Blue Care Network Best Practices

Prenatal and Postpartum Care

Communication and patient relationships are integral to increasing postpartum visits

Martha Walsh, M.D.

Martha Walsh’s Brighton practice uses direct communication with patients to make sure every pregnant woman receives appropriate prenatal and postpartum care.

"The bigger challenge can sometimes be with postpartum care," said Martha Walsh, M.D., who is also associate directory of quality at the OB/GYN division of IHA.

"A lot of patients may think they’re done with their pregnancy and don’t see the value in the postpartum visit. But the onus is on us to let patients know that it’s an important visit," said Dr. Walsh. Issues discussed at the postpartum visit include healing, contraception, coping with parenthood and breastfeeding.

Dr. Walsh tells patients to make their appointments between six and eight weeks after they deliver. But nurses call patients sooner — within two weeks of delivery. Nurses check to see how patients are feeling and how they are doing with breastfeeding. The nurses screen for depression over the phone. "It's a quick assessment," said Dr. Walsh. "We will do a full depression screening if nurses think it's necessary after the initial phone call."

The depression screening is important to help identify cases of postpartum depression. "A lot of times with postpartum depression, patients don’t always call. Our nurses have identified patients who may not have called and have brought them in quickly," said Dr. Walsh.

Nurses at the practice are also responsible for making sure patients schedule their postpartum visits. If patients don’t schedule a follow-up visit within recommended guidelines, nurses make phone calls and mail letters. Usually, the practice makes at least two phone calls and mails one letter. "Most of the patients come in," said Dr. Walsh. "But if they don’t respond, then I personally call them to see if there are other issues preventing them from scheduling a visit."

Dr. Walsh plans to try more coordination with pediatricians to encourage patients to schedule postpartum visits. "We talked to pediatricians about reminding patients of their postpartum visits when they take their babies in for the first well-baby visit." Because some of Dr. Walsh's patients have the same pediatrician, it's something the office can easily incorporate.

Dr. Walsh says many of her patients come in for postpartum care because the office has established good relationships with them during their pregnancies. "They want to show us how they and their babies are doing," said Dr. Walsh.

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