Abstract
Introduction
Despite advances in obstetric care, maternal morbidity and mortality remain significant public health concerns in the US. Approximately 50% of pregnancy-related deaths occur after the traditional 42-day postpartum period after patients transition out of obstetric care, creating a "postpartum cliff." Fragmented communication between obstetric and primary care providers and underemphasis on longitudinal care may delay management of chronic medical conditions that persist beyond pregnancy. To address this gap, an integrated Family Medicine (FM) clinic was established within the EVMS MFM practice in January 2025 and expanded to General Obstetrics in February 2026. This study evaluated whether the integrated clinic improved postpartum continuity of care by increasing follow-up attendance.
Methods
We conducted a retrospective cohort study of adults receiving prenatal and postpartum care within the EVMS OB-GYN Department. The sample included 29 patients who attended at least one integrated FM clinic visit between June 2025 and April 2026, compared with 12 eligible patients receiving standard obstetric care. Demographics, attendance at a postpartum PCP visit, and number of postpartum PCP visits were obtained through retrospective chart review.
Results
The mean age at most recent delivery was 30.1 years (SD = 5.9), with delivery occurring at a mean gestational age of 36.3 weeks (SD = 4.4). Nineteen patients (46.3%) identified as White and 20 (48.8%) as Black. Most patients (75.6%) had Medicaid, while 19.5% had Tricare and 4.9% had another form of insurance or no insurance. Among patients seen in the integrated clinic, 20 of 29 (69.0%) had at least one postpartum PCP visit, compared with 3 of 12 (25.0%) patients in the comparator group. Fisher’s Exact test demonstrated a significant difference in attendance at any postpartum PCP visit between groups (p = .03), with patients in the integrated clinic more likely to have at least one postpartum visit. Mann-Whitney U analysis also demonstrated a significant difference in the number of postpartum PCP visits between groups (p = .04), with the integrated clinic group having more visits.
Conclusion
Patients receiving care through the integrated FM clinic had significantly greater postpartum PCP follow-up than patients receiving standard obstetric care, both in likelihood of attending a postpartum visit and in number of visits. These findings suggest that embedding primary care within obstetric practice may help address barriers to postpartum continuity and facilitate transition to longitudinal care. Although the small sample size and retrospective design limit our conclusions, integrated obstetric-primary care models may represent a promising strategy to reduce fragmentation of care and support ongoing maternal health after pregnancy.