In the United States, the postpartum period is a critical time for both maternal and
child health; the US maternal mortality rate is the highest among other developed,
high-income countries. More than half of all maternal deaths occur postpartum, from one
day to one year after birth. There are vast racial and ethnic disparities in maternal
mortality and severe morbidity, disproportionately experienced by Black and Latina
mothers and other BIPOC women. Black women are 3-4 times more likely to experience
maternal mortality than white women10, and Hispanic women are twice as likely to
experience severe maternal outcomes compared with non-Hispanic white women. The American
College of Obstetricians and Gynecologists recognized the deficiencies in postpartum care
and coined the term the 'fourth trimester' to mark the time following birth through the
first 3-months postpartum. They recently updated recommendations to address these
challenges. The Biden Build Back Better Act also prioritized this issue. Joyuus is a
web-based self-care mobile tool addressing the 12 months postpartum, to reduce the risks
of avoidable morbidity and mortality for underserved women. The tool addresses physical,
mental, real world, cultural, and knowledge barriers which impact quality postpartum
care. Joyuus provides information, resources, expert perspectives, peer communications
and red flags presented in a variety of formats to help women identify how to adopt
healthy self-care habits. Importantly, it also identifies when self-care leads to seeking
provider care. Pregnant women often turn to the internet to find information about their
health and their developing baby's health. Yet, studies find that mothers are not finding
sufficient resources to match their postpartum needs. The Phase I grant demonstrated in a
sample of Black women that this audience is highly engaged across the income and
education spectrum and prefers mobile access and text-based communication. In Phase II
work will continue to include lived experiences of women most at risk for negative
postpartum outcomes as part of the complete tool. The first step will be to conduct a
needs assessment to understand informational, cultural and language wants and needs in
the Latina population. The broader randomized trial will invite a diverse population of
BIPOC and white women. The Phase II scope aims to complete three major tasks:
AIM 1: Expand feasibility activities to address Latina population. Explore self-care (and
seeking care) needs for the postpartum Latina community and integrate with the Phase I
focus group findings.
AIM 2: Build complete tool. The investigators will complete the development of a fully
interactive Joyuus web based mobile tool in English and Spanish.
AIM 3: Test in randomized controlled trial. The investigators will test the effectiveness
of Joyuus with a diverse national sample of postpartum women, considering the impact on
maternal function, depression, anxiety, resilience, knowledge, and social support.