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Bridging care gaps: A qualitative study of postpartum health coaching for hypertensive disorders of pregnancy

Year: 2026

Type: article

Abstract: Introduction: Hypertensive disorders of pregnancy (HDPs) affect approximately one in seven US deliveries and are associated with significant adverse maternal health outcomes. Standard postpartum care, typically a single 6-week visit, is insufficient for ongoing HDP management, education, and support. Combining home blood pressure monitoring with health coaching may enhance self-management, lifestyle change, and engagement with care, yet patient perspectives remain underexplored. This qualitative study examined 1-year postpartum experiences among birthing people with HDPs and explored perceptions of a postpartum health coaching intervention. Methods: This qualitative study was embedded within the STAC-MyHEARTp randomized trial (NCT05685251), which compared home blood pressure monitoring plus health coaching to usual care. Using an explanatory sequential design, semi-structured interviews were conducted posttrial and analyzed thematically. Self-Determination Theory and Self-Regulation Theory guided coding and interpretation, with comparison across intervention and control arms. Results: Thirty-two participants (16 per arm) completed interviews. Four themes were identified: (1) postpartum experiences were emotionally and medically challenging, characterized by fear, anxiety, and hypervigilance; (2) participants strongly desired education and support, with coaching filling gaps unmet by standard care; (3) coaching provided behavioral, emotional, and healthcare benefits, including enhanced motivation, confidence, self-monitoring, lifestyle change, and self-advocacy; (4) persistent gaps, particularly in mental health support and continuity of care, remained across groups. Control participants recognized the potential value of structured support. Conclusions: Health coaching offers meaningful, multidimensional support for individuals with HDP, promoting self-efficacy, engagement, and lifestyle change. Integrating structured coaching into comprehensive postpartum care can address persistent gaps, improve patient experience, and potentially enhance long-term cardiovascular and psychosocial outcomes, underscoring the need for sustained, person-centered postpartum care.

Source: Pregnancy

DOI: 10.1002/pmf2.70354