April 27, 2023
Prenatal and postpartum care contributes to the long-term well-being of new mothers and their infants, according to the American College of Obstetricians and Gynecologists. We encourage you to talk with our members about the importance of attending all care visits during and after pregnancy.
Addressing Health Disparities
The rate of women who die from maternal health causes continues to rise in the U.S., according to the Centers for Disease Control and Prevention. Rates rose to 32.9 deaths per 100,000 live births in 2021, up from 20.1 in 2019. The rate for Black women was more than twice as high as the rate for white women. Rates also are higher for American Indian and Alaska Native women than white women.
Maternal Mortality Review Committees found that 80% of pregnancy-related deaths could be prevented. Consider talking with our members about the unique risks and barriers to care they may face. See our Health Equity and Social Determinants of Health page for more information. Our Preventive Care Guidelines and Perinatal Wellness Guidelines for members also may be helpful.
Tracking Prenatal and Postpartum Care Visits
We track the quality measure Prenatal and Postpartum Care (PPC) to help assess and improve our members’ care. PPC captures:
- Timeliness of prenatal care, or the percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment with Blue Cross and Blue Shield of Illinois
- Postpartum care, or the percentage of deliveries in which women had a postpartum visit on or between seven and 84 days after delivery
We also track two quality measures focused on maternal mental health: Prenatal Depression Screening and Follow-Up (PND-E) and Postpartum Depression Screening and Follow-Up (PDS-E). Read more about maternal mental health here.
Tips to Close Gaps in Care
- Check with our members to ensure that initial prenatal visits are scheduled in the first 12 weeks of pregnancy with an OB-GYN, primary care provider or other prenatal practitioner.
- Be aware that post-operative visits, which typically occur within a couple of days of discharge or during an inpatient stay after a cesarean section, don’t count as a postpartum visit. A postpartum visit must take place on or between seven and 84 days after delivery. Members should be reminded to schedule their postpartum care visit during the C-section post-op visit.
- Data for this measure is collected from claims and chart review for services performed by an OB-GYN, midwife, family practitioner or other PCP. Services provided during telehealth visits, e-visits and virtual check-ups are eligible for reporting to meet the measure.
- When documenting a prenatal visit, include diagnosis of pregnancy, last menstrual period or estimated date of delivery, prenatal risk assessment, complete obstetrical history, fetal heart tone and screening tests.
- When documenting a postpartum visit, notate postpartum care, check or six-week check. Document the pelvic exam and evaluation of weight, blood pressure, breasts and abdomen.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.