{
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  "id": "maternal:bottleneck-fourth-trimester-care-gap",
  "owner": "maternal",
  "kind": "bottleneck",
  "slug": "bottleneck-fourth-trimester-care-gap",
  "name": "Care thins out in the weeks after birth",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "A 2017 report says the strong focus on women's health during pregnancy is not matched by care after birth, which comes late and rarely. It says that for most American women no follow-up is scheduled until 6 weeks, that this visit is poorly attended, and that many new mothers feel unprepared for common health problems and do not know whom to call.",
  "summary_technical": "Evidence is the abstract of a 2017 AJOG report by the 4th Trimester Project: background statements about the gap before the six-week visit and poor attendance at it, and four themes from 87 participants at a March 2016 meeting. These are opinions and background claims, not measured attendance or outcomes, and they are about the United States. Current efforts are not listed because none was read for this record.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "postpartum"
      ],
      "care-area": [
        "postpartum-recovery"
      ]
    }
  },
  "payload": {
    "stage": "The weeks between birth and the late postpartum visit",
    "scope": "Mothers in the United States in the first weeks after birth, as described by one 2017 stakeholder meeting report.",
    "severity_rationale": "The report calls the period a critical transition with unmet maternal health needs (its title); the abstract gives no figures for harm.",
    "burden_claims": [
      "maternal:claim-fourth-trimester-care-gap"
    ],
    "current_efforts": []
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  "claims": [
    {
      "release_id": "c7fb95f1d15a7d13",
      "id": "maternal:claim-fourth-trimester-care-gap",
      "owner": "maternal",
      "subject_entity_id": "maternal:bottleneck-fourth-trimester-care-gap",
      "category": "burden",
      "statement": "The abstract of a 2017 report from the 4th Trimester Project says that most American women are not scheduled for any follow-up care until six weeks after childbirth and that this visit is poorly attended, and that many new mothers feel unprepared for common health problems and do not know whom to contact. The report comes from a meeting of 87 individuals in Chapel Hill, North Carolina, in March 2016, which named four topic areas: heavy attention to women's health before birth is not matched by postpartum care, which is infrequent and late; clinical guidelines often do not fit women's real experiences and constraints; women need to be recognised as experts on their infants, with their strengths as mothers affirmed; and mothers need comprehensive care, which system constraints make hard to provide.",
      "context": {
        "id": "maternal:ctx-fourth-trimester-meeting-87-stakeholders",
        "label": "Participants in the 4th Trimester Project meeting, Chapel Hill, North Carolina, March 2016",
        "recipient": "maternal",
        "population": "Eighty-seven individuals, including mothers, health care providers and other stakeholders, who convened in March 2016 in Chapel Hill, North Carolina, to look at what families need most between birth and 12 weeks postpartum. The statements are the themes that emerged at this meeting plus background statements in the abstract, not measured outcomes in a sample of mothers.",
        "care_setting": "Not applicable: a stakeholder meeting",
        "geography": "United States (meeting in Chapel Hill, North Carolina; the abstract speaks of American women)",
        "life_stage_note": "Birth to 12 weeks postpartum",
        "life_stage_terms": {
          "maternal": [
            "postpartum"
          ]
        },
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "A single meeting in March 2016",
        "eligibility": {
          "inclusion": [
            "Individuals convened by the 4th Trimester Project"
          ],
          "exclusion": [
            "Not stated in the PubMed abstract"
          ]
        }
      },
      "evidence_stage": "observational",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "The first two statements are background statements in the abstract without their own source, and the four topic areas are the views that emerged among 87 attendees at one meeting, not measurements. The abstract gives no figures for attendance at the 6-week visit. The report describes the United States and may not apply elsewhere. Only the PubMed abstract was read.",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
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