Moms overcome barriers to postpartum care with help from patient navigators
· Medical Xpressedited by Sadie Harley, reviewed by Robert Egan
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While the transition to motherhood can be challenging for anyone, barriers such as inadequate health literacy, unreliable transportation, difficulty navigating a complex health care system, limited access to child care or insecure housing can be the tipping point between a new mom accessing needed care or going without it.
A new Northwestern Medicine study has found patient navigators—trained guides who help patients access care and resources while working alongside the health care team—can ease that transition among low-income pregnant individuals, leading to better health in their postpartum period and more consistent primary care for years to come.
The study is published in JAMA Health Forum. The authors say it is among the first to outline what ideal postpartum care in the U.S. should look like.
A breakdown of the findings
Compared with those who did not receive patient navigation, patients who were paired with a navigator were more likely to:
- Attend postpartum care visits (96% vs. 80% among those receiving usual postpartum care without a patient navigator)
- Be counseled about all needed postpartum topics (65% vs. 51%)
- Have screening and care for postpartum depression (86% vs. 72%) in the critical "fourth trimester" months
- Attend a primary care visit (57% vs. 30%) at one year after giving birth
- Be using their desired family planning method, such as birth control, at one year to help space out their pregnancies (65% vs. 43%)
- Receive preventive health testing (i.e., blood pressure (85% vs. 62%), lipids (28% vs. 13%) and glucose (31% vs. 16%))
"Pregnancy and the postpartum periods are complex, and people often deprioritize themselves, particularly if they don't have much support or have complex social needs," said corresponding author Dr. Lynn Yee, chief of maternal-fetal medicine in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician.
"Combined with a fragmented health care system, many people do not receive the care they need."
"That makes a perfect storm of suboptimal women's health in this very key postpartum period, which is when we know many women drop out of care. If we can address this gap early and sustain their engagement with health care, we can make a difference in the health and well-being of women over the long run."
In cancer care, patient navigation has received widespread adoption and is funded by Medicaid, but has been largely underused and understudied in postpartum care, Yee said. This is the first large-scale study to examine the benefits of patient navigation among pregnant and postpartum individuals. The findings lay the groundwork for future research and potential funding for patient navigation.
What patient navigators did, how it helped
In the study of 405 pregnant individuals at Prentice Women's Hospital in Chicago between 2020 and 2024, patient navigators were paired with pregnant individuals near the end of their pregnancy and throughout the first year after delivery.
The navigators, who spoke both English and Spanish, created postpartum care plans with patients and shared them with the medical team; scheduled and attended appointments; coordinated social needs such as transportation and child care; communicated with doctors and nurses; helped patients understand complex medical information and develop self-efficacy skills; and improved health literacy.
Previous research has shown that pregnancy complications such as gestational diabetes and preeclampsia can affect long-term health, making the transition to primary care of great importance.
Even patients with healthy pregnancies can face postpartum challenges, like postpartum depression, unfulfilled social needs such as lack of partner support or housing challenges, or safety risks like domestic violence, making it difficult to prioritize their health, Yee said. The program's success at engaging postpartum patients in transitioning to primary care shows how navigators can help close these gaps, the authors said.
"Cumulatively, not engaging in health-promotion behaviors in the postpartum period has reverberating implications for the family unit, too," Yee said.
The study also found the medical care team appreciated the navigators' help. The navigators would step in to let a doctor know a patient couldn't attend an appointment and reschedule it, for instance, or complete administrative tasks, thereby freeing up the care team. Navigators also ensured patients followed up on post-appointment tasks, such as getting a glucose tolerance test or attending a subsequent appointment.
"One of the goals of navigators was not just to help patients, but to help clinicians too, and doctors were happy at how much more efficient and engaged patients were," said co-author Joseph Feinglass, research professor of general internal medicine at Feinberg.
A patient navigator's firsthand account from the study
Before joining the study, patient navigator Viridiana Carmona-Barrera worked in hospital, insurance and women's health settings, uniquely positioning her to help pregnant patients.
She recalled one pregnant patient with chronic health conditions who was at risk of missing a critical appointment because of transportation and childcare challenges. When other outreach efforts fell short, Carmona-Barrera helped coordinate transportation and child care so the patient could attend.
"I like being someone who can help make these processes easier," Carmona-Barrera said. "As committed as health care organizations are to supporting patients, navigating the system can still be challenging."
Teaching self-sufficiency so navigators were no longer needed
A primary objective of the study authors and patient navigators was to increase patients' independence and comfort with engaging with the health care system so they wouldn't need a navigator in the future and would continue seeking primary care on their own.
"Their goal was to put themselves out of business, to be able to get to the end of the year and say, 'You don't need me anymore,'" Yee said. "That's success for a navigation program."
Publication details
A randomized trial of patient navigation to improve postpartum health care, JAMA Health Forum (2026). "jamanetwork.com/journals/jama- … althforum.2026.3338?
Journal information: JAMA Health Forum
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Obstetrics & gynecologyWomen's healthCommon illnesses & Prevention Provided by Northwestern University Who's behind this story?
Sadie Harley
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