A CME Journal For Family Physicians

NEWS

ACOG Issues Recommendations for “Fourth Trimester” of Pregnancy

An updated committee opinion geared towards reinforcing the importance of the “fourth trimester” of pregnancy has been issued by the American College of Obstetricians and Gynecologists’ (ACOG’s) Presidential Task Force on Redefining the Postpartum Visit and the Committee on Obstetric Practice.
Because the “fourth trimester”—or the weeks immediately following birth—can set the stage for long-term health and wellbeing in mothers and infants alike, the committees propose that postpartum care become an ongoing process rather than a single encounter, with individualized services and support made available to all new mothers.
Their statement on optimizing postpartum care includes the following recommendations:
Clinicians should provide anticipatory guidance during pregnancy and develop a postpartum care plan that addresses mothers’ transition to parenthood and well-woman care.
During pregnancy, clinicians and patients should discuss the woman’s reproductive life plans, including desire for and timing of any future pregnancies. These discussions should provide a context for potential contraceptive options as well.
Maternal care providers and new mothers should ideally have contact within the first 3 weeks postpartum, with follow-up and ongoing care given as needed. This should conclude with a comprehensive postpartum visit no more than 12 weeks after birth.
The comprehensive postpartum visit should involve a full assessment of women’s physical, social, and psychological well-being.
Follow-up with an obstetrician-gynecologist or other obstetric care provider is essential for a woman who has experienced a miscarriage, stillbirth, or neonatal death.

REFERENCE:
American College of Obstetricians and Gynecologists’ Presidential Task Force on Redefining the Postpartum Visit and the Committee on Obstetric Practice. ACOG committee opinion number 736. Obstet Gynecol. 2018;131:e140-50. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care

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