The “simple addition” was yearlong patient navigation: individualized help from trained lay navigators for pregnant and postpartum people facing barriers to care. In a randomized trial, navigation did not significantly increase the share of participants who received every one of six specified care components by 12 weeks. It did improve the average share of components received, several individual care measures, and connection to primary care at about one year.
What patient navigators did
Lynn M. Yee and colleagues tested the service in a randomized clinical trial published in JAMA Health Forum on October 2, 2026. At one urban academic medical center, 405 English- or Spanish-speaking pregnant people aged 16 or older with Medicaid insurance enrolled between January 2020 and July 2024. Researchers assigned 203 to one year of navigation and 202 to usual care.
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The navigators were trained bilingual lay staff. They worked individually with participants to address postpartum-specific barriers, coordinate appointments and resources, support communication with care teams, and develop a plan for continued self-management and engagement with care. Northwestern University’s October 6, 2026 summary describes practical assistance with scheduling and attending appointments, transportation and childcare, clinician communication, and making medical information easier to understand.
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1Scan for outdated or missing drivers - takes under a minute2Repair Windows errors before they cause bigger problems3Fix the driver behind crashes, sound loss and screen glitchesThe trial evaluated a care-delivery service, not a product. It does not establish which individual navigation activity produced the observed differences.
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Did navigation increase the chance of receiving every component?
No statistically significant difference was found in the trial’s primary outcome: receiving all six specified components by 12 weeks postpartum. That outcome was met by 19 of 203 participants assigned to navigation (9.4%) and 16 of 202 assigned to usual care (7.9%; P=.60). The authors reported that the composite was uncommon in both groups and that the study was underpowered to detect a difference in it.
The six components were:
- A comprehensive postpartum visit.
- All indicated anticipatory guidance.
- Receipt of the participant’s desired family-planning method.
- Depression screening and linkage to care when indicated.
- Initiation and maintenance of breastfeeding.
- Indicated vaccinations.
Which parts of care improved?
Although the all-or-nothing primary outcome did not differ significantly, participants assigned to navigation received a higher average proportion of the care components: 71% (SD 17%) versus 64% (SD 23%) with usual care (P=.002). The trial also reported higher rates for several individual measures by 12 weeks postpartum:
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| Measure | Navigation | Usual care | Reported P value |
|---|---|---|---|
| Comprehensive postpartum visit | 96% | 80% | <.001 |
| All indicated anticipatory guidance | 65% | 51% | .01 |
| Depression screening and linkage to care when indicated | 86% | 72% | <.001 |
These figures describe specific outcomes in this trial; they do not mean that every postpartum-care measure improved.
What remained different at about one year?
At 11–13 months postpartum, a primary-care visit was recorded for 57% of participants assigned to navigation, compared with 30% receiving usual care (P<.001). Desired family-planning method use was 65% versus 43%, and depression screening and linkage to care was 37% versus 21%. The authors also reported differences in diabetes and cardiometabolic screening and some vaccination outcomes; those endpoints require their individual definitions and denominators to interpret, so they are not combined here.
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What the trial can—and cannot—show
Random assignment supports a comparison of navigation with usual care in the study setting, but the findings come from one urban academic medical center and Medicaid-insured participants. They do not establish that the same results would occur in other populations, locations, or navigation models. Nor does the trial identify which part of the service—such as appointment coordination, practical support, or communication with clinicians—accounted for the observed differences.
The useful distinction is between completion of the entire six-part package and improvement in care engagement: navigation did not significantly increase completion of all six components by 12 weeks, while participants received a larger average share of components and were more likely to have several specific services, including a primary-care visit around one year.
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