The first few weeks after childbirth can be critical for new mothers and their babies. Yet new moms are typically discharged from the hospital with a day or two of giving birth, with little follow-up.
It’s no coincidence that the United States has one of the highest rates of maternal deaths and life-threatening complications. A group of physicians suggests an overhaul of the system. They say new mothers should be seen earlier and more often after having a baby.
Obstetrician group aims for better ‘fourth trimester’ maternity care
About 700 American women die each year from pregnancy and childbirth, according to a report by NPR and ProPublica. Another 50,000 moms suffer life-threatening complications, such as stroke, hemorrhage and heart attack. The U.S. has among of the worst rates for maternal injury and death in the industrialized world. Outcomes are even worse for women of color.
Prenatal care in the U.S. is generally good. Pregnant women commonly have a dozen visits with their doctor leading up to the birth. But post-partum care is sadly lacking, particularly for the mother. Many new moms have little or no contact with their doctor or nurses once they take their baby home from the hospital. Typically, the first appointment with the OB-GYN is four to six weeks after childbirth. However, those first days and weeks are a critical time for the mother and the baby.
The American College of Obstetricians and Gynecologists (ACOG) has issued an 11-page recommendation for “Optimizing Postpartum Care.” Among their suggestions for the fourth trimester:
- An OB-GYN visit no later than three weeks after birth
- An OB-GYN visit within three days if the mom had hypertension (high blood pressure)
- Additional follow-ups through the end of the 12th week
- Discussion of risk factors and symptoms, such as pre-eclampsia, gestational diabetes and pre-term labor
African-American moms are especially at risk for post-partum complications. Black women are three to four times more likely than their white counterparts to die from pregnancy/childbirth.
The Next Wave Of Medical Malpractice?
Failure to monitor, assess and inform expectant mothers of their risks – and failure to follow up with those who have known risk factors – could be professional negligence. As ACOG pushes for reform, there will be a brighter spotlight on providers who fail to meet the recommended standard of care, as well as hospital administrators and insurance companies who turn away mothers who report symptoms.