Fourth Trimester Program provides enhanced postpartum support for Black mothers

AdventHealth for Women has launched a Fourth Trimester Program specially designed to provide enhanced postpartum support for Black mothers with high blood pressure and drive lasting change to address the health disparities and elevated maternal morbidity rates affecting Black women.

“We cannot look away from the health disparities that currently exist in our country,” said Dr. Rizwanna Fareeduddin, chief medical officer of AdventHealth for Women, noting that Black women are three times more likely to die during pregnancy or the year after. And of those deaths, 80% are preventable.

Inspired to change those statistics, AdventHealth for Women established the Fourth Trimester program to provide additional care during the 12 weeks after delivery and empower women to prioritize their postpartum health.

Black women are three to four times more likely to die during pregnancy or the year after. Of those deaths, 80% are preventable. — CDC

“Historically, when women have had babies, all the attention is on the baby, but we’re really driving home the point to them that they’re important too and their health matters,” said Nadine Walker, executive director of AdventHealth for Women.

The program was created after hospital data revealed that Black and African American mothers were being readmitted following C-section delivery at significantly higher rates than white mothers, increasing their risk of stroke and heart attack. Consistent with national trends, postpartum high blood pressure emerged as the leading cause for the readmissions.

At the heart of the program is a team of dedicated care coordinators who personally connect with every mother enrolled in the program. Based at AdventHealth for Women in Orlando and soon Celebration, the team makes sure that moms have all their follow-up appointments scheduled and medications filled before leaving the hospital and educates patients about managing high blood pressure. Mothers are also given blood pressure cuffs to monitor their vitals at home, empowering them to take charge of their health.

The coordinators don’t stop there. The team checks in with moms every week, offering not only medical support but also helping with insurance, paperwork, milk and baby supplies, transportation, and even housing and financial assistance.

“I’m here to be that big support and be that person to go out and advocate for them,” said care coordinator Erike King. “Now, these moms have a voice. We’re going to save a lot of moms.”

One of the program’s success stories is Eliza Gordon, 32, who just welcomed her third child with husband Tarvis Gordon, 35. Gordon was a perfect candidate for the Fourth Trimester Program, having dealt with complications from preeclampsia, HEELP syndrome and high blood pressure during her pregnancies. She had never heard of a “fourth trimester” and said meeting King was like “having a big sister in the hospital.”

“She made me focus on me and my health and she took so much off my plate,” said Gordon, who lives in DeLand.

"It's like having a big sister in the hospital with you." — Eliza Gordon, 32

And so when Gordon began having chest pain and her feet and legs started to swell, she immediately recognized the signs of a blood pressure spike.

“We had just gotten home and gotten settled, I really did not want to go back to the hospital. But I saw the brochure Erike gave me laying on my counter and knew I need to be reevaluated,” Gordon said.

The Fourth Trimester Program has never been more important, especially as Florida remains one of the worst states for maternal mortality, and the United States continues to have the highest rates of maternal deaths among developed nations.

Leaders at AdventHealth for Women — a connected network of women’s hospitals and specialists — nationally recognized for maternal care, are committed to changing that.

For Gordon, the program made all the difference in her postpartum recovery.

“Having a program like this makes sure women are getting the care they deserve – equal care – and that their voice is being heard and not only heard but advocated for,” Gordon said, “I feel really empowered to be part of a program that’s taken the steps needed to make change in the health care system.”