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May 21, 2019
by Patricia Tomasi

Many Mothers Overlook Postpartum Care During “Fourth Trimester”

May 21, 2019 08:00 by Patricia Tomasi  [About the Author]

A new U.S. online survey conducted between April 4th and 8th, 2019, by the Harris Poll on behalf of MediaSource has found that 40 per cent of over 1200 women surveyed felt overwhelmed, depressed, or anxious following labor and that more than 25 per cent did not have a health care plan in place to cope with the "fourth trimester". 

“Orlando Health commissioned this survey to gain insight on the challenges new moms experience during the first few months after delivery,”  Megan Gray, MD and OB/GYN at Orlando Health Winnie Palmer Hospital for Women & Babies, told us. “We felt that Mother’s Day was a good time to engage in a discussion about what moms can do to take just as much care of themselves as their babies.”

The fourth trimester is the term given to the time post-delivery. While women tend to their care during the first three trimesters of pregnancy with numerous doctor’s appointments and tests, in the fourth trimester following labor, the focus tends to shift primarily to the baby, leaving many women feeling neglected and exhausted. Some go on to develop a maternal mental illness such as postpartum depression or postpartum anxiety.

Nearly 20 per cent of women in the U.S. suffer from a maternal mental illness due to numerous reasons including lack of proper care and follow-up following labor and delivery. Some symptoms of postpartum depression include feeling sad, overwhelmed, anxious, irritable, angry and fatigued. The ‘baby blues’, often confused with postpartum depression, occurs in 80 per cent of women. Postpartum depression is diagnosed when new moms experience symptoms lasting longer than two weeks.

“Nothing really surprised me about the survey results,” Gray told us. “I have witnessed, through becoming a new mom myself and my work with thousands of postpartum moms, that these are real issues that many new moms go through, but are often afraid to talk about out loud. I think more women should feel empowered to talk about their experiences and be honest about the challenges of having a new baby.”

American pediatrician, Dr. Harvey Karp first coined the term, “fourth trimester”. The theory rests on the fact that humans are born less developed than other mammals and come equipped with a calming reflex to help that’s helps them to settle down. But mom bloggers have also jumped on the term, equating it to the overwhelming period for a new parent as well as the baby following labour and delivery. There’s now a book called, “The Fourth Trimester”, as well as another called, “The Fifth Trimester” that focuses on the time period when a woman returns to work.

The current survey found that 37 per cent of new moms felt embarrassed by their bodies following delivery. As well, 57 per cent of new moms under the age of 45 were more forthcoming about symptoms of anxiety and depression rather than women over the age of 45 at 31 per cent. Sixty-three per cent of moms said their health concerned them as much as their baby’s health regardless of the fact that 26 per cent said they didn’t have any kind of postpartum health plan. Among moms aged 18-34, that number rises to 37 per cent.

“We as healthcare providers have more work to do,” Gray told us. “We need to better educate moms about the challenges of the fourth trimester earlier in their pregnancy so they can be better prepared. We also need to consider seeing our patients for postpartum visits sooner than six weeks and more frequently so we can address and treat both physical and mental complications before they become detrimental to the patient’s wellbeing.”

About the Author

Patricia Tomasi

Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog:

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