CHAPEL HILL, NC– An interdisciplinary team at the University of North Carolina at Chapel Hill has been approved for a Eugene Washington PCORI Engagement Award by the Patient-Centered Outcomes Research Institute (PCORI) to define unmet patient-centered health care needs in what is known as the “fourth trimester,” the three months after a mother gives birth.

The goal of the 4th Trimester Project is to bring together mothers, health care providers, and other stakeholders to define unmet health care needs during the fourth trimester.

Lead investigators of the project are Sarah Verbiest, Dr.PH., clinical associate professor in the School of Social Work and executive director of the Center for Maternal and Infant Health in the UNC School of Medicine; Alison Stuebe, M.D., M.Sc, associate professor of maternal-fetal medicine at the Department of Obstetrics and Gynecology in the UNC School of Medicine and Distinguished Scholar of Infant and Young Child Feeding in the Gillings School of Global Public Health; and Kristin Tully, Ph.D., research associate at the Carolina Global Breastfeeding Institute in the Department of Maternal and Child Health in the Gillings School of Global Public Health.

“The postpartum period is a critical time for women’s health and well-being, however, until recently, new mothers’ needs have largely been neglected. While newborn care and wellness is important, we know that mother’s health is important for the whole family. The opportunity to build partnerships with women and fully engage their voices and experiences is exciting,” said Verbiest.

In the weeks following delivery, a woman must recover from childbirth, adapt to changing hormones and learn to feed and care for her newborn. During this fourth trimester many women experience considerable challenges, including fatigue, pain, breastfeeding difficulties, depression, lack of sexual desire and incontinence. Amid these concerns, postpartum care is often fragmented among maternal and pediatric providers, and 20-to-40 percent of women do not attend a postpartum visit. Rising maternal mortality and morbidity in the U.S. have made this work an even greater priority.

The research team’s goal is to bring together mothers, health care providers and other stakeholders to define what families need most during the fourth trimester. The 4th Trimester Project will engage stakeholders around these issues for two in-person meetings, interim webinars and online discussions. The first meeting will be held in March in Chapel Hill, N.C., immediately following the Breastfeeding and Feminism 2016 Conference March 20-22, 2016.

Based on the unmet health priorities that stakeholders identify, the team will design research studies to deliver optimal care during this critical period, improving outcomes for mothers, infants and families.

"In standard maternity care, we see a mom weekly in the month before her due date – and then, once the baby is out, we wish her luck and see her in six weeks," Stuebe said. "Every mother deserves comprehensive support to recover from birth and develop the confidence to feed and care for her baby. With this project, we will partner with mothers to find out what support would enable them to grow thriving families."

The project is part of a portfolio of projects approved for PCORI funding to help develop a skilled community of patients and other stakeholders from across the entire healthcare enterprise and to involve them meaningfully in every aspect of PCORI’s work.

“This project was selected for Engagement Award funding not only for its commitment to engaging patients and other stakeholders, but also for its potential to increase the usefulness and trustworthiness of the information we produce and facilitate its dissemination and uptake,” said Jean Slutsky, PCORI’s Chief Engagement and Dissemination Officer. “We look forward to following the project’s progress and working with UNC to share the results.”

UNC-Chapel Hill’s project and the other projects approved for funding by the PCORI Engagement Award Program were selected through a highly competitive review process in which applications were assessed for their ability to meet PCORI’s engagement goals and objectives, as well as program criteria. For more information about PCORI’s funding to support engagement efforts, visit

PCORI is an independent, non-profit organization authorized by Congress in 2010 to fund comparative effectiveness research that will provide patients, their caregivers, and clinicians with the evidence needed to make better-informed health and healthcare decisions. PCORI is committed to seeking input from a broad range of stakeholders to guide its work.

Other co-investigators of the project include Ben Goodman, research scientist at the Center for Child and Family Policy at Duke University and co-director of Durham Connects/Family Connects; Miriam Labbok, director of the Carolina Global Breastfeeding Institute and Professor of the Practice of Public Health in the Gillings School of Global Public Health; and Monica Simpson, executive director of SisterSong Women of Color Reproductive Justice Collective.


4th Trimester Project contacts:

Alison Stuebe, 919-966-1601, [email protected]

Kristin Tully, 919-962-1538, [email protected]

Sarah Verbiest, 919.843.7865, [email protected]


UNC School of Medicine contact: Courtney Mitchell, 919-843-4927, [email protected]

Gillings School of Global Public Health Contact: David Pesci, 919-962-2600, [email protected]

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