Optimizing Postpartum Care in the Fourth Trimester
In This Article
- Postpartum care, sometimes considered the "fourth trimester" of pregnancy, tends to focus more on the health of the newborn, rather than the health of the mother
- Medical professionals are beginning to advocate for an expansion of postpartum care that offers more extended support for mothers in the weeks and months following birth
- Women often need tailored care for a variety of issues, both physical and emotional, after pregnancy and childbirth
During pregnancy women have frequent visits with their obstetrician to ensure their own health in anticipation of childbirth. However, care in the postpartum period, sometimes considered the "fourth trimester," tends to focus more on healthy outcomes of pregnancy—specifically the health of the newborn. Many medical professionals are beginning to advocate for an expansion of postpartum care that offers more extended support for mothers in the weeks and months following birth.
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Ilona T. Goldfarb, MD, MPH, a maternal-fetal medicine specialist in the Department of Obstetrics and Gynecology at Massachusetts General Hospital, explains that traditional postpartum care is limited considering the critical significance of the postpartum period for mothers. In an article on the Harvard Health Blog, Dr. Goldfarb notes that women often need tailored care for a variety of issues including pain caused by tearing during a vaginal birth, a surgical incision after a cesarean delivery or the physical and emotional challenges of breastfeeding.
In May 2018, the American College of Obstetrics and Gynecology (ACOG) published a committee report on the optimization of postpartum care. The report called for postpartum care to become an ongoing process. This includes a full assessment of physical, social and psychological well-being over time, rather than in a single, isolated visit. It also called for a change in reimbursement policies for postpartum care that can facilitate a transition towards more supportive, thorough care for mothers.
Dr. Goldfarb also notes that women can and should ask their obstetric team about what kind of postpartum support they can expect to have. She recommends that women ask about the need to adjust medications, warning signs to look for and timing for their first postpartum check-up. Women should also ask about how they can maintain any medical discoveries made during pregnancy as part of their long-term health maintenance plan.
Read More on Harvard Health Blog
Learn more about the Department of Obstetrics & Gynecology
Learn more about the Obstetrics Program at Mass General