The term “The Fourth Trimester” has been described for years, relating to a new baby’s first three months. You can find scores of articles about meeting a baby’s needs in the fourth trimester, with advice on everything from swaddling to feeding to sleep.
But what about the women?
For years, the primary focus has been on the health of the newborn, which is only one part of the package deal of childbirth. Historically, the women received a 15 minute postpartum checkup at six weeks, a screen for postpartum depression, and maybe, if they were lucky or persistent, referrals for physical therapy or other resources.
With the introduction of the fourth trimester for women, that’s beginning to change. New guidelines from the American College of Obstetrics and Gynecology (ACOG), increased information about the potential for long-term changes to a woman’s body after pregnancy, and a call from women themselves for better care is leading to a push for improved postnatal care.
What Kind of Care Should Be Included in the Fourth Trimester?
According to the ACOG guidelines, women should have their first contact, either by phone or in person, with their OB within the first three weeks after delivery. A comprehensive postnatal visit should happen soon after, and include a screening for the woman’s “mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance.” It also looks at postnatal care as an ongoing process, not something that begins and ends at a six-week visit. It encourages referrals to care providers, like women’s health physical therapists, who can address the woman’s physical recovery from childbirth, as well as lactation consultants, therapists or specialists in postpartum complications and management.
What Does This Mean for Women?
In short, it means more comprehensive care. It means looking at the prolonged health of the woman, beyond the baby. It means addressing and treating the physical changes brought on by childbirth and expanding the ways to help women recover over the next months. It places a focus on physical, mental, social support and access to therapies, including physical therapy for new moms. It means a long overdue focus on the health of the woman.