Primary Care After Pregnancy Survey: Patient Preferences, Health Concerns, and Anticipated Barriers.

Despite recommendations for ongoing care after pregnancy, many individuals do not see a primary care clinician within the first postpartum year, missing a critical window to engage reproductive-age individuals in primary care. We administered an anonymous, cross-sectional, trilingual survey at a large urban safety-net hospital to assess postpartum individuals' preferences, health concerns, and anticipated barriers to primary care during the year after pregnancy. While 90% of respondents preferred a visit within one year, most individuals - including those with complicated pregnancies - did not recall a primary care recommendation from their pregnancy care team. Respondents reported a variety of primary care-amenable health concerns, and many social and logistical barriers to care. Preference for virtual care increased if self-monitoring tools were hypothetically available, indicating virtual visits may improve primary care access.

Strategies for Recruiting a Diverse Postpartum Survey Sample.

BACKGROUND: Data from diverse populations are needed to inform interventions for maternal health equity. However, research recruitment of postpartum individuals is challenging, especially in minoritized and structurally marginalized populations. MATERIALS AND METHODS: We developed a recruitment strategy for a cross-sectional survey among postpartum individuals at an urban safety-net hospital in New England, inclusive of those with a language preference other than English (LPOE) and those not attending scheduled postpartum visits. Recruitment was primarily conducted before, during, and after clinic visits in obstetrics or pediatrics. Surveys could be completed in-person, over the phone, or online. All study materials were trilingual (English, Spanish, Haitian Creole). After reaching our recruitment goal of 120 individuals, we analyzed our recruitment efforts to identify key recruitment strategies. RESULTS: From April to June 2022, 245 individuals were invited to participate, and 120 (49%) completed the survey, of whom 119 contributed recruitment data to the present analysis. Most participants (83.1%) self-identified as Black or Hispanic, and 30.2% had an LPOE. Compared with the overall sample, participants with an LPOE were more likely to have been recruited in-person (73% versus 78%), while those not attending postpartum visits required more outreach attempts (mean 2.3 versus 2.6). We identified 4 key strategies contributing to recruitment success: multilingual materials, frequent assessment and adjustment of our recruitment approach, pediatrics-based recruitment, and multiple timings and modes of outreach. CONCLUSIONS: Using a multi-stage, multilingual, and multi-method recruitment strategy including pediatrics-based outreach, we recruited a diverse postpartum sample with > 80% individuals of color and > 30% with an LPOE. Our experience can inform more inclusive postpartum research.