Postpartum Home Visiting (HEART at Home)

High blood pressure during and after pregnancy can put people at risk for serious health problems after delivery. Many patients do not receive enough follow-up care once they leave the hospital, and high blood pressure can continue or worsen in the weeks after childbirth. This study will test whether a new care approach is practical and acceptable for patients and health care teams. The study combines home blood pressure monitoring, home visits by trained postpartum doulas, and telehealth visits with medical providers during the first three months after delivery. This novel intervention is called HEART at Home (Home-based Engagement And Remote Treatment for Hypertension). People who recently gave birth and have ongoing high blood pressure will be invited to join the study. Participants will measure their blood pressure at home using a provided cuff and share their readings through a secure mobile system. Nurses and doctors will review these readings and adjust blood pressure medications when needed. Participants will also receive home visits and phone or text check-ins from trained postpartum doulas, who will provide education, help with blood pressure measurement, and support in connecting to ongoing medical care. At about 12 weeks after delivery, participants will have planning for future care with a primary care provider or heart specialist. The study will collect information about how easy the program is to carry out, how often participants complete visits, and how helpful participants and providers find the program. The study will also track blood pressure control and any emergency room visits or hospital readmissions related to blood pressure. This information will be used to improve postpartum care for people with high blood pressure in the future.