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ACOG Rethinks Approach to 'Fourth Trimester' Care

Photograph by Twenty20

After giving birth, the rule of thumb has been to schedule the first postpartum checkup within six weeks. That way, after recuperating at home with Baby and trying to acclimate to parenthood, moms can then touch base with their OB-GYN to assess how they're healing and how they're handling motherhood in general.

According to the American College of Obstetricians and Gynecologists (ACOG), about 40 percent of new moms aren't scheduling these necessary appointments. However, ACOG has redesigned its approach to stress the importance of postpartum care in the so-called "fourth trimester" after Baby is born.

“New mothers need ongoing care during the ‘fourth trimester,'" said Dr. Alison Stuebe, lead author of the revised committee opinion. "We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families.”

We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families.

She adds that the goal of the task force is to ensure that every new family is given a "comprehensive care plan and a care team that supports the mother’s strengths and addresses her multiple, intersecting needs following birth.”

When new moms opt out of scheduling these important checkups, they limit their access to critical information about issues like postpartum depression and short interpregnancy intervals (conceiving less than 18 months after giving birth).

By revising current postpartum guidelines, ACOG hopes to reinforce the importance of the "fourth trimester" and “set the stage for long-term health and well-being.”

Dr. Haywood L. Brown, ACOG president, said the revised guidance caters to “the postpartum needs of all women, including those most at risk of falling out of care.”

“As the nation’s leading group of physicians providing health care for women,” he added, “we must use the postpartum period as a gateway opportunity to counsel women on long-term health implications.”

ACOG’s recommendations, which touch on everything from mood swings to policy changes that support ongoing postpartum care, also encourage women to contact their maternal care provider within the first three weeks of giving birth.

Though a three-week OB-GYN visit might sound premature—especially because it means you’ll have to get dressed and leave the house with a baby who may or may not have a meltdown in the car—it might be the break a new mother needs to keep her health in check, because motherhood can be both exhilarating and terrifying.

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