New CME Course Emphasizes Importance of 4th-Trimester Care
June 20, 2023, Michael Devitt — The AAFP has just released “4th Trimester: Optimizing Postpartum Care,” an on-demand, multisession CME program that focuses on the care birthing people require in the first few months postpartum. This self-study activity is the latest Academy resource that aims to benefit family physicians who care for birthing people or who have an interest in growing their practice to include this population.
The course is designed to raise clinician awareness of the fourth-trimester model of care and provide family physicians with resources to address their patients’ physical, social and mental health needs. It combines recorded panel discussions with visual and interactive components and includes strategies to help family physicians manage their patients’ concerns while optimizing care during this crucial time.
“Maternal mortality and morbidity rates continue to increase despite more awareness and efforts to improve outcomes,” explained Zita Magloire, M.D., a physician partner at Cairo Medical Care, L.L.C., in Cairo, Ga., and Georgia AFP liaison to the Georgia Perinatal Quality Collaborative. “The fourth-trimester model of care is one approach to improving outcomes.”
Magloire added that the course would be ideal for residents or residency faculty who want to improve their knowledge about pregnancy care and related issues, particularly those who may have had limited exposure to postpartum care but would like to provide it in practice or those who plan to complete a fellowship that includes this type of care.
Program Description
The program consists of nearly 20 sessions and panel discussions that cover various aspects of the fourth-trimester model, including:
- A Role for All Family Physicians in the Fourth Trimester Model of Care: Overview and Case Studies
- Billing for Pregnancy Complications and Non-Obstetric Medical Issues During the Global Period
- Coordinating Mental Health Care During the Perinatal Period
- Essential Resources for Delivering Optimum Care: Preconception Through End of First Year Postpartum
- Optimizing Breastfeeding Support in the Fourth Trimester Model
- Osteopathic Approach to the Fourth Trimester
- Promoting Community and Health Equity Through Group Visits
Story Highlights
Each session offers between 0.25 and 1.25 CME credits, and individuals who complete the entire series are eligible to claim up to 13.25 AAFP Prescribed credits. Those who complete the series will also have the opportunity to earn an additional 2.00 Prescribed credits for participating in a Translation to Practice® activity, which involves submitting a commitment to change statement, implementing the change in their practice and reporting the effects of the change to AAFP at set intervals.
As an on-demand activity, learners may complete sessions in the order they prefer. The format also lets participants pause or replay sessions at their discretion so they can focus on areas of interest or repeat sessions to reinforce concepts and enhance their knowledge of particular topics.
On completion, learners should be able to
- explain three changes to practice recommended in ACOG Committee Opinion No. 736: Optimizing Postpartum Care, developed by the American College of Obstetricians and Gynecologists’ Presidential Task Force on Redefining the Postpartum Visit and the Committee on Obstetric Practice;
- summarize trends in maternal mortality and morbidity in the United States; and
- conceive of two ways the fourth-trimester model of care can provide opportunity for growth in one’s practice.
Maternal Health Resources
The launch of the fourth-trimester course comes amid increasing alarm about the state of maternal health in the United States. Data from the CDC and the Organization for Economic Cooperation and Development indicate that the maternal mortality rate in the United States far exceeds that of other developed countries, and nearly doubled between 2018 and 2021 — the last year for which data are available — growing from 17.4 deaths per 100,000 live births to 32.9 deaths per 100,000 live births. The situation is even more concerning for Black women, for whom the maternal mortality rate in 2021 was 69.9 deaths per 100,000 live births — more than twice the rate for white or Hispanic women.
A Center for Healthcare Quality and Payment Reform report, meanwhile, suggested that more than 600 rural hospitals in the United States are at risk of closing in 2023, which would reduce access to care and increase health disparities for thousands of women of childbearing age.
The AAFP has developed numerous resources to raise awareness of the importance of maternal health and guide members in providing optimal care for women before, during and after pregnancy. The recently launched Center for Women’s Health combines existing resources with member stories to encourage healthy living across the lifespan. In addition, the Academy has developed webpages that address specific topics such as maternal health, clinical guidelines and recommendations, women’s health CME activities and the AAFP’s ongoing advocacy related to women’s health.