Correlates of postpartum care visit non-attendance among low-income women: Insights from the Andersen Behavioral Model
- 1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
- 2Midlands Healthy Start, Prisma Health, Columbia, South Carolina, United States of America
Abstract
Timely postpartum care is critical for the detection and treatment of pregnancy-related conditions and complications, thereby reducing maternal morbidity and mortality. However, attending postpartum care visits can be particularly challenging for low-income individuals. This study examined the correlates of postpartum care visit non-attendance among low-income women using the Andersen Behavioral Model of Health Services Use. Data were analyzed from 671 women enrolled during pregnancy in the South Carolina Midlands Healthy Start Program (2019–2024), a federally-funded program with the aim of improving perinatal outcomes through enhanced care coordination and case management for underserved pregnant and postpartum women. Multiple logistic regression models were used to identify correlates of postpartum visit non-attendance. Participants were predominantly non-Hispanic Black (87.5%) and low-income (90.9% receiving Medicaid). Overall, 27.0% did not attend a postpartum care visit within 12 weeks of delivery. Compared to non-Hispanic White participants, non-Hispanic Black (adjusted odds ratio (AOR): 0.48; 95% confidence interval (CI): 0.25, 0.94) and Hispanic participants (AOR: 0.12; 95% CI: 0.02, 0.66) had lower odds of non-attendance. Participants with a high school diploma/GED or less had higher odds of non-attendance (AOR: 1.83; 95% CI: 1.23, 2.71). Lack of partner involvement (AOR: 1.95; 95% CI: 1.14, 3.32) and frequent experiences of discrimination (AOR: 2.79; 95% CI: 1.22, 6.38) measured using the Everyday Discrimination Scale were also associated with increased odds of non-attendance. This study identified key factors associated with postpartum visit non-attendance among low-income women, including race, education level, partner involvement, and experiences of discrimination. These findings highlight the need to address individual, familial, and contextual factors to improve postpartum care engagement.
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BibTeX
@article{parkinson2026correlates,
title = {{Correlates of postpartum care visit non-attendance among low-income women: Insights from the Andersen Behavioral Model}},
author = {Adrienne Parkinson and Jihong Liu and Xingpei Zhao and Kimberly Alston},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359407},
url = {https://doi.org/10.1371/journal.pone.0359407},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Correlates of postpartum care visit non-attendance among low-income women: Insights from the Andersen Behavioral Model
AU - Adrienne Parkinson
AU - Jihong Liu
AU - Xingpei Zhao
AU - Kimberly Alston
PY - 2026
DA - 2026/10/06
JO - PLOS One
DO - 10.1371/journal.pone.0359407
UR - https://doi.org/10.1371/journal.pone.0359407
AB - Timely postpartum care is critical for the detection and treatment of pregnancy-related conditions and complications, thereby reducing maternal morbidity and mortality. However, attending postpartum care visits can be particularly challenging for low-income individuals. This study examined the correlates of postpartum care visit non-attendance among low-income women using the Andersen Behavioral Model of Health Services Use. Data were analyzed from 671 women enrolled during pregnancy in the South Carolina Midlands Healthy Start Program (2019–2024), a federally-funded program with the aim of improving perinatal outcomes through enhanced care coordination and case management for underserved pregnant and postpartum women. Multiple logistic regression models were used to identify correlates of postpartum visit non-attendance. Participants were predominantly non-Hispanic Black (87.5%) and low-income (90.9% receiving Medicaid). Overall, 27.0% did not attend a postpartum care visit within 12 weeks of delivery. Compared to non-Hispanic White participants, non-Hispanic Black (adjusted odds ratio (AOR): 0.48; 95% confidence interval (CI): 0.25, 0.94) and Hispanic participants (AOR: 0.12; 95% CI: 0.02, 0.66) had lower odds of non-attendance. Participants with a high school diploma/GED or less had higher odds of non-attendance (AOR: 1.83; 95% CI: 1.23, 2.71). Lack of partner involvement (AOR: 1.95; 95% CI: 1.14, 3.32) and frequent experiences of discrimination (AOR: 2.79; 95% CI: 1.22, 6.38) measured using the Everyday Discrimination Scale were also associated with increased odds of non-attendance. This study identified key factors associated with postpartum visit non-attendance among low-income women, including race, education level, partner involvement, and experiences of discrimination. These findings highlight the need to address individual, familial, and contextual factors to improve postpartum care engagement.
SN - 1932-6203
ER -