The fourth trimester: toward improved postpartum health and healthcare of mothers and their families in the United States

The United States (US) has the worst maternal mortality rate in the developed world. Moreover, it is one of the only countries in which the rates of life-threatening complications of childbirth have steadily increased during the past two decades. At an absolute level, maternal mortality is rare. Less than one-tenth of one percent (17.3 × 100,000) of women die from a pregnancy or childbirth-related problem. However, this statistic tells only part of the story. The maternal death rate of women of color is three to four times the death rate of White women. The number of women who attempt suicide within a year of giving birth is two to three times the number of maternal deaths. And, according to the Centers for Disease Control and Prevention (CDC, 2017), for every maternal death it is estimated that 50 or more women suffer serious medical complications. The breadth and impact of maternal morbidity and mortality is deeply disturbing for any society with access to the most advanced medicine in the world. Perhaps most disturbing is that the majority of these deaths and “near-misses” are preventable. Thankfully maternal health experts are beginning to change their thinking about postpartum health. With this timely issue in mind, our aim in preparing this Special Issue was to present the latest research on health issues that affect women during the postpartum period and what we, as clinical scientists and behavioral medicine clinicians, might do fix the problem. …