Timing Newborn Follow up Care in Low Income First Time Minority Mothers

Title: Newborn Follow up Care in Low Income First Time Minority Mothers

Background:Due to shortened postpartum stays, the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists recommend that all infants receive follow-up care within 48 hours post-hospital discharge to prevent infant morbidity and mortality. However, studies indicate that many do not receive newborn follow up visit within 2 days after discharge especially low income mothers ()O’Donnell, Trachtman, Islam & Racine, 2013, Shakib, Buchi,  Smith, & Young, 2015; Pregnancy Risk Assessment Monitoring System, 2010). Receiving timely newborn follow up care is more difficult with the recent budget cuts to the healthcare system. For the 2015 House Budget, hospitals and health care systems are facing cuts approaching half a trillion dollars (Herman, 2014). These budget reductions are forcing hospitals to eliminate many health care services in the community, especially those in maternal child health (Abraham, 2011; Ferrara & Hunter, 2010; Kauffman, 2014).

Objective: The purpose of this study with low income first time minority mothers was to examine the mean timing and barriers to receiving the first newborn follow up care.

Method:This study is a secondary analysis of data from a randomized clinical trial that compared maternal health, infant health, and health care charges in two groups of mothers and newborns.

Results: 85 mothers (45 Intervention, 40 Control) have been enrolled. Mothers’ ages range from 18-42 with a mean age of 25. The mothers’ race/ethnicity includes 38 Hispanic, 46 Black (19 African American, 28 English-speaking Haitians) and 1 White non-Hispanic. The majority (n = 53; 64%) of the infants received late routine medical follow up visits post hospital discharge (M = 8 days post hospital discharge) ranging from 4 days posthospital discharge to 40 days posthospital discharge. Intervention group had a mean of 9 days for their routine medical follow up visits posthospital discharge compared to controls of 8 days for their routine medical follow up visits posthospital discharge. The majority mothers (68%) in the intervention group reported not receiving insurance coverage (Medicaid or private) as the primary barrier to receiving newborn follow up care.

Discussion:Study data provide a better understanding of the challenges encountered by first time mothers of full term infants and allow us to identify first time mothers who may need additional help in caring for their infant. With this understanding, healthcare providers can improve the care that first time mothers receive after they deliver their infant and to reduce infant morbidity, mortality subsequent health care costs.

Author: Jean Hannan, PhD, ARNP

Institution Affiliation: Florida International University

Nicole Wertheim College of Nursing and Health Sciences

Disclosures:  Funded by Funded by MBRS Score National Institute of Health;

Eunice Kennedy Shriver National Institute of Child Health & Human Development, 1SC2HD076043-01