After delivery, who checks on the veteran?
VA promises every pregnant veteran a maternity care coordinator, with coordination running through twelve months postpartum. Using the aggregated workpapers behind VA OIG report 24-00818-208, released under the Freedom of Information Act, this report publishes what the medical records show for CY 2024 deliveries: completed coordinator contact falls from 79 percent right after delivery to 41 percent by month twelve, required screening completion stays low all year, and the average veteran waited 197 days for her first VA postpartum primary care visit - against a policy that requires that visit to be scheduled within three months.
- By Alec Morgan
- The Veteran Benefit Desk
- Published September 2, 2026
- ISSN 3144-0835
- https://doi.org/10.68077/vbd.maternity-care
Independent research; not peer reviewed. Corrections and version notes are published under our Corrections Policy.
The postpartum drop-off, straight from the medical records
VA OIG reviewers read the records of 100 CY 2024 deliveries at each postpartum contact point and recorded whether coordinator contact was attempted, whether it was completed, and whether each required screening was completed by any member of the care team. Percentages use OIG's published compliance methodology:
- Completed coordinator contact
- Depression screening completed
- Documented contact attempt
- Housing and food security screening completed
- Relationship safety screening completed
CY2024 postpartum EHR sample, n=100 records per point; OIG removes N/A records (criterion did not apply) from applicable compliance denominators. "Completed" screenings count those documented by the coordinator or any care team member.
What the released record shows
There are two drop-offs, not one
Right after delivery, reviewers found a documented contact attempt in 88 percent of applicable records and a completed contact in 79 percent - a 9-point gap. By month twelve the attempt rate had fallen to 69 percent and the completed-contact rate to 41 percent - a 28-point gap. So this is not simply "VA stopped calling": some records show no required attempt at all, and even when outreach is documented, contact increasingly fails. Across the whole episode, only 24 percent of veterans (95 percent CI 16 to 33) had completed contacts at every required point.
Screening completion stayed low all year
Counting screenings completed by any care team member, depression screening ran 56 percent post-delivery and 44 percent at twelve months. Housing and food security screening ranged 37 to 42 percent, and relationship safety screening never exceeded 36 percent, ending the year at 25 percent. The rates do not simply track the contact decline - they were low at every point. The postpartum year is exactly when these risks concentrate, and the twelve-month coordination expansion exists because of them.
Reaching the veteran closed much of the gap - but not all of it
Among veterans a coordinator actually reached at month twelve, depression screening was offered 88.9 percent of the time and performed 75 percent; housing and food security was offered 80.6 percent and performed 77.8 percent; relationship safety was offered 72.2 percent and performed 52.8 percent. A compliant "offer" can include a documented decline or a documented inability to screen. Getting the veteran on the phone helps substantially - it does not finish the job.
When a screen came back positive, follow-up was documented
In the one cell large enough for OIG to publish an estimate - depression screenings at three months, 11 positives - documented appropriate follow-up was 100 percent. At every other released point the positive count equals the documented-follow-up count (depression: 8, 9, 5, 6; relationship safety: 1, 1; housing/food: 1, 1), but OIG suppressed percentage estimates where counts were below 11. The released evidence points at identification and outreach as the weak links, not what happens after a risk is actually identified.
197 days to the first postpartum visit - and a scheduling loophole
In the CY 2024 sample, 45 percent of veterans had a VA women's health or primary care visit scheduled within three months of delivery and 34 percent completed one. The mean time from delivery to that first visit was 197.16 days (95 percent CI 170.1 to 224.9). VA's own response to the report draws a careful line: policy requires the visit be scheduled within the first three months, "but does not specify that such visits be completed in the same timeframe." OIG recommended evaluating both. Among records with no timely visit, the top documented reasons were "attempted to schedule, unable to contact the patient" (31.8 percent) and "no scheduling attempts documented at all" (24.2 percent).
Billing friction shows up in three independent sources across three years
In 2024, approximately 80 percent of maternity care coordinators told OIG billing was an area for improvement (2024 OIG report on perceived barriers to coordinating veteran maternity care). In the CY 2024 record reviews released here, coordinators documented billing concerns for 24.7 percent of patients (95 percent CI 16.1 to 33.7) across the episode. And in the separate 2025 veteran survey, 36.6 percent of respondents reported billing and payment concerns. Staff said it was a problem, the medical records kept showing it, and veterans kept reporting it. These are independent samples, so they cannot be compared head-to-head - together they show persistence, not a single rate.
Veterans like their coordinators; the classes fall short for some
Among respondents who had coordinator contact, 95 percent were satisfied with support during pregnancy and 95.4 percent after delivery (released yes/no-only estimates, n=129 and n=121). On classes, many respondents said they did not want or need them (56.4 percent for parenting classes). Among those who expressed a view, satisfaction was 63 percent for childbirth preparation and 61 percent for parenting classes - the weakest results in the survey, but not the collapse the raw all-respondent numbers imply.
Most got their first community appointment when they wanted it
80.9 percent of respondents got their first community maternity appointment as soon as they wanted; 14.1 percent did not. For that minority, the main documented barriers were community provider availability (69.8 percent) and delays in VA authorization paperwork (34.9 percent) - a small subgroup (n=18, multiple responses allowed), so treat the reason breakdown as directional.
The accountability clock is running
VA concurred (in full or in principle) with all four recommendations, and as of September 2026, all four remain open in our live recommendation tracker. The targets VA committed to:
That is what the pending FOIA requests below are for: they establish the documented baseline before VA's promised corrective actions come due.
Methodology and honest limits
Source: aggregated, de-identified workpapers behind VA OIG report 24-00818-208 (Review of VHA Maternity Care Coordination and Women Veterans' Experiences), released under FOIA case 26-00076-FOIA on August 28, 2026 with no exemptions cited. Three separate samples are involved and should not be mixed: (1) the postpartum EHR review published here - a simple random sample of 100 patients from the CY 2024 delivery population (EHR review); (2) a separate FY 2023 prenatal review: 400 records sampled, 294 confirmed pregnancies (public report); and (3) the veteran experience survey - 500 patients selected, 496 confirmed live births, 131 responses (26.34% response rate). EHR estimates carry 95 percent confidence intervals, OIG suppressed calculations where counts were below 11, and compliance percentages remove N/A records (criterion did not apply) from the denominator. Survey estimates were bootstrapped with 10,000 replicates and, per OIG, describe respondents only.
What the public report already said versus what this release adds: the published report disclosed the contact decline, the 24 percent across-episode contact rate, the 24.7 percent billing finding, and timely-visit results including 35 percent within three months, with an average of 174 days and a median of 126 days from separate FY 2025 administrative population data. The FOIA files add what the report did not publish: the 197.16-day mean with its confidence interval for the CY 2024 EHR sample, the full per-point estimates with confidence intervals and N/A structure, the when-contacted screening rates, the positive-screening follow-up cells, and the complete survey cross-tabulations.
These are national estimates by design. The released files do not support facility or VISN comparisons, which is why the facility-level performance record is the subject of a separate pending request below.
The released files
- VA OIG response letter, August 28, 2026 (records released without cited exemptions)Decision letter
- Postpartum EHR review aggregate results, CY24 deliveries sample (XLSX)Data
- Veteran experience survey aggregate results (PDF)Data
- Survey instrument screenshots (PDF)Instrument
- Definitions and notes (PDF)Methodology
- VA OIG acknowledgement letter, August 13, 2026 (PDF)Correspondence
This is the first release, not the last
Three related requests are pending with VA. As each is answered, this report will be extended with the new records:
This release is national-estimate only by design; the facility-level record is a separate pending request.
The policy and program-management paper trail behind the numbers.
How VA implemented the expansion of maternity care coordination from 8 weeks to 12 months postpartum.
Follow every request in the open FOIA log.
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