Research Alert: July 27, 2023

State Differences in Recommended Components of Care Received During Postpartum Visits for Rural and Urban Residents, 2016-2019

The postpartum year after childbirth is a crucial time for the detection and prevention of maternal health complications, yet many postpartum people do not receive all of the recommended components of postpartum care. Rural residents face greater barriers to accessing postpartum care and support as rural obstetric units continue to close, in addition to experiencing higher rates of poverty, food insecurity, violence, and comorbidities that can increase risks for poor postpartum outcomes. The purpose of this policy brief is to measure state-level differences in the receipt of recommended postpartum care components among rural and urban residents in the United States who gave birth from 2016 to 2019.

Key Findings:

• There is substantial state-level and rural-urban variation in the number of recommended care components (contraceptive counseling, depression screening, smoking screening, abuse screening, eating and exercise discussions, and birth spacing counseling) received during postpartum visits.
• The median number of postpartum care components received ranged by state from 2.8 to 4.1 (out of 6). Among rural residents, state variation was greater, ranging from 2.6 to 4.4.
• Contraceptive counseling (planning for pregnancy prevention) was the most commonly received postpartum care component, while birth spacing counseling (planning for timing of future pregnancies) was the least common.
• Abuse screening had the greatest variation across states while contraceptive counseling had the least variation; across rural populations, abuse and depression screening had the greatest variation while eating and exercise discussions had the least variation.
• Rural populations often fell below the national median for receipt of postpartum care components.

Additional Resources of Interest:

• More information about the University of Minnesota Rural Health Research Center
• More information from the Rural Health Information Hub's topic guides: Healthcare Quality, Rural Health Disparities