Patient navigators are trained guides who help patients access care and resources while working alongside the clinical team. In the trial, conducted at Prentice Women’s Hospital in Chicago between 2020 and 2024, 405 pregnant individuals were enrolled near the end of their pregnancies and supported throughout the first year after delivery. The navigators, all of whom spoke both English and Spanish, created individualized postpartum care plans with their patients and shared those plans with the medical team. They scheduled and attended appointments, coordinated social needs such as transportation and childcare, communicated with doctors and nurses, and helped patients make sense of complex medical information. Crucially, they also worked to build what researchers call self-efficacy skills, improving health literacy so that patients could eventually manage their own care independently.

The results were striking across nearly every measure the researchers tracked. Compared with patients who received usual postpartum care, those paired with a navigator were far more likely to attend their postpartum visits—96 percent versus 80 percent. They were more likely to be counseled about all needed postpartum topics, at 65 percent versus 51 percent, and more likely to receive screening and care for postpartum depression during the critical months often described as the fourth trimester, at 86 percent versus 72 percent. The differences persisted well past the immediate postpartum period: at one year after giving birth, 57 percent of navigated patients had attended a primary care visit compared with just 30 percent of those without a navigator.

Preventive health testing told a similar story. Navigated patients were substantially more likely to receive blood pressure checks, at 85 percent versus 62 percent, along with lipid panels at 28 percent versus 13 percent and glucose testing at 31 percent versus 16 percent. They were also more likely to be using their desired family planning method, such as birth control, at one year postpartum—65 percent versus 43 percent—a measure that matters both for individual health and for helping patients space out future pregnancies safely. Taken together, the numbers suggest that navigation does not merely nudge patients toward a single appointment but reshapes their entire trajectory of engagement with the healthcare system.

The stakes of this engagement are considerable. Previous research has shown that pregnancy complications such as gestational diabetes and preeclampsia can have lasting effects on long-term health, particularly cardiovascular and metabolic health, which makes the transition from obstetric care back to primary care a pivotal moment. Even patients with entirely healthy pregnancies can face serious postpartum challenges, including postpartum depression, unfulfilled social needs such as lack of partner support or housing instability, and safety risks like domestic violence. Any of these can make it extraordinarily difficult for a new mother to prioritize her own health. Corresponding author Dr. Lynn Yee, chief of maternal-fetal medicine in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, explained the underlying problem: pregnancy and the postpartum period are complex, and people often deprioritize themselves, particularly when they lack support or face complex social needs. Combined with a fragmented healthcare system, she noted, many people simply do not receive the care they need.

Yee described the resulting situation as a perfect storm of suboptimal women’s health during a key postpartum period—the very time when many women drop out of care altogether. If that gap can be addressed early and patients’ engagement with healthcare can be sustained, she argued, the payoff extends across the long run, improving health and well-being for years. The implications ripple outward as well. As Yee observed, cumulatively failing to engage in health-promotion behaviors during the postpartum period has reverberating implications for the entire family unit, since a mother’s health underpins the wellbeing of her infant and household.

The trial also documented benefits flowing in the other direction, toward clinicians. The medical care teams at Prentice Women’s Hospital came to appreciate the navigators’ assistance in concrete ways. Navigators would alert a doctor when a patient could not attend an appointment and reschedule it, for example, or complete administrative tasks that would otherwise consume clinical staff time, thereby freeing up the care team. They also made sure patients followed through on post-appointment tasks, such as completing a glucose tolerance test or attending a subsequent visit. Joseph Feinglass, research professor of general internal medicine at Feinberg and a co-author of the study, said one of the goals of navigators was not just to help patients but to help clinicians too, and that doctors were happy at how much more efficient and engaged their patients became.

Firsthand accounts from the navigators themselves illustrate how the model works in practice. Viridiana Carmona-Barrera, who worked in hospital, insurance, and women’s health settings before joining the study, described one pregnant patient with chronic health conditions who was at risk of missing a critical appointment because of transportation and childcare challenges. When other outreach efforts fell short, Carmona-Barrera coordinated both transportation and childcare so the patient could attend. She said she likes being someone who can help make these processes easier, noting that as committed as healthcare organizations are to supporting patients, navigating the system can still be challenging—a candid acknowledgment that even well-resourced institutions leave gaps that individual patients cannot always close alone.

Perhaps the most distinctive feature of the Northwestern program is its explicitly temporary ambition. Rather than creating permanent dependence on a support service, the authors designed navigation to build patients’ independence and comfort with engaging the healthcare system, so that they would not need a navigator in the future and would continue seeking primary care on their own. Yee put it memorably: the navigators’ goal was to put themselves out of business, to reach the end of the year and be able to tell a patient that she no longer needed them. That, she said, is success for a navigation program. This self-sufficiency framing distinguishes the intervention from models that simply add services, positioning navigation as a bridge rather than a crutch.

The broader significance of the trial lies in what it could mean for policy and practice. In cancer care, patient navigation has moved from a promising idea to an institutionalized component of treatment, supported by Medicaid funding and embedded in oncology programs nationwide. Maternal health, by contrast, has seen little of this investment despite persistent disparities in postpartum outcomes, particularly among low-income populations who face barriers such as inadequate health literacy, unreliable transportation, limited access to childcare, and insecure housing—any of which, the researchers note, can be the tipping point between a new mother accessing needed care or going without it. By demonstrating measurable improvements in postpartum visit attendance, depression screening, preventive testing, and long-term primary care engagement, the Northwestern findings lay the groundwork for future research and for potential funding mechanisms that could bring patient navigation to postpartum care at scale. The study, titled A randomized trial of patient navigation to improve postpartum health care, offers what its authors describe as an outline of what ideal postpartum care in the United States should look like—and a practical, testable path toward achieving it.

Subject of Research: Patient navigation to improve postpartum healthcare engagement among low-income mothers

Article Title: Moms of infants overcome barriers to postpartum care with help from patient navigators

Article References: Moms of infants overcome barriers to postpartum care with help from patient navigators. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: patient navigation, postpartum care, maternal health, randomized trial, Northwestern University, JAMA Health Forum, primary care transition, postpartum depression, health literacy, low-income mothers, fourth trimester, preventive care