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Cited by 3Maternal and Neonatal HealthcareMaternal and Perinatal Health InterventionsHealth Policy Implementation Science

Implementation and evaluation of postpartum midwifery care at home at a federally qualified health center in Washington, DC

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DePalma, Katie, Marcelle, Ebony, Clark, Emma, O’Brien, Teresa, Chimata, Sanjana, Eliason, Erica, Muhammad, Bayyinah, Stamm, Sola +4 more·2025·Health Equity
DOI 10.1177/24731242251382349PMC PMC12670692
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Abstract

Background: The postpartum period is a critical time to support birthing people and infants, address and mitigate perinatal health inequities, and promote joy and connection. Yet many birthing people do not perceive value in postpartum visits, particularly when measured against the competing demands and barriers to care faced by those experiencing poverty and other systemic oppression. These inequities are particularly acute for Black birthing people insured by Medicaid due to structural and interpersonal racism, as well as economic disenfranchisement. We implemented an opt-in postpartum care at home program led by midwives at a federally qualified health center to increase the perceived value of postpartum care and increase patient engagement. Methods: We evaluated implementation using the reach, effectiveness, adoption, implementation, and maintenance framework. We assessed reach and effectiveness using electronic health record data for 2022 (pre-implementation) and 2023 (implementation). Results: Among 473 birthing people eligible during the evaluation period, 118 (28%) had a postpartum home care visit. Postpartum visit attendance rates increased from 78% in 2022 to 84% in 2023. In-home postpartum care increased family involvement, enabled longer and more comprehensive visits, and improved provider satisfaction. Conclusions: Postpartum care at home can reduce barriers to care, increase visit attendance, and promote joy. In-home postpartum care with a midwife has the potential to mitigate health inequities experienced by Black birthing people by fostering trust and shifting the power dynamic in the patient–provider relationship. Community-based care must be designed and implemented with antiracist and emancipatory approaches.

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  • Home-visit and digital models showed promise for service engagement and access.

    “Home-visit and digital models also showed promise for service engagement and access, although implementation depends on local service organisations and resources (DePalma et al., 2025).”

    From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as DePalma et al., 2025

    The Conceptual model and Results support the home-visit portion: the paper reports increased postpartum visit attendance and reduced barriers to care. It mentions virtual hand-offs by video or phone as a component of home visits, but does not evaluate a separate digital care model or show that one improved engagement or access. The Implementation section also describes staffing and scheduling constraints. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Implementation of home-visit and digital models depends on local service organisations and resources.

    “Home-visit and digital models also showed promise for service engagement and access, although implementation depends on local service organisations and resources (DePalma et al., 2025).”

    From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as DePalma et al., 2025

    The Results (Implementation) show that home-visit availability depended on clinic staffing, scheduling, and travel distance; the Discussion also identifies local resources and provider requirements. The paper describes virtual hand-offs within its home-visit program, but it does not evaluate implementation of a separate digital model. It therefore supports the claim for home visits, not for digital models generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Postpartum midwifery home visits increased postpartum visit attendance from 78% to 84%, and 28% of eligible patients selected home visits.

    “Postpartum visit attendance increased from 78% to 84%, and 28% of eligible patients selected home visits.”

    From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as DePalma et al. (2025)

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Authors
DePalma, K., Marcelle, E., Clark, E., O’Brien, T., Chimata, S., Eliason, E., Muhammad, B., Stamm, S., Vernot-Jonas, N., Olowski, P., Sherman, D., & Marea, C. X.
Affiliations
  • Georgetown University (US)
  • Community of Hope, Washington, District of Columbia, USA.
  • Rutgers, The State University of New Jersey (US)
  • School of Nursing, Georgetown University, Washington, District of Columbia, USA.
Corresponding author
Marea, Christina X.
ORCID
Venue
Health Equity
Publisher
SAGE Publications
Published
2025-04-01
Volume
9
Issue
1
Pages
618-630
ISSN
2473-1242 (ISSN-L)
DOI
10.1177/24731242251382349
PMC
PMC12670692
OpenAlex
W4414638897
Cited by
3
References
43
Citations by year
2026: 3
FWCI
3.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Equity (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Institute of Mental Health (R25 MH136652-05)
  • Rita and Alex Hillman Foundation (Innovations in Care Award)
  • National Center for Advancing Translational Sciences (KL2TR001432)
Topics
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
postpartum care, midwives, federally qualified health centers, Medicaid, Black birthing people, barriers to care, patient engagement, family involvement, patient-provider relationship, community-based care, implementation evaluation

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