The care domain is a defined area of social welfare provision and plays a crucial role in the overall quality of care. Fields of care are necessary because they provide a framework for organizing and delivering care. Ease of access, quality of care received, satisfaction with treatment, health plan description, effectiveness of care, and outcome metrics are all part of the care domains. The fields of care have various performance measures, and prenatal and postpartum care is among the performance measures (Gratziou & Rovina et al., 2018). Prenatal care is the health care you receive during pregnancy. Prenatal care includes regular check-ups, tests, and screenings to help keep the mother and baby healthy. On the other hand, postpartum care is the care the mother receives after giving birth, including caring for the baby, recovering from childbirth, and adjusting to life with a new baby.
Prenatal and postpartum care are essential to the well-being of both child and mother. Unfortunately, due to various factors, including lack of access to care, financial constraints, and societal norms, many women do not receive the care they need during these crucial times. As a result, both mothers and children can suffer from health problems, both short- and long-term (Gratziou & Rovina et al., 2018). It is crucial, then, that women have access to improved prenatal and postpartum care. Various performance measures have been developed to ensure that women receive the care they need. Prenatal and postpartum care have various primary patient interventions that have improved patient outcomes and saved patient costs.
Patient Interventions
Prenatal and postpartum care is critical to ensuring a healthy pregnancy and birth. The National Committee for Quality Assurance (NCQA) recognizes three patient prenatal and postpartum care interventions as performance measures: comprehensive prenatal care, adequate weight gain during pregnancy, and smoking cessation.
Comprehensive Prenatal Care
Comprehensive prenatal care includes a broad range of services designed to care for the whole person, not just the pregnancy. These services should be tailored to the patient’s needs and may include nutrition counseling, mental health support, and social services (Groenhof & Veerbeek et al., 2018). To implement this intervention, providers should assess the needs of each patient and connect them with the appropriate resources—Archived through referrals to community organizations or on-site services. To measure the outcomes of this intervention, providers can track the patients who receive comprehensive prenatal care and the number of patients who experience adverse consequences, such as preterm birth or low birth weight.
Appropriate Weight Gain throughout Pregnancy
Furthermore, both the mother and the baby benefit significantly from the woman accumulating a healthy weight throughout pregnancy. Women who are overweight have a higher chance of developing several health problems during and after pregnancy. To help ensure adequate weight gain, providers should assess a woman’s weight at each prenatal visit and guide diet and exercise (Ells & Scott et al., 2018). To measure the outcomes of this intervention, providers can track the number of patients who gain the recommended amount of weight during pregnancy and patients who experience complications.
Smoking Cessation During Pregnancy
Last but not least, smoking causes several pregnancy problems, including delivery difficulties, low birth weight, and placental abruption. Providers should do tobacco use screenings at each prenatal appointment and provide counseling and services to assist pregnant women quit smoking (Gratziou & Rovina et al., 2018). To measure the outcomes of this intervention, providers can track the number of patients who quit smoking during pregnancy.
Improved Patient Outcomes
Patient experience outcomes include patient-reported experience measures. According to the Agency for Clinical Innovation (ACI), Patient-reported experience measures patient satisfaction with healthcare. This data may provide a more accurate picture of patient satisfaction and help improve local services and address concerns faster. Patients may be asked to rate their treatment on a 1-to-5 scale. A care delivery mechanism may reduce the Length of stay, which is good, but if patients feel rushed out, their satisfaction scores will drop (NCQA, 2021). The interventions can result in improved patient outcomes for the practice of prenatal and postpartum care.
Comprehensive prenatal care reduces preterm birth, low birth weight, and neonatal death. It can also lead to improved maternal health outcomes, including reduced risk of hypertension and postpartum hemorrhage. In addition, comprehensive prenatal care can reduce healthcare costs by preventing complications that require more expensive interventions, such as hospitalization or surgery. Adequate weight gain during pregnancy is essential for optimizing maternal and fetal outcomes (Guo & Chen et al., 2019). Women who do not acquire enough weight during pregnancy are more likely to have premature infants, low birth weights, or infant deaths.
Increased dangers for the mother include hypertensive problems throughout pregnancy and postpartum bleeding if the baby doesn’t grow enough weight. Smoking cessation during pregnancy is vital for improving maternal and fetal health outcomes. Babies born to mothers who smoke during pregnancy have a higher chance of being born prematurely, having a low birth weight, and dying shortly after delivery. Furthermore, smoking increases the probability of developing hypertensive disorders during pregnancy and postpartum hemorrhage, both dangerous to the mother.
Cost Savings
Comprehensive prenatal care, appropriate weight gain, and smoking cessation may lower prenatal and postpartum costs. A thorough literature analysis indicated that treatments to enhance pregnancy outcomes are cost-effective (Naughton & Fulton et al., 2018). The interventions found to be cost-effective were comprehensive prenatal care, smoking cessation, and adequate weight gain during pregnancy. Comprehensive prenatal care is associated with a reduction in the number of preterm births, low birth weight babies, and neonatal deaths. These reductions in adverse outcomes are associated with reduced healthcare costs. Therefore, Comprehensive prenatal care measures save money.
Pregnancy weight gain minimizes low-birth-weight babies. Low birth weight promotes neonatal mortality and childhood health concerns. According to a comprehensive study, moderate weight gain therapies are cost-effective during pregnancy (Naughton & Fulton et al., 2018). Preterm births, low birth weight newborns, and neonatal fatalities may be prevented if mothers quit smoking throughout their pregnancies. The healthcare savings attributable to these decreases in bad outcomes are substantial. Research on the cost-effectiveness of smoking cessation during pregnancy has shown that such programs save money.
Patient Ratings
Patient ratings are one way to measure how well a provider is doing. Comprehensive prenatal care, adequate weight gain during pregnancy, and smoking cessation during pregnancy can improve patient ratings for various reasons. Comprehensive prenatal care aims to decrease mother and newborn mortality and enhance pregnancy outcomes. For the best results, it’s best to start this sort of treatment as soon during pregnancy as possible so that all women may get it. The likelihood of having a premature delivery, a baby with a low birth weight, or a baby who dies shortly after birth may all be decreased with the help of comprehensive prenatal care. The health of the mother and child depends on the woman gaining enough weight during pregnancy.
Too little or too much weight gain during pregnancy can cause the baby to be born early, the baby to be born with a low birth weight, or both the mother and the baby to die. So, women need to gain the right amount of weight while pregnant. Lastly, it is essential for both the mother’s and the baby’s health for the mother to stop smoking while she is pregnant. The risks of having a premature baby, a baby with a low birth weight, and a baby dying shortly after delivery are amplified when the mother smokes. Women who smoke during pregnancy are also more likely to experience placental abruption and placenta previa. To reduce these risks, women must quit smoking before or during pregnancy.
Conclusion
Prenatal care is essential for a healthy pregnancy. It is vital for pregnant women to see a healthcare provider early in their pregnancy and to continue to receive care throughout their pregnancy. Prenatal care can help identify potential health problems, manage complications, and promote a healthy pregnancy. Postpartum care is also crucial for the health of the mother and baby (NCQA, 2021). Women should have regular check-ups and screenings in the postpartum period. Nutrition and weight loss are essential in the postpartum period, and women should aim to lose the weight they gain during pregnancy. Smoking is also harmful to the mother and baby and should be avoided postpartum. Several interventions can help pregnant women have a healthy pregnancy, including comprehensive, adequate weight gain, prenatal care, and smoking cessation during pregnancy. These interventions can help to improve outcomes for both the baby and the mother.
References
Diamanti, A., Papadakis, S., Schoretsaniti, S., Rovina, N., Vivilaki, V., Gratziou, C., & Katsaounou, P. A. (2019). Smoking cessation in pregnancy: An update for maternity care practitioners. Tobacco-induced diseases, 17. https://doi.org/10.18332%2Ftid%2F109906
Farpour-Lambert, N. J., Ells, L. J., Martinez de Tejada, B., & Scott, C. (2018). Obesity and weight gain in pregnancy and postpartum: an evidence review of lifestyle interventions to inform maternal and child health policies. Frontiers in endocrinology, 9, 546. https://doi.org/10.3389/fendo.2018.00546
Griffiths, S. E., Parsons, J., Naughton, F., Fulton, E. A., Tombor, I., & Brown, K. E. (2018). Are digital interventions for smoking cessation in pregnancy effective? A systematic review and meta-analysis. Health Psychology Review, 12(4), 333–356. https://doi.org/10.1080/17437199.2018.1488602
Guo, H., Zhang, Y., Li, P., Zhou, P., Chen, L. M., & Li, S. Y. (2019). Evaluating the effects of a mobile health intervention on weight management, glycemic control, and pregnancy outcomes in patients with gestational diabetes mellitus. Journal of endocrinological investigation, 42(6), 709–714. https://doi.org/10.1007/s40618-018-0975-0
NCQA. (2021). Adult BMI Assessment – NCQA. NCQA. Retrieved November 13, 2022, from https://www.ncqa.org/hedis/measures/adult-bmi-assessment/
Parekh, N., Jarlenski, M., & Kelley, D. (2018). Prenatal and postpartum care disparities in a large Medicaid program. Maternal and child health journal, 22(3), 429-437. https://doi.org/10.1007/s10995-017-2410-0
Van Den Heuvel, J. F., Groenhof, T. K., Veerbeek, J. H., Van Solinge, W. W., Lely, A. T., Franx, A., & Bekker, M. N. (2018). eHealth as the next-generation perinatal care: an overview of the literature. Journal of medical Internet research, 20(6), e9262. https://doi.org/10.2196/jmir.9262
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