A Qualitative Study on Barriers and Facilitators to Postpartum Cardiovascular Disease Risk Screening in Women with Hypertensive Disorders of Pregnancy: Perspectives from Patients and Healthcare Providers.

Purpose: To explore the barriers and facilitators to postpartum cardiovascular disease (CVD) risk screening among women with hypertensive disorders of pregnancy (HDP) from both patient and healthcare provider perspectives, with the aim of informing clinical screening strategies, optimizing postpartum care services, and improving maternal health outcomes. Patients and Methods: This study employed purposive sampling and was conducted between February and May 2025 at a tertiary hospital in Suzhou, Jiangsu Province, China. Semi-structured, one-on-one interviews were conducted with 15 women diagnosed with HDP at 3-12 months postpartum. In addition, focus group interviews were held with nine healthcare providers from the obstetrics department and community health centers (CHCs, primary care facilities in China). A content analysis approach was used to analyze the qualitative data. Results: Three themes and twelve subthemes emerged: (1) Limited perception of CVD risk, poor ability to screen and apply health information, fear-driven avoidance behavior, conflicting role priorities, and economic burden are individual barriers; (2) lack of guidance from healthcare providers, fragmented and unstandardized postpartum care system are system-level barriers; (3) family history of hypertension, emphasis on personal health, strong family support, and positive experience with past interventions are promoting factors that encourage women to get screened. Conclusion: Postpartum CVD risk screening in women with HDP remains inadequate. Strengthening transitional care, integrating structured screening into postpartum guidelines, expanding insurance coverage, and enhancing digital health and provider training are essential to close clinical gaps and improve long-term cardiovascular outcomes.