Date of Award

January 2026

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Joan Combellick

Abstract

Postpartum morbidity and mortality rates in the United States far exceed rates in other developed countries (Tikkanen et al., 2020). The greatest risk of postpartum mortality and morbidity is highest before the traditional 6-week comprehensive postpartum visit with the delivering provider (ACOG, 2018; Hauspurg et al., 2022; Dol et al., 2022). The standard of care for follow-up with a primary care provider (PCP), for postpartum birthing parents does not exist in the United States; however, there is a call for better connection and communication between delivering providers and PCPs (ACOG, 2018). Given this gap in postpartum healthcare, this DNP project reconnected postpartum birthing parents to their PCPs by the development and implementation of a decision tree to screen their health care needs, within three weeks of delivery, virtually or in person at two community health centers. An expert panel validated the decision tree based on current guidelines for evaluating postpartum-related concerns. Following revisions, the decision tree was implemented at two community health centers and evaluated subsequent treatment, screening, referral, and workflow. Following implementation, it was concluded that postpartum birthing parents can easily connect with their PCP when the PCP is aware of their discharge after delivery. Engaging with their PCP after discharge, improves health outcomes for birthing parents. Finally, the process of implementing a postpartum screening tool was deemed to be appropriate, feasible, and acceptable by participating providers and staff. These findings are being adopted by the participating clinics and have inspired conversations about practice change.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 10/06/2028

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