The Fourth Trimester: Looks at Ways the U.S. Struggles with Postnatal Care

May 16, 2018 | Strategic Insights for Health System


​Postnatal care is “one of the most underdiscussed and understudied issues in medicine," according to a May 4, 2018, article on This lack of recognition of the so-called fourth trimester is one reason that the maternal mortality rate in the United States is higher than most others in the developed world, the article said (see HRC Alerts, November 2, 2016: “An International Embarrassment": Maternal Mortality Rates Rise in U.S., Even as They Decrease Elsewhere). Far too often, the article said, new mothers are not made aware of possible complications after childbirth, are too embarrassed to discuss symptoms, or “have no clue" that helpful postnatal treatments exist. Providing one medical visit six weeks after birth is “often woefully insufficient for the issues they're dealing with," the article said. According to the article, about half of women who give birth are still in pain weeks later, more than 40% of women who deliver vaginally report perineal pain, and nearly 60% of those with cesarean section report incision pain two months after childbirth. Furthermore, nearly 80% of new mothers say they have pain that interferes with daily activities and one of three report urinary or bowel problems.

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