The Fourth Trimester – did you know there was such a thing? Most women are familiar with the 9-month pregnancy model – with each trimester consisting of a three month (12 week) span. However, the American College of Obstetrics & Gynecology (ACOG) is getting the word out about the Fourth Trimester– and how important it is that women and their babies receive high-quality, postpartum care.
What is the Fourth Trimester?
The Fourth Trimester is a term used to describe the three-months after baby is delivered. These first months of mother-and-baby care are instrumental in setting up healthy breastfeeding habits, mother-baby bonding and the general day-to-day routines (or lack thereof) required to ensure mother and baby heal, adjust and adapt to post-pregnancy life.
In a perfect world, the fourth trimester would allow a mother to be home with her baby, no need to go to work or arrange child care. She’d have plenty of support from family, extended family and her community, allowing her body to heal, rest and rejuvenate. This mother has all the help she needs when it comes to breastfeeding, and her baby gets to spend the large majority of the time in his/her favorite “habitat” – in mother’s arms, on her chest and/or abdomen, preferably skin-to-skin whenever possible.
Unfortunately, the majority of U.S. moms and babies do not get the support they need during this critical time, and it’s taking a toll on their health.

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The bleak reality is that in the United States:
- We spend more money on healthcare than anywhere else in the world and yet…
- More women die during childbirth than anywhere else in the developed world.
- For every 1 woman that dies during or immediately after childbirth, 70 more came close to it.
These are dire statistics and ACOG is calling for a reinvention of the postpartum care model.
ACOG Says Mothers Should Have as Many 4th-Trimester Postpartum Visits as They Need
The newest ACOG Guidelines for Optimizing Postpartum Care makes several important recommendations.
Women should receive mother-driven postnatal care
ACOG states that not only should women have ample access to postpartum care, particularly during the first three weeks after their delivery, and the care should be “individualized and woman-centered.” During this time, she should be supported physically, mentally and emotionally and care providers should offer plenty of information and coaching with regards to her transition into motherhood, as well as her changing well-woman care needs. This level of postpartum support could dramatically reduce the number of women suffering from postpartum depression and other mental health disorders.
Mothers with high-risk pregnancies and/or existing conditions require specialized postnatal plans
Understandably, women who experienced high-risk pregnancies (high-blood pressure, gestational diabetes, pre-eclampsia, etc.) and/or those who have pre-existing health conditions would be specifically coached regarding the effect their conditions could have on the postpartum period as well as their future health. Additionally, OB/GYNs should provide a collaborative care model with the patient’s primary care providers to minimize risk, and to optimize care and long-term health outcomes.
Women experiencing miscarriages, stillbirths or neonatal deaths require exceptional care
Unfortunately, women who experience a miscarriage, still birth or neonatal death can wind up swept by the wayside after a cursory visit with their OB/GYN. This is symbolic of the healthcare disconnects that ACOG is working to abolish.
Going through these experiences is not only hard on a woman’s physical well-being, it takes an inevitable toll on her emotional and psychological well-being. The hope is that more attuned, attentive and compassionate care in the aftermath of these devastating will provide deeper holistic support for the mother.
Overlake OB/GYN is excited to read these new guidelines for the Fourth Trimester and we’re proud to offer strong postpartum support for all of our patients. Are you looking for that level of attention and care from your OB? Schedule a consult with Overlake.