Prevalence and Determinants of Health Care Utilization Among Dutch Women in the First Year Postpartum

Abstract

Introduction

The first year after childbirth can be affected by persistent or new-onset maternal health problems related to pregnancy and childbirth, leading to a reduction in quality of life, maternal well-being, and mother-child bonding. Evidence on determinants of health care utilization among postpartum women is limited by generalizability or the focus on 6 weeks postpartum. This study aimed to examine the prevalence of maternal health problems and health care utilization and to identify the determinants of health care utilization among postpartum women in the Netherlands within the first year after childbirth.

Methods

A cross-sectional design was used. Data were collected using a questionnaire from women 12 to 30 months postpartum in the Netherlands between March and May 2024. Health care utilization was measured as a proxy for health services. Nineteen potential determinants were derived from Andersen's behavioral model of health care utilization, of which 7 aligned with Levesque's complementary model of access to care and were analyzed using forward logistic regression.

Results

In the sample of 1268 responses, 89.6% reported health problems, and 94.2% utilized health care in the first year after childbirth. The most frequently reported health problem was (extreme) fatigue (51.4%). The most common health care provider consulted was a general practitioner (73.2%). The odds of health care utilization were lower when postpartum women were unaware of health care services (odds ratio, 0.40; 95% CI, 0.25-0.67).

Discussion

The study demonstrated a high prevalence of health problems and health care use among Dutch postpartum women. Lack of awareness about the availability of health care was a key finding. Improving the dissemination of information about postpartum health care options may increase awareness of health problems beyond the immediate postpartum period. Additionally, findings emphasize the importance of long-term counseling in addressing potential health problems.