Utilization and content of postpartum care in a multi-ethnic cohort of women in Los Angeles: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

Objective: To determine the utilization of and content in postpartum visits in a population-based sample of women who recently gave birth in Los Angeles County. Methods: We used data from the 2007 LAMB survey, a population-based, mail sample survey with telephone follow-up for non-respondents based on multistage clustered design. Analyses were based on the unweighted responses of 4446 women with live births. Utilization of a postpartum visit was self-reported. Postpartum counseling was assessed by asking respondents if “during the [postpartum] checkup,” their doctor or nurse talked about: ”birth control,” ”breastfeeding,” ”baby's sleeping position,” ”losing weight gained during pregnancy,” and ”domestic violence or child abuse.” Results: Ninety-two percent of respondents reported receiving a postpartum visit. There were significant disparities in the receipt of postpartum care across racial-ethnic groups (p<0.01). Among women who obtained a postpartum visit, 11% reported receiving no counseling about birth control, 22% had no counseling about breastfeeding, 44% had no counseling about the baby's sleeping position, 53% had no counseling about postpartum weight loss, and 75% had no counseling about domestic violence or child abuse. Discussion: Findings suggest higher utilization of postpartum care than previously reported in the literature. However, there were significant gaps in content which represent important missed opportunities for promoting child and family health at the postpartum visit.