Barnes-Jewish Hospital | Washington University Physicians

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SIMPLIFYING POSTPARTUM CARE

By Jen A. Miller

Photo courtesy of Shutterstock

mother holding baby stock photo

When a new mother with high blood pressure is sent home with her newborn, she leaves the hospital with instructions to return—or visit her doctor—for a blood pressure check within the first 72 hours after discharge from the hospital. And she must repeat that visit seven to 10 days later.

Some pregnant women have high blood pressure, or hypertension, at the time of conception; others may develop it during pregnancy as a symptom of preeclampsia or eclampsia. In any case, it’s vital for these women to continue to monitor blood pressure after labor and delivery. Left unchecked, high blood pressure can cause headache, fluid retention and nausea, as well as organ damage, stroke and worse. Worldwide, hypertension is the second leading cause of maternal mortality, according to the World Health Organization.

But those follow-up visits can cause logistical problems for a woman at home with a newborn, especially if she has other children to care for as well. “It’s unrealistic to expect moms with newborns to pack up the baby and drive back to their doctor so soon after birth. Or ask them to use public transportation, or arrange for childcare for their just-born child—especially if they’re breastfeeding,” says Roxane Rampersad, MD, maternal-fetal medicine specialist at the Women & Infants Center, a collaboration by Barnes-Jewish Hospital, Washington University Physicians and St. Louis Children’s Hospital. As a result, she says, “women who needed special care weren’t coming in.” In fact, at Barnes-Jewish Hospital just 20% of new moms with high blood pressure were complying with postpartum instructions.

We wanted a program that would work for all participants.

— Roxane Rampersad, MD, Maternal-Fetal Medicine Specialist

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BY ANDREA MONGLER
ILLUSTRATION FROM NLM/SCIENCE SOURCE/SCIENCE PHOTO LIBRARY

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