title: The effect of maternity care coordination services on utilization of postpartum contraceptive services.
abstract: To examine whether maternity care coordination (MCC) services are associated with utilization of postpartum contraceptive services.
  
  
  
  Using a random sample of 7120 live births, we analyzed administrative data to assess whether MCC services affected utilization of contraceptive services within 3months of delivery. Treatment groups were constructed as MCC during the prenatal period only (n=531), MCC in both the prenatal and postpartum periods (n=1723) and a non-MCC control group (n=4866). Inverse probability of treatment weights (IPTWs) were calculated and applied to balance baseline risk factors across groups. We used the IPTW linear probability model to estimate postpartum contraceptive service utilization, controlling for demographic, social, reproductive and medical home enrollment characteristics.
  
  
  
  At 3months postpartum, MCC participation was associated with a 19-percentage point higher level of utilization of postpartum contraceptive services among women who received both prenatal and postpartum care coordination services (p<.001), as compared with controls. Women who received only prenatal MCC services showed no difference in utilization of services at 3months postpartum from non-MCC controls. Sensitivity modeling showed the effect of MCC was independent of postpartum obstetrical care. Additionally, MCC had differential treatment effects across subpopulations based on maternal age, race, ethnicity and education; women who were white and did not have a medical home were more likely to benefit from MCC services in initiating postpartum contraceptives.
  
  
  
  MCC programs may be instrumental in increasing timely utilization of postpartum contraceptive services, but continuation of the intervention into the postpartum period is critical.
  
  
  
  MCC offered both prenatally and in the postpartum period appears to complement clinical care by increasing postpartum contraceptive service utilization. Providers should consider the potential added benefits of care coordination services in tandem with traditional obstetric care to increase postpartum contraceptive use and subsequently reduce short birth intervals.
authors.affiliation: Department of Health Policy and Management, The Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 1101McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC 27599-7411, USA. Electronic address: Regina.Rutledge@unc.edu.
authors.forename: Regina I
authors.initials: RI
authors.lastname: Rutledge
authors.affiliation: Department of Health Policy and Management, The Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 1101McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC 27599-7411, USA. Electronic address: Domino@unc.edu.
authors.forename: Marisa Elena
authors.initials: ME
authors.lastname: Domino
authors.affiliation: Department of Health Policy and Administration, The Pennsylvania State University, 604E Ford, University Park, PA 16802, USA. Electronic address: mmh18@psu.edu.
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Hillemeier
authors.affiliation: Department of Management, Policy, and Community Health, The University of Texas School of Public Health, 1200 Pressler E343; Houston, TX 77030, USA. Electronic address: Rebecca.S.Wells@uth.tmc.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wells
mesh_terms: D000293:Adolescent; D000328:Adult; D001721:Birth Intervals; D003267:Contraception / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000592:standards*; D008484:Medicaid; D011181:Postnatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Contraception; Maternity care coordination; Postpartum contraception; Prenatal care coordination