Having a baby changes everything.
Now, new moms get early attention on how that’s affecting their mental health and overall well-being.
A “fourth trimester” checkup has been added to pregnancy and postpartum care, part of your birth experience through the Women’s Health Center.
Fourth trimester care is a growing priority nationally to address mental health, physical health, and adjustment to life with a new addition to the family. All women should have contact with their OB team within three weeks after giving birth, recommends the American College of Obstetricians and Gynecologists (ACOG).
“If we can catch women having issues at two weeks rather than six weeks out, they may be more successful, have less emotional turmoil, and be less likely to develop conditions like anxiety or depression,” says Christie Brockman, RN, the clinic triage nurse who initiated fourth trimester checkups in the Women’s Health Center.
“We see patients 10 to 15 times throughout their pregnancy, and then they have their baby and we say, ‘We’ll see you back in a month and a half,’” Brockman adds. “Most moms have some questions or concerns; this is a welcome opportunity to address them.”
New moms see a nurse practitioner, physician assistant, or midwife for the fourth trimester visit. The appointment runs 30-40 minutes, and covers:
- Depression screening (using PHQ-9, a nine-question survey widely used in primary care to screen for the presence and severity of depression)
- Past history of anxiety, depression or other mental health issues that increase the risk of post-partum depression
- Physical and emotional recovery from delivery
- Infant feeding and care concerns
- Sleep and fatigue
- Mom’s social support system
- Bowel and bladder function
- Vaginal bleeding
A physical exam is done only if needed.
The provider may ask:
- How was your birth experience?
- Are you bonding OK with your baby?
- Are you feeling overwhelmed or isolated?
- How is your baby doing?
- Do you have any concerns about yourself or your baby?
If needed, the provider can connect you with resources including mental health counseling, pelvic health or a lactation specialist.
The traditional six-week visit continues to be a comprehensive visit, with full physical exam and addressing all post-partum needs.
The fourth trimester visit is part of pregnancy care for patients of Women’s Health Center. (Check with your insurance carrier to see how it’s covered for you.)
Fourth trimester visits let moms know they have support. “It’s hard to reach out and ask for help when you’re overwhelmed and focused on caring for your new baby, and you think you’re supposed to be fine until your next appointment in six weeks,” Brockman says.
Even moms who are feeling well appreciate the check-in: “First-time moms sometimes just need reassurance that they’re doing the right things,” Brockman says. “Even if everything’s going okay, it’s still hard to be a new mom.”