It’s time to introduce a new paradigm for comprehensive care of women’s physical and mental health in the 3 months after giving birth, according to the American College of Obstetricians and Gynecologists.
In their newly revised committee opinion on postpartum care, ACOG encouraged doctors to think of a woman’s immediate postpartum period as a “fourth trimester” during which better care for women may help reduce maternal deaths and morbidity. That care includes a 3-week postpartum visit and a more comprehensive one within 3 months post partum.
Dr. Alison Stuebe
Despite common practices in many other cultures that provide intense, dedicated support to women during the 30-40 days after giving birth, U.S. women typically only see their ob.gyn. at a single 6-week postpartum visit and receive little to no other formal maternal support. Beyond that visit, U.S. postpartum care typically is fragmented and inconsistent, split sporadically among pediatric and maternal providers and with little support in the transition from inpatient to outpatient care, the committee wrote.
Further, 40% of women do not attend a postpartum visit at all, and more than half of maternal deaths occur after the baby’s birth. The committee aims to overhaul maternal care and potentially help reduce those numbers. That process begins with prenatal discussions about the mother’s transition to parenthood, caring for herself and her health, her reproductive life plans, her desires related to future children, the timing of future pregnancies, and appropriate contraceptive options and decisions.
“Underutilization of postpartum care impedes management of chronic health conditions and access to effective contraception, which increases the risk of short interval pregnancy and preterm birth,” the committee wrote. “Attendance rates are lower among populations with limited resources, which contributes to health disparities.”