconsin, Madison

Population of Focus: Postpartum women with hypertensive disorders of pregnancy

Sample Size: 428 women (214 control group; 214 intervention group)

Age Range: Childbearing age

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital),

Intervention Description: A remote, text message-based blood pressure monitoring program known as Heart Safe Motherhood.

Intervention Results: 192 (96.5%) participants submitted at least 1 blood pressure measurement via text message to the program. Elevated blood pressures were recorded for 70 (35%) participants, 32 (16%) of whom were started on oral antihypertensives after discussing their blood pressure measurements with an on-call provider. A total of 10 participants (5%) required hypertension-related readmission after delivery.

Conclusion: Postpartum participants are willing and capable of using the Heart Safe Motherhood program for remote blood pressure monitoring and reported high satisfaction with the program across multiple sites. Our study demonstrated that this remote blood pressure monitoring program can be implemented successfully and demonstrated replicable efficacy at diverse sites.

Study Design: Prospective implementation design

Setting: Three different academic settings in the U.S.

Population of Focus: Postpartum people with hypertensive disorders of pregnancy (HDP) who were enrolled in the Heart Safe Motherhood program.

Sample Size: 199 participants across three academic medical centers

Age Range: Childbearing age

Intervention Components (click on component to see a list of all articles that use that intervention): Telemedicine Systems (Hospital),

Intervention Description: Telehealth implementation of postpartum care during COVID

Intervention Results: In the preimplementation period, Black patients were less likely to attend a postpartum visit than non-Black patients (63.9% in Black patients vs 88.7% in non-Black patients; adjusted odds ratio, 0.48; 95% confidence interval, 0.29-0.79). In the postimplementation period, there was no difference in postpartum visit attendance by race (79.1% in Black patients vs 88.6% in non-Black patients; adjusted odds ratio, 0.74; 95% confidence interval, 0.45-1.21). In addition, significant differences across races in postpartum depression screening during the preimplementation period became nonsignificant in the postimplementation period. Telehealth implementation for postpartum care significantly reduced racial disparities in postpartum visit attendance (interaction P=.005).

Conclusion: Telehealth implementation for postpartum care during the COVID-19 pandemic was associated with decreased racial disparities in postpartum visit attendance.

Study Design: Retrospective cohort study

Setting: Urban tertiary care center with two clinical sites providing remote telehealth care

Population of Focus: Black and non-Black birthing people pre- and post-pandemic

Sample Size: 1579

Age Range: 27-35