California has long stood out as a leader in maternal health. While the U.S. as a whole struggles with some of the highest maternal mortality rates in the developed world, California consistently outperforms the national average. Currently, the state has the lowest rates in the country at 11 deaths per 100,000 live births — compared to the national average of 23.
That success is partly due to California’s relative wealth and resources, but just as importantly, to its commitment to innovation. California regularly invests in large-scale initiatives to improve maternal health across populations.
Its latest contribution is the Postpartum Pathway Concept Paper, which offers a set of recommendations to target one of the most overlooked stages of pregnancy: the postpartum period. This is a time when mothers face enormous physical, mental, and emotional demands — yet the healthcare system typically provides little structured support beyond a single appointment at 4–6 weeks.
The numbers speak for themselves. According to the CDC, more than half of maternal deaths in the U.S. occur in the first six months after birth, and California is no exception. Many mothers skip that single postpartum visit due to the demands of caring for a newborn, a lack of education about its importance, or barriers like transportation and childcare. Rates of missed appointments are even higher among Medicaid patients, many of whom also lack clarity about what benefits are available to them during pregnancy and after.
Recognizing these gaps, California convened a multidisciplinary sub-workgroup to design a Postpartum Pathway: a model for extending care that addresses not just clinical needs, but also behavioral health and social support.
Goals of the Pathway
The recommendations are ambitious but clear:
- Reduce postpartum morbidity and mortality.
- Address racial and ethnic disparities, especially for Black, American Indian/Alaska Native, and Pacific Islander mothers.
- Mitigate postpartum stress, trauma, and mood disorders, ensuring timely access to treatment.
- Reduce isolation among vulnerable and marginalized communities.
- Increase access to chronic and interconception care to improve outcomes for future pregnancies.
The Recommendations
The paper proposes six core strategies to make good on the proposed goals:
- Coordinated, team-based care with a lead maternity care manager guiding patients through the system.
- Data sharing and interoperability to make care seamless across settings.
- Patient-centered, personalized care that accounts for social drivers of health and leverages tools like telemedicine and home visits.
- Patient education to empower mothers to recognize symptoms, understand benefits, and navigate the system.
- Workforce development to train providers in maternal health and social support, while expanding roles for community health workers and doulas.
- Behavioral health integration through routine screening, timely referrals, and investment in a perinatal behavioral health workforce.
These strategies are significant in their holistic approach, targeting not just the health risks associated with postpartum, but responding to social and behavioral contributors to poor outcomes as well.
Where Babyscripts Fits In
The Postpartum Pathway reads like a roadmap for postpartum maternal healthcare. At Babyscripts, it validates work already underway with our remote patient monitoring (RPM) program, which combines digital tools with care management to support and guide patients throughout maternity journey, including the postpartum period.
Babyscripts’ care managers meet with patients on a regular basis to support adherence to care plans, provide education and coaching, and help patients monitor and address risks. They enable care coordination by ensuring that concerns are escalated to the appropriate care team member, reducing the risk of patients getting lost in a fragmented system.
These human resources are supported by a companion app, which delivers gestational- and postpartum-stage-specific education directly to patients’ phones. The app reinforces the care manager’s guidance, emphasizing the importance of follow-up, helping patients recognize concerning symptoms, and empowering them to take an active role in their health.
The app also provides digital screening tools for postpartum depression, anxiety, and social determinants of health risks. Concerning responses are flagged and routed to the care team, while patients are directed to appropriate resources and referrals. This approach helps normalize behavioral health as part of routine postpartum care and ensures mothers receive the support they need.
Delivered remotely and tailored to each patient’s risk profile, health history, and social context, the flexibility of the RPM model mirrors the Pathway’s call for care that adapts to individual needs and geography.
By automating routine tasks such as daily symptom checks or blood pressure monitoring, Babyscripts frees clinicians and care managers to focus on patients who need the most attention. Integration with the EMR provides a single, real-time view of patient health, while automated alerts help care teams stay aligned across specialties. In this way, Babyscripts contributes to the interoperable systems envisioned by the Postpartum Pathway.
Looking Ahead
The Postpartum Pathway is aspirational, but Babyscripts’ real-world experience implementing our RPM program shows that many of the Pathway’s goals are achievable today. By connecting patients to their care team, supporting self-management, and facilitating timely interventions, this model demonstrates that a safer, more responsive postpartum experience is possible — one that keeps mothers supported long after they leave the hospital.
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