Project Summary

The projected outputs from this project are two conferences to determine health concerns and unmet clinical needs of mothers during the fourth trimester and identify priority CER questions that address these needs; two public executive summaries of the conferences, three evaluation reports in response to the conferences and the interim partnership process, and a road map for PCOR/CER research in the fourth trimester, including conceptual models for PROMIS instruments.

Project collaborators include patient stakeholders (new mothers); North Carolina Child Fatality Task Force (within the North Carolina General Assembly); Durham Connects; SisterSong Women of Color Reproductive Justice Collective; Women's Birth and Wellness Center; El Centro Hispano; El Pueblo; New Hanover County North Carolina WIC; Orange County North Carolina Health Department; Durham County North Carolina Health Department; The Women's Health Information Center at North Carolina Women's Hospital; Piedmont Health Services; and Healthy Beginnings - North Carolina Department of Health and Human Services. 

In the weeks following delivery, a woman must recover from childbirth, adapt to changing hormones, and learn to feed and care for her newborn. During this "4th Trimester," many women experience considerable challenges, including fatigue, pain, breastfeeding difficulties, depression, lack of sexual desire, and incontinence. Amid these concerns, postpartum care is often fragmented among maternal and pediatric providers, and 20 to 40 percent of women do not attend a postpartum visit. Rising maternal mortality and morbidity in the nation have made addressing this gap an even greater priority. Our goal is to bring together mothers, healthcare providers, and other stakeholders to define what families need most during the 4th Trimester. Our stakeholder teams will determine priority health themes and systems. Based on the unmet health priorities that stakeholders identify, we will design research studies to deliver optimal care during this critical period, improving outcomes for mothers, infants and families.

More on This Project

Tully KP, Stuebe AM, Verbiest SB. The fourth trimester: a critical transition period with unmet maternal health needs. The American Journal of Obstetrics & Gynecology (April 2017).

Project Resource: Meeting Agenda

Project Resource: Meeting Flyer

Project Resource: Meeting Summary

Project Resource: Research Road Map

Project Resource: July 2017 Conference Proceedings

Project Information

Sarah Verbiest, MPH, MSW, DrPH
Alison Stuebe, MD, MSc
UNC Center for Maternal and Infant Health

Key Dates

24 months


Project Status
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022