ACOG Seeks to Optimize Postpartum Care, the 'Fourth Trimester'

The American College of Obstetricians and Gynecologists (ACOG) recently published Committee Opinion Number 736, released May 2018, which recommends Optimizing Postpartum Care. We birth workers and pre/post-natal yoga teachers have been talking about this “fourth trimester” and the importance of postpartum care for new mothers well after the birth of her baby and well beyond the typical 6-week postpartum check-up. “This Committee Opinion has been revised to reinforce the importance of the “fourth trimester” and to process a new paradigm for postpartum care.”
 
In ACOG’s No. 736 Abstract (replaces No. 666, June 2016), the following published statements are especially exciting to me: “To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs.”
 
ACOG also discusses financial responsibility which may make Insurance companies’ eyebrows furrow, “Changes in the scope of postpartum care should be facilitated by reimbursement policies that support postpartum care as an ongoing process, rather than an isolated visit.”
 
Here is where I start doing cart-wheels, “…the American College of Obstetricians and Gynecologists recommends that the timing of the comprehensive postpartum visit be individualized and woman centered. To better meet the needs of women in the postpartum period, care would ideally include an initial assessment, either in person or by phone, within the first 3 weeks postpartum to address acute postpartum issues. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive well-woman visit no later than 12 weeks after birth. Insurance coverage policies should be aligned to support this tailored approach to the “fourth trimester” care (see Policy and Postpartum Care).”

Whoah. I still do the ‘Happy Dance’ after I read that! Out of curiosity, has ACOG hired more women? I am happy to see ACOG finally coming on-board with a formal Committee opinion in an effort to change postpartum medical practice as well as affect policy changes for financial reimbursement. I haven’t been this excited over an ACOG opinion since they revised their decision about VBAC births! Although change make take time before we see it materialize into practice, this recognition of the Fourth Trimester is a step in the right direction!

(Replaces Committee Opinion Number 666, June 2016)

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