The Fourth Trimester-It’s About Time, It’s About YOU! – Dr. Julie Schurr

Pediatricians often speak to new parents about the “fourth trimester” (AKA the first three months of life) as an incredible time of change, adaptation and development in the newborn. I have always thought, as an OB/GYN, “what about the changes as a new mom?” Becoming a new parent is a momentous phase in a woman’s life and all to often eclipsed by her new baby. Having experienced the “fourth trimester” personally on two separate occasions, I can confidently profess that there is definitely change, adaptation and development as a new parent and in the past we were left to fend for ourselves; often not very successfully. My concern, both personally, and as an Obstetrician, was acknowledged in May of this year when the American College of Obstetrics and Gynecology (ACOG) provided new recommendations for the care of postpartum patients experiencing the challenges of new motherhood, especially within the first three months.

Physicians and midwives are encouraged to see their newly-delivered patients on several occasions postpartum compared to the singular six-week postpartum check where contraception was discussed and a patient was given the thumb’s up to resume “normal” activity. ACOG now recommends patients be seen within the first three weeks, namely to address both physical and emotional challenges that are so very common. These are important issues: postpartum depression, hypertension, sleep-deprivation, anemia, breast feeding concerns, incision-healing, perineal pain and bladder control. A follow-up visit between 6-12 weeks postpartum is still in order to confirm healthy, on-going recovery and to address common concerns as the “fourth trimester” draws to a close; namely, contraception and intimacy, physical activity, goals for breast feeding , emotional well-being and coping strategies, and preparedness for returning to work. Both obstetrical groups in our office: Physicians for Women-Melius, Schurr & Cardwell and The Madison Midwives see their postpartum patients according to the new guidelines and additionally if necessary to promote a healthy “fourth trimester” and beyond. Check out Part Two on this topic- My Top Tips for Surviving the Fourth Trimester!

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