Provide Care for a New Mother’s “Fourth” Trimester

Women are essentially “abandoned” by the health care system after giving birth. That needs to change.

A new mother’s needs don’t diminish when she becomes, well, a new mother. Motherhood underscored a dearth of care for mothers after Esther Laury gave birth. Laury, an assistant professor at Villanova University, thought that years of being a nurse and interacting with health care providers meant that she’d know what to expect and how to maneuver through the system when she became pregnant, she writes in the Philadelphia Inquirer. And the system worked well, for the first three trimesters.

Then: “Swollen legs, extreme abdominal cramps, high blood pressure, limited access to care, and unanswered questions colored my postpartum experience,” writes Laury. “I did not feel special anymore. I felt confused, abandoned, and scared. All the meticulous care once lavished on me had disappeared.”

At one point she called her obstetrician’s office for help only to be redirected to the emergency department because she did not have the symptoms of uterine hemorrhage. (It turned out to be a urinary tract infection.)

Laury writes that the problem points to a dearth of care particularly for black women; 18 in 1,000 die because of a pregnancy-related issue in the United States.

Laury says that guidelines offered by the American College of Obstetricians and Gynecologists should be followed to better manage care in the fourth trimester. They include:

  • Regular ongoing care instead of the traditional single postpartum visit.
  • Care that is individually tailored for each woman.
  • First postpartum visit within three, not six, weeks of birth.
  • A final comprehensive postpartum visit no more than 12 weeks after birth.