By Barb Arland-Fye
The Catholic Messenger
BETTENDORF — Balancing self-care with baby care can be challenging for any new mom during the first several months after the birth of her child. Moms in need find this balancing act particularly challenging. The “4th Trimester Package,” a collaborative effort between Life & Family Medical and the Women’s Choice Center, seeks to nurture good self-care for moms in need.
“Fourth-trimester care is a growing field, a niche area of care. It recognizes an underserved area in women’s health,” says Dr. Julie Schroeder, a family medicine physician at Life & Family Medical, who heard another physician’s talk about fourth-trimester care during a continuing education conference she attended.
Concern about maternal mortality rates, which have doubled in the last 20 years, according to Common Good Iowa (CGI), is one factor in this growing field. Among the women who died in the postpartum period, “about a quarter were eligible for Medicaid at the time of birth and their deaths occurred after their Medicaid postpartum coverage ended” (Iowa Maternal Mortality Review Committee, 2021).
Among the goals of the Iowa Department of Health and Human Services (HHS) is “reducing short- and long-term health problems or deaths that result from or are worsened by being pregnant and giving birth, from conception through one year postpartum” (the 2021 Iowa Maternal Health Strategic Plan).
New moms with limited resources or support “don’t know where to go and they’re often overwhelmed with baby care,” said Sarah Leinart, a nurse with Women’s Choice Center. “If they have this tool (the 4th Trimester Package) in place before the baby is born, then they know they have someone to turn to — Dr. Julie.”
Expectant moms served by the Women’s Choice Center, which serves women and men facing unexpected pregnancies, receive a brochure spelling out the 4th Trimester Package’s details. The brochure raises a crucial question: “During your pregnancy you may feel like you are getting a lot of attention from many places — friends, family, doctors — but what happens after delivery? …”
“As a patient at Women’s Choice Center, we want to give you the gift of extra care and attention that specifically focuses on you as a new mom for the three months after delivery (a time known as the 4th Trimester).”
The “care package” includes a set of visits with Dr. Schroeder, a pre-delivery visit, post-delivery visit and additional visits as indicated. It offers a safe place to ask questions and discuss the birthing experience, physical recovery from pregnancy and delivery, breastfeeding, partner relationship, managing home demands and baby care concerns.
“Maybe the delivery didn’t go as (the mom) thought it might. Maybe she was not the first person to hold her own baby,” Leinart said. The mom might wonder whether the bleeding she is experiencing is normal or why she is feeling “blue” or depressed.
The 2021 Iowa Maternal Health Strategic plan reports “Mental health conditions are the most common complication of childbirth impacting 1 in 5 individuals during pregnancy and the year following pregnancy.” Untreated mental health conditions can have negative and long-term impact on pregnant and postpartum women and their infants and are a leading and preventable cause of maternal mortality, the strategic plan states.
In her commitment to ensuring new moms maintain good health, Dr. Schroeder said the 4th Trimester Package is designed to help them determine the top three things on their plate that need attention. “Three things … so that when somebody asks, ‘How can I help you,’ (the mom) can say, ‘These are three answers.’” This proactive approach empowers moms and gives them permission to trust their instincts, Dr. Schroeder added.
Leinart said one of the criticisms of pregnancy centers is that they are just interested in saving the baby. The 4th Trimester Package underscores the commitment to help moms transition to motherhood and parenting. Dr. Schroeder provides a “loving mom” presence for a new mom who might not have a supportive partner or any partner in her life, Leinart added.
The 4th Trimester Package, introduced last month, is a gift for moms in need from the Women’s Choice Center and Life & Family Medical, ministries of Life & Family Education Trust, which share a building that previously housed an abortion clinic. Funding comes from benefactors of these ministries.
Dr. Schroeder doesn’t seek to replace a mom’s primary care doctor. “I don’t want to step on the toes of other health care providers.” She sees her role as “care coordinator, making sure there are no gaps.” She also will make referrals to other health care providers or resources, depending on the new mom’s specific and unique needs.
“One of the really important things we do is take great pride and great effort to make sure every mother is connected” with the services they need, Leinart said. “If we can at least get them through the first three months, help them to build some confidence in themselves as mothers,” Dr. Schroeder said, “then we’ve accomplished something.”
(To learn more or to donate to the 4th Trimester program, visit www.womenschoice center.org (563-322-0475) or www.lifeandfamilymedical.com (563-526-4536).