Abstract
Introduction
Fragmented transitions from obstetric (OB) to primary care after delivery may contribute to unmet non-OB healthcare needs and adverse maternal outcomes. To improve care coordination and support for OB patients, a Family Medicine provider was embedded within Maternal Fetal Medicine (MFM) and General OB practices to create an integrated clinic. This study evaluated sociodemographic factors associated with patient engagement, patient needs, and provider-clinic alignment.
Methods
A retrospective cohort study compared 29 pregnant and postpartum patients who utilized the integrated clinic with 12 referred patients who did not utilize clinic services. Eligible patients delivered between June 2025 and April 2026 and met predefined prenatal/postpartum visit criteria. Manual chart review of Epic collected demographic characteristics, pregnancy outcomes, and the three primary diagnoses addressed during integrated clinic visits. Data from a parallel MFM/OB provider needs assessment survey were collected to identify provider-perceived specialty care needs. Study data were managed in REDCap.
Results
The mean maternal age at delivery was 30.1 years (SD = 5.9) with a mean gestational age of 36.3 weeks (SD = 4.4). The sample was 46.3% Black and 48.8% White, with two patients missing racial data. 75.6% of patients had Medicaid, 19.5% had Tricare, and 4.9% had private insurance or no insurance. The top three patient needs addressed during integrated clinic visits were 1) psychiatric needs such as depression or anxiety, 2) OB-related conditions such as history of Cesarean section and pre-eclampsia, and 3) cardiology concerns such as myocardial infarction and history of cardiac arrest. The MFM/OB provider needs assessment survey responses aligned with patient needs addressed during integrated clinic visits. The specialty with the highest perceived need was psychiatry (n = 24), followed by cardiology (n = 17), and then primary care (n = 13). No significant differences in age, race, gestational age at delivery, or insurance type were observed between patients who utilized the integrated clinic and those who did not (all p > .05).
Conclusion
Integrated primary care services addressed diverse healthcare needs that aligned with MFM/OB provider-identified needs. While no significant demographic differences were observed between patients who utilized the integrated clinic and those who did not, larger studies are needed to identify factors influencing patient engagement.