The postpartum period is a critical time for the health and well-being of women and their newborns. Over the weeks and months following birth, women are recovering, physically and emotionally, from pregnancy and childbirth, and adjusting to hormonal changes. Common healthcare needs during the postpartum period include family planning services, chronic disease management, and mental health services. However, currently as many as 40% of women do not attend a postpartum visit.

Texas has several programs that provide low-income women with access to medical care after childbirth, including Medicaid for Pregnant Women and CHIP Perinatal (which provide coverage for limited time following delivery, and up to two postpartum visits), and Healthy Texas Women and Family Planning programs (which serve women who are not pregnant and meet other eligibility requirements). The state entities responsible for these programs have made considerable efforts to raise awareness of the programs and integrate these programs in a seamless manner. However, information is needed on how these programs are being translated to, and experienced by, the population they aim to serve. Information is also needed on factors influencing program effectiveness and utilization. Further, an assessment is needed of how these programs can best be integrated and blended with local programs to maximize resources and improve women’s access, experiences, and ultimately, their health.

In year two of the project, PATH researchers are following up with the previously engaged cohort of participants through one full year following delivery. The participants will continue to be asked questions about access to, usage of, and experience of postpartum health care. They will also be asked questions to assess their preferences and factors associated with desiring doula care.

Researchers will also conduct semi-structured interviews with community-based doulas serving women in Bastrop, Caldwell, Hays, Travis, Williamson counties to assess services offered, reimbursement, workforce development, and perceptions of demand and access. They will utilize available estimates to make projections of demand for doula support and potential impact on maternal infant outcomes among underserved women in central Texas.

PATH is a project of UT System Office of Health Affairs Population Health and the Texas Collaborative for Healthy Mothers and Babies (TCHMB), with support from the St. David’s Foundation.

PATH Year 2 report

Download the full report

PATH Year 1 report

Download the Full Report

This report provides information on access to healthcare coverage during the postpartum period for underserved women, and provides recommendations for improving access to care, specifically through the Texas women’s health programs.

Data sources for this report include interviews with 32 pregnant/postpartum women and with 20 providers and clinic staff who serve this population. Each woman was interviewed up to three times (late prenatal, 1-2 weeks postpartum, and 4-6 weeks postpartum). Qualitative interview data were supplemented with available quantitative data on Texas’ women’s health programs sourced from publicly-available Texas state agency documents. Participant recruitment was conducted in partnership with two large Federally Qualified Health Center (FQHC) systems in central Texas.