Increased potential for life-threatening stroke, cardiovascular disease and Type 2 diabetes makes “fourth trimester” important.

Published: February 17, 2021 | Updated: September 19, 2024

The “fourth trimester” of pregnancy — those months after childbirth — is a time to adjust to being a mom and an opportunity to check on your recovery from what had been an intense and challenging nine months for your body.

Monitoring your health during this period is important because pregnancy can increase your risk for conditions that will build up over the years and can become life-threatening. Increased potential for stroke, cardiovascular disease and Type 2 diabetes can be traced back to pregnancy.

According to the Centers for Disease Control and Prevention (CDC), as many as 50,000 women experience severe unexpected issues because of pregnancy, and 700 women a year die as a result of pregnancy or pregnancy-related complications.

“Women can have complications from childbirth up to a year after delivery,” said Lyndsey D. Neese, M.D., obstetrician and medical director of quality for women’s services at Norton Healthcare. “Women also can experience long-term health consequences related to their pregnancy.”

For women who experience preterm delivery, gestational diabetes, hypertension or preeclampsia during pregnancy, there is a greater risk for arteriosclerotic cardiovascular disease. The build-up of fats, cholesterol and other substances in and on the artery walls can break free into the bloodstream, causing strokes and heart attacks.

A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that around 40% of women did not attend a visit with their medical provider after childbirth.

“It’s incredibly important that women attend their postpartum visit with their medical provider,” Dr. Neese said. “We actually call this the ‘fourth trimester,’ and during this visit we can look at any potential issues and set up additional exams as needed.”

Postpartum complications to watch for

The CDC’s Hear Her campaign lists symptoms women and their families should look for up to a year after childbirth:

• Severe headache that won’t go away or gets worse
• Dizziness and/or fainting
• Vision changes such as seeing spots or blurred vision
• Fever over 100.4 degrees Fahrenheit
• Swelling in hands that makes it hard for you to bend fingers; swelling in face that makes it hard to open your eyes or your lips and mouth are swollen
• Swelling or pain in your leg that may be red, swollen or warm. You may or may not be able to stand or walk.
• Thinking about hurting yourself or your baby
• Trouble breathing or tightness in chest and/or throat
• Chest pain in the center of your chest or that travels to your back, neck or arm
• Fast heartbeat
• Throwing up (more than you would during morning sickness) and unable to drink anything for more than eight hours or eat anything for more than 24 hours
• Sharp and/or sudden stomach pain that gets worse or doesn’t go away
• Vaginal bleeding or discharge
• Extreme tiredness that may come on suddenly