The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
The fourth trimester: a critical transition period with unmet maternal health needs
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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“However, unmet needs for education in physical self-care and infant care, breastfeeding initiation, emotional support, and anticipatory guidance are also of concern (Suplee, Kleppel, Santa-Donato, et al. 2016; Tully et al., 2017).”
From Scoping Review of Postpartum Discharge Education Provided by Nurses (2022) · cites this paper as Tully et al., 2017
In the citing paper
“Women were generally satisfied and felt ready at time of discharge in contrast to retrospective reports of unmet learning needs (Martin et al., 2014; Tully et al., 2017).”
From Scoping Review of Postpartum Discharge Education Provided by Nurses (2022) · cites this paper as Tully et al., 2017
In the citing paper
“Women were generally satisfied and felt ready at time of discharge in contrast to retrospective reports of unmet learning needs (Martin et al., 2014; Tully et al., 2017).”
From Scoping Review of Postpartum Discharge Education Provided by Nurses (2022) · cites this paper as Tully et al., 2017
In the citing paper
“The fi rst postpartum year is especially critical: 63% of pregnancy-related deaths occur within twelve months of delivery. 6,8,9”
From Care utilization and clinical outcomes among high-risk patients enrolled in a postpartum navigation program: a retrospective matched cohort study (2026) · cites this paper as [9]
Citations
Cites
The National Committee for Quality Assurance
Iglehart, J. K. (1996) · New England Journal of Medicine · doi:10.1056/nejm199609263351322 · Cited by 1,826
Higgins, J. A. (2014) · Contraception · doi:10.1016/j.contraception.2014.01.027 · Cited by 257
Views of Women and Clinicians on Postpartum Preparation and Recovery
Martin, A., Horowitz, C., Balbierz, A., & Howell, E. A. (2014) · Maternal and Child Health Journal · doi:10.1007/s10995-013-1297-7 · Cited by 141
Predictors of Compliance with the Postpartum Visit among Women Living in Healthy Start Project Areas
Bryant, A. S., Haas, J. S., McElrath, T. F., & McCormick, M. C. (2006) · Maternal and Child Health Journal · doi:10.1007/s10995-006-0128-5 · Cited by 137
Schmied, V. A., Mills, A. E., Kruske, S., Kemp, L., Fowler, C., & Homer, C. (2010) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2010.03321.x · Cited by 123
(2016) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001318 · Cited by 80
Howell, E. A., Balbierz, A., Wang, J., Parides, M., Zlotnick, C., & Leventhal, H. (2012) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e318250ba48 · Cited by 78
An intervention to extend breastfeeding among black and Latina mothers after delivery
Howell, E. A., Bodnar-Deren, S. M., Balbierz, A., Parides, M., & Bickell, N. A. (2013) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2013.11.028 · Cited by 60
The views of mothers and GPs about postpartum care in Australian general practice
Brodribb, W. E., Zadoroznyj, M., & Dane, A. C. (2013) · BMC Family Practice · doi:10.1186/1471-2296-14-139 · Cited by 52
Kitzinger, S. (1975) · PubMed · Cited by 21
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ACOG Committee Opinion No. 736: Optimizing Postpartum Care
(2018) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002633 · Cited by 1,090
Social and Structural Determinants of Health Inequities in Maternal Health
Crear-Perry, J., Correa‐de‐Araujo, R., Johnson, T. L., McLemore, M. R., Neilson, E., & Wallace, M. E. (2020) · Journal of Women s Health · doi:10.1089/jwh.2020.8882 · Cited by 908
ACOG Committee Opinion No. 736: Optimizing Postpartum Care
McKinney, J. L., Keyser, L. E., Clinton, S. C., & Pagliano, C. (2018) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000002849 · Cited by 430
McNamara, J., Townsend, M. L., & Herbert, J. S. (2019) · PLOS ONE · doi:10.1371/journal.pone.0220032 · Cited by 222
Nutritional Gaps and Supplementation in the First 1000 Days
Beluska-Turkan, K., Korczak, R., Hartell, B., Moskal, K., Maukonen, J., Alexander, D. E., Salem, N., Harkness, L., Ayad, W., Szaro, J., et al. (2019) · Nutrients · doi:10.3390/nu11122891 · Cited by 214
Metadata
- Authors
- Tully, K. P., Stuebe, A. M., & Verbiest, S. B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Tully, Kristin P.
- 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)
- 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
- 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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