When it comes to improving health outcomes for postpartum women, it’s important to catch any early signs of postpartum complications. Things like headache, shortness of breath, nausea, or excessive bleeding.
“There’s some very clear early warning signs in that postpartum period where people are at highest risk for complications and those are complications like heart attack or stroke or hemorrhage or infection,” said Dr. Constance Guille, a reproductive psychiatrist and director of the women’s reproductive behavioral health division at the Medical University of South Carolina.
Dr. Guille created a program called H.E.A.R.4Mamas (Healing, Equity, Advocacy, and Respect), which monitors women daily through surveys sent via text messaging to detect warning signs of postpartum complications. It’s important to screen women daily in the early postpartum period because most cases of postpartum depression or hemorrhage occur during the first two months after delivery. Checking in regularly through text messages and phone calls has proven to be effective in detecting serious conditions.
According to Dr. Guille, people are three times more likely to screen positive for postpartum maternal health conditions using text messaging compared to when they’re asked screening questions face to face. They’re also more than four times more likely to get referred to treatment and more than five times more likely to attend treatment using text and phone in comparison to face to face referrals. And, when a patient is referred to treatment, Dr. Guille said telehealth makes accessing that care much easier.
“Telehealth is really critical to all of these programs where we are referring people to treatment because if people can receive treatment in their home via telehealth they are much more likely to accept treatment, they are more likely to attend their visit as opposed to having to come into a clinic,” Dr. Guille said.
South Carolina ranks eighth in the nation for highest rates of maternal morbidity and mortality. Black women in particular have much worse maternal health outcomes than white women. Chinise Clinton is an obstetric nurse advocate and a family nurse practitioner at MUSC. She said stigma and discrimination worsen health outcomes for minorities.
“Black women are four times more likely to die from a postpartum complication in South Carolina,” Clinton said.
Awareness is key to helping families identify the warning signs of postpartum complications, she said.
“The screenings allow patients to determine how they feel and then with the connection we’re able to do chronic disease management, preventative health care, maternal care support and mental health support.,” Clinton said. “So like if a woman has depression or high blood pressure, we’re able to decide if something is normal or urgent and they can take the next best steps to get to an Emergency Room or back to their OB provider.”
Dr. Guille said she wants more people to understand that the health and wellbeing of moms affect the newborn and the entire family unit. If moms are the primary caregiver, and they are not doing well, the family is often not doing well.
"The postpartum year is critical for maternal health and bonding and child development," Dr. Guille said. "We want people to understand the gravity of maternal health and mental health conditions, and we want women to know that help is available."
