Research and Development of STAC

Why STAC Was Developed

The United States has the highest maternal mortality rate in the developed world, and it is getting worse. High blood pressure affects approximately 22% (14,000) of pregnancies in Wisconsin and is one of the leading causes of maternal complications. Many new mothers experience worsening high blood pressure after they are discharged from the hospital, and high blood pressure is one of the leading causes of hospital readmission.

The American College of Obstetricians and Gynecologists (ACOG) recommends early outpatient follow-up for hypertension disorders of pregnancy, with blood pressure evaluation no later than 7-10 days after birth. However, as many as 40% of women do not attend postpartum visits. This rate is even lower among populations with limited resources, further contributing to health disparities.

Staying Healthy After Childbirth (STAC) is an evidence-based program for management of postpartum high blood pressure that allows for earlier identification of rising blood pressure, resulting in earlier treatment and a reduction in readmission compared to standard care. STAC is set up to care for all patients with any type of hypertension that was diagnosed in their pregnancy or postpartum period.

Evidence for STAC

Postpartum hypertension is among the most common indicators for hospital readmission. Pregnancy-related hypertension often worsens after hospital discharge (postpartum days 5-10).

STAC was tested in a non-randomized controlled trial with remote patient monitoring for postpartum hypertension compared to standard outpatient postpartum care at a single academic center. During the study, using the program resulted in significantly reduced hospital readmission compared to standard care.

Our study results demonstrated the remote patient monitoring group experienced a significant decrease in hypertension-related readmission (0.5% versus the control group 3.7%). Among program participants, 116 (54.2%) experienced an increase in postpartum hypertension requiring treatment after discharge.

Some people who participated in the research study completed a satisfaction survey. The survey found:

  • 91% of participants would recommend this intervention to other women with hypertension
  • 95% of participants would rather participate in home monitoring than go to the hospital or clinic

The research team published results from a feasibility study and a larger trial. Read more about the program:

Hoppe KK, Thomas N, et al. Telehealth with remote blood pressure monitoring compared with standard care for postpartum hypertension. Am J Obstet Gynecol. 2020,223(4):585-588

Hoppe KK, Williams M, et al. Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study. Pregnancy Hypertens. 2019,15:171-176

Who We Are

Role title: DO, MS

created the Staying Healthy After Childbirth program in 2017 to help address the gap in blood pressure follow-up after leaving the hospital and the growing trend in postpartum readmissions for high blood pressure. Dr. Hoppe and her team have extensive experience in conducting the program, having served over 700 participants. Dr. Hoppe is part of the Center for Perinatal Care, a joint program of UW Health and Unity Point Health-Meriter Hospital. Dr. Hoppe is a physician expert on the WisPQC Maternal Hypertension Initiative.

Kristin Hildebrandt

Role title: MSN, RN

Kristin is the current nurse lead of the Staying Healthy After Childbirth Program (STAC), and started this role in the fall of 2022.

She has been involved in obstetric nursing at Unity Point Health-Meriter for more than 20 years in both inpatient and outpatient settings.

Kristin earned her BSN in 1999 and MSN in 2018, both from Edgewood College School of Nursing in Madison, Wisconsin.

Kristin has assisted in developing and implementing the STAC Program since its transition from a research study in 2019.

She is passionate about women’s health and continually works to improve postpartum nursing care.