The American College of Obstetricians (OB) and Gynecologists recently updated their guidelines to include the “4th trimester” for women.
What is the “4th” trimester?
Currently, the recommendations state that new Mothers should see their OB at 6 weeks post-delivery. However, 40% of women never make it to this visit. This new approach would recommend a visit at three weeks and regularly for up to 12 weeks after delivery. At 12 weeks, a comprehensive medical exam would include physical, psychological and support services.
Why is this needed?
There is a continuum of care from start of the pregnancy, through delivery and now up to three months after the child is born. There are issues with post-partum depression, hormones and mood, physical health, sleep, breast feeding, contraception, and chronic health conditions that also need to be addressed during this post-partum period. Often, women will deliver and then have to find another doctor to care for their other medical conditions.
What are the needs of Mothers that are not being met with the 6 week checkup?
For the 60% of Mothers who do make it back, there is just one visit to try to sort out all of the issues a new Mother may have. By moving up the first visit to three weeks, and then regularly after, providers can check for post-partum depression which can be devastating for so many women. Sleep deprivation, stress from breastfeeding, hormonal changes are all contributors to this and can be assessed sooner to see if a woman is at risk.
How could this change post-partum care for women?
These recommendations can be transformational. It’s time to think about Mothers in a much more holistic way. It gives those women who need the additional help opportunities to reach out and discuss with a provider. These recommendations may also change what is and is not covered by insurance ultimately. Most importantly, it emphasizes caring for oneself in addition to the newborn. So very important in so many ways for Mothers.
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