Cited by 338Maternal and Neonatal HealthcareMaternal and Perinatal Health InterventionsMaternal Mental Health During Pregnancy and Postpartum

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The fourth trimester: a critical transition period with unmet maternal health needs

Tully, Kristin P., Stuebe, Alison M., Verbiest, Sarah B.·2017·American Journal of Obstetrics and Gynecology

DOI 10.1016/j.ajog.2017.03.032

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Abstract

After childbirth, most American women are not scheduled for follow-up care for 6 weeks, and this visit is poorly attended. Many new mothers feel unprepared for the common health issues they encounter and are uncertain of whom to contact. To improve care, the 4 th Trimester Project is bringing together mothers, health care providers, and other stakeholders to explore what families need most from birth to 12 weeks postpartum. Eighty-seven individuals convened in March 2016 in Chapel Hill, NC. Four major topic areas emerged: (1) the intense focus on women's health prenatally is unbalanced by infrequent and late postpartum care; (2) medical practice guidelines often do not align with women's experiences and constraints; (3) validation of women as experts of their infants and elevating their strengths as mothers is necessary to achieve health goals; and (4) mothers need comprehensive care, which is difficult to provide because of numerous system constraints. Considerations for improving postpartum services include enabling more convenient care for families that is holistic, culturally appropriate, conversation based, and equitable. Maternal health issues in the fourth trimester intersect and can compound one another. Enhanced collaboration among health care providers may improve the focus of clinical interactions to address the interrelated health issues most important to women.

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Authors: Tully, K. P., Stuebe, A. M., & Verbiest, S. B.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Tully, Kristin P.
ORCID: Tully, Kristin P.
Stuebe, Alison M.
Verbiest, Sarah B.
Venue: American Journal of Obstetrics and Gynecology
Publisher: Elsevier BV
Published: 2017-07
Volume: 217
Issue: 1
Pages: 37-41
ISSN: 0002-9378 (ISSN-L)
DOI: 10.1016/j.ajog.2017.03.032
OpenAlex: W2604340266
Cited by: 338
References: 10
Citations by year: 2026: 39 · 2025: 32 · 2024: 40 · 2023: 45 · 2022: 61 · 2021: 48 · 2020: 30 · 2019: 25 · 2018: 14 · 2017: 3
FWCI: 31.78
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: fourth trimester, postpartum care, postpartum follow-up, patient-provider partnership, clinical guidelines, maternal empowerment, culturally appropriate care, health equity, holistic care, health system constraints
MeSH terms: Maternal Health, Female, Humans, Maternal Health Services, Postnatal Care, Pregnancy, Prenatal Care, Puerperal Disorders, Quality of Health Care, Quality of Life, Postpartum Period

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The fourth trimester: a critical transition period with unmet maternal health needs

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