Expanding Access to Postpartum Care
UT Southwestern ❘ Discovery@UTSW 2026 ❘ P14-15 eMCAP IMPACT
UTSW researchers work to improve maternal outcomes for underserved communities.
In southern Dallas County, UT Southwestern researchers are creating groundbreaking initiatives that are giving access to postpartum care to thousands of new mothers.
The bold new study, Improving Maternal Postpartum Access to Care through Telemedicine (IMPACT), is exploring how virtual care and smartphone-based education can transform maternal health outcomes.
Funded in 2024 by an $18 million award from the Patient-Centered Outcomes Research Institute (PCORI), the five-year IMPACT study launched as a randomized controlled trial involving 3,500 medically underserved women at two public safety-net hospitals: Parkland Memorial Hospital in Dallas and Grady Memorial Hospital in Atlanta.
It compares two models of postpartum care – intensive education vs. enhanced virtual care – to determine which better detects early complications, prevents hospital readmissions, and improves overall quality of life.
The study is led by David B. Nelson, M.D., Associate Professor of Obstetrics and Gynecology and Division Chief of Maternal-Fetal Medicine at Parkland Health; study senior author Elaine Duryea, M.D., Associate Professor of Obstetrics and Gynecology and Chief of Obstetrics at Parkland Health; and Catherine Spong, M.D., Chair and Professor of Obstetrics and Gynecology.
Building on Success
Their work on IMPACT builds on the success of the extending Maternal Care After Pregnancy (eMCAP) initiative, a partnership between UT Southwestern and Parkland Health.
The eMCAP program, which kicked off in October 2020, was designed to address alarming disparities in maternal health, particularly among non-Hispanic Black and Hispanic women. Parkland, one of the busiest maternity hospitals in the country, serves a population where systemic barriers – transportation, insurance gaps, and language differences – often prevent mothers from receiving adequate care after childbirth. eMCAP stepped in with a bold solution: Extend care for a full year postpartum, far beyond the traditional six-week window.
Meeting Patients Where They Are
Since its inception, the eMCAP initiative’s impact has been profound. Women with chronic conditions such as hypertension and diabetes mellitus enrolled in eMCAP were significantly more likely to attend follow-up visits, and better manage their health postpartum. Mental health screenings became routine, and those with elevated scores were successfully referred to licensed counselors.
Services are tailored to meet patients where they are with mobile clinics, virtual visits, and community health workers embedded in neighborhoods. By offering remote consultations and smartphone-based education, the program eliminates logistical hurdles to accessing care.
The eMCAP program has enrolled more than 8,000 patients and has expanded to east Dallas County as well as Hunt County with a mobile health unit grant from the U.S. Department of Health and Human Services. The program also served as a foundation a $25 million-plus Dallas-Fort Worth initiative, for which UT Southwestern is clinical lead.
How IMPACT Works
“IMPACT centers on an important component of pregnancy care, detecting and addressing complications in the postpartum period with the goal of preventing emergency visits and hospitalizations,” says Dr. Spong. “The work from eMCAP, identifying common barriers and potential solutions, is the foundation for this work.”
The first year of the IMPACT study focused on observing 1,000 patients to solidify understanding of the social determinants of health faced by postpartum patients in Texas. In phase two, 2,500 patients are randomized into two groups:
- Group one receives extensive discharge instructions and educational push notifications on their phones, which cover timely information about their health check-ins and ways to access expert care.
- Group two receives normal discharge instructions and access to serialized telemedicine appointments.
Patients in each group will be followed for a year by a team of dedicated providers and researchers from PCORI, who will assess patients’ mental health, diabetes, and blood pressure outcomes. The team will also measure which communications channels patients prefer, and which work best to manage postpartum health conditions and reduce hospital and emergency department visits.
“IMPACT builds on the work from the eMCAP program by investigating how technology can best be leveraged to improve the delivery of effective postpartum care,” Dr. Duryea says. “By comparing a patient-driven approach to a more traditional telehealth visit model, this study will help determine the best way to improve the detection of postpartum complications before they cause harm.”
Feedback Matters
Patients helped create the study structure and have access to results in real time. They have a voice throughout the study, giving feedback at the point of care and participating on the research advisory board.
Dr. Nelson has been encouraged by the enrollment, engagement, and participation of the patients in the IMPACT study.
“Our goal is to offer evidence-based guidance for optimizing postpartum care delivery and help reduce maternal health disparities,” says Dr. Nelson. “We look forward to sharing our results as soon as they are available.”
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