(766) Pediatric and Family Medicine Providers' Willingness and Barriers to Screen for Urgent Maternal Warning Signs

The CDC’s Hear Her Campaign highlights urgent maternal warning signs to prevent pregnancy-related deaths and tackle maternal health disparities. Yet, maternal mortality and disparities remain high, with 2/3 of deaths occurring post-delivery, when postpartum patients have multiple contact with pediatric and family medicine providers. Our objectives were to assess pediatric and family medicine providers’ willingness to screen for urgent maternal warning signs during routine well-child visits (WCV) and their perceived barriers to screening implementation.

Study Design:
We developed and electronically distributed a questionnaire to pediatric (Peds) and family medicine (FMs) providers, assessing their demographics, willingness to screen postpartum patients for warning signs during routine WCV, and perceived barriers to screening implementation. Data was analyzed using chi-square and t-tests.

Results:
175 participants (69 Peds;106 FMs) completed the questionnaire. Peds and FMs were similar in age, sex, ethnicity, and training years (p >0.05). Peds were less likely to identify as White (p=0.002) and more likely to work in academic centers (p< 0.001). Both groups saw equal percentages of Black and Indian/Native American patients (p >0.05). Peds saw fewer publicly insured patients (p=0.021). While more Peds agreed that there are major racial/ethnic disparities in maternal mortality (89.9% vs. 62.3%, p< 0.001) and “almost always” screened for postpartum depression (85.5% vs. 56.6%, p< 0.001), they were less aware of the urgent maternal warning signs (24.6% vs. 79.3%, p< 0.001), less confident in recognizing these signs (7.7% vs. 41.5%, p< 0.001), and less willing to screen for physical warning signs (65.2% vs. 81.1%, p=0.049). The top three reported barriers to screening for warning signs were lack of time (62.3%), lack of provider training (43.4%), and lack of reimbursement (32.0%).

Conclusion:
Peds and FMs should be trained to screen postpartum patients for urgent warning signs. Barriers to screening should be addressed so they can become vital partners in tackling the maternal mortality and disparity crisis.