January 20, 2016

An interdisciplinary team at the University of North Carolina at Chapel Hill has been approved for a Eugene Washington PCORI Engagement Award by the Patient-Centered Outcomes Research Institute (PCORI). The team will work to define currently unmet patient-centered healthcare needs in what is known as the “fourth trimester,” the three months after a mother gives birth.


Researchers from the Gillings School include (L-R): Drs. Alison Stuebe, Sarah Verbiest, Miriam Labbok and Kristin Tully.

Project investigators from the UNC Gillings School of Global Public Health include Alison Stuebe, MD, Distinguished Scholar of Infant and Young Child Feeding, Sarah Verbiest, DrPH, adjunct assistant professor of maternal and child health, Miriam Labbok, MD, director of the Carolina Global Breastfeeding Institute and Professor of the Practice, and Kristin Tully, PhD, research associate at the Carolina Global Breastfeeding Institute. These researchers will work with colleagues from UNC’s School of Social Work and School of Medicine, as well as others from the Triangle area.

In the weeks following delivery, a woman must recover from childbirth, adapt to changing hormones and learn to feed and care for her newborn. During this fourth trimester, many women experience considerable challenges, including fatigue, pain, breastfeeding difficulties, depression, lack of sexual desire and incontinence.

Amid these concerns, postpartum care is often fragmented among maternal and pediatric providers, with 20 to 40 percent of women never attending a postpartum visit. Rising maternal mortality and morbidity in the United States have made addressing this problem a greater priority than ever.

4th trimester logo

The 4th Trimester Program logo depicts a mother and child surrounded by a supportive community.

The 4th Trimester Program’s main goal is to bring together mothers, healthcare providers and other stakeholders to define what families need most during the three critical months following birth. The research team will engage stakeholders around these issues during in-person meetings, webinars and online discussions. The first meeting will be held in Chapel Hill, N.C., immediately following the Breastfeeding and Feminism 2016 Conference on March 20-22.

Based on the unmet health priorities that stakeholders identify, the team will then design research studies to explore ways to deliver optimal care during this important period, thus improving outcomes for mothers, infants and families.

“In standard maternity care, we see a mom weekly in the month before her due date – and then, once the baby is out, we wish her luck and see her in six weeks,” Stuebe said. “Every mother deserves comprehensive support to recover from birth and develop the confidence to feed and care for her baby. With this project, we will partner with mothers to find out what support would enable them to grow thriving families.”

This news story is adapted from the original article posted by UNC’s School of Medicine.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu
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