The award will help UNC bring mothers and providers together to address unmet health care needs during the “fourth trimester.”

Media contact: Courtney Mitchell, 919-843-4927
Courtney.Mitchell@unchealth.unc.edu
Jan. 20, 2016
CHAPEL HILL, NC – An interdisciplinary team at the University of North Carolina at Chapel Hill has been approved for a Eugene Washington Patient-Centered Outcomes Research Institute (PCORI) Engagement Award. The award will allow UNC researchers to define unmet patient-centered health care needs in what is known as the “fourth trimester,” the three months after a mother gives birth.
The lead investigators of the “4th Trimester Project” are Sarah Verbiest, DrPH, MSW, MPH clinical associate professor in the School of Social Work and executive director of the Center for Maternal and Infant Health in the UNC School of Medicine; Alison Stuebe, MD, MSc, associate professor of maternal-fetal medicine at the Department of Obstetrics and Gynecology in the UNC School of Medicine and Distinguished Scholar of Infant and Young Child Feeding in the Gillings School of Global Public Health; and Kristin Tully, PhD, research associate at the Carolina Global Breastfeeding Institute in the Department of Maternal and Child Health in the Gillings School of Global Public Health.
“The postpartum period is a critical time for women’s health and well-being,” said Dr. Verbiest. “However, until recently, new mothers’ needs have largely been neglected. While newborn care and wellness is important, we know that a mother’s health is important for the whole family. The opportunity to build partnerships and fully engage with mothers through hearing their voices and learning about their experiences is exciting,” said Verbiest.
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, and 20 to 40 percent of women do not attend a postpartum visit with their physician. Rising maternal mortality and morbidity in the U.S. have made this work an even greater priority.
The 4th Trimester Project will bring together stakeholders to discuss these issues for two in-person meetings, interim webinars and online discussions. The first meeting will be held in March in Chapel Hill, NC, immediately following the Breastfeeding and Feminism 2016 Conference on March 20-22, 2016.
Based on the unmet health priorities that stakeholders identify, the team will design research studies to deliver optimal care during this critical period, 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 born, 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.”
The 4th Trimester Project is part of a portfolio of projects approved for PCORI funding, designed to help develop a skilled community of patients and other stakeholders from across the entire health care enterprise and to involve them meaningfully in every aspect of PCORI’s work.
“This project was selected for Engagement Award funding not only for its commitment to engaging patients and other stakeholders, but also for its potential to increase the usefulness and trustworthiness of the information we produce and facilitate its dissemination and uptake,” said Jean Slutsky, PCORI’s Chief Engagement and Dissemination Officer. “We look forward to following the project’s progress and working with UNC to share the results.”
UNC-Chapel Hill’s 4th Trimester Project and the other projects approved for funding by the PCORI Engagement Award Program were selected through a highly competitive review process, in which applications were assessed for their ability to meet PCORI’s engagement goals, objectives, and program criteria. For more information about PCORI’s funding to support engagement efforts, see here.
PCORI is an independent, non-profit organization authorized by Congress in 2010 to fund comparative effectiveness research that will provide patients, their caregivers, and clinicians with the evidence needed to make better-informed health and healthcare decisions. PCORI is committed to seeking input from a broad range of stakeholders to guide its work.
Other co-investigators of the 4th Trimester Project include Ben Goodman, research scientist at the Center for Child and Family Policy at Duke University and co-director of Durham Connects/Family Connects; Miriam Labbok, director of the Carolina Global Breastfeeding Institute and Professor of the Practice of Public Health in the Gillings School of Global Public Health; and Monica Simpson, executive director of SisterSong Women of Color Reproductive Justice Collective.