The Fourth Trimester

Abstract

This Article introduces a new conceptual framework to the legal literature on pregnancy and pregnancy discrimination: the fourth trimester. The concept of a fourth trimester, drawn from maternal nursing and midwifery, refers to the crucial three to six month period after birth when many of the physical, psychological, emotional, and social effects of pregnancy continue. Giving this concept legal relevance extends the scope of pregnancy beyond the narrow period defined by conception, gestation, and birth and acknowledges that pregnancy is a relational process, not an individual event. In the United States, however, antidiscrimination law has failed to acknowledge the demands of the fourth trimester; it operates from the presumption that pregnancy begins at conception and ends at birth. Without employing a fourth trimester framework, the current federal antidiscrimination regime will continue to permit pregnancy discrimination against women because employers can discriminate on the basis of activities that typify the fourth trimester of the pregnancy. Judges, administrative actors, movement lawyers, and other policy makers should recognize that the law should prohibit discrimination on the basis of fourth trimester activities like breastfeeding, caring for newborn infants, or recovery. As a matter of law and policy, discrimination arising from these activities during the fourth trimester should be regarded as pregnancy discrimination.

Women’s Choice of Immediate Postpartum Reversible Contraceptives Visiting a Tertiary Hospital of Nepal

“…1 It is also termed as 4th stage of labor, 4th trimester, puerperium, immediate postpartum period or puerperal period. 2,3 Conception is possible during the artificially defined 6 weeks puerperium due to different factors i.e. uncertain ovulation and menstruation date; infrequent/ improper/ no breast feeding patterns, no use of contraception, etc.…”

Women's views on postnatal care from a midwife who has not provided their pregnancy and birth care: Implications for midwifery relationships

“…The fourth trimester is discussed, acknowledged and recognition of it encouraged in many areas in recent literature (Bick et al, 2020;Hamilton et al, 2018;Knight et al, 2021, Montogomery & Laury, 2019Stube et al, 2021;Tully et al, 2017) and is discussed in greater detail in the discussion chapter of this thesis. There are a plethora of definitions of the fourth trimester but it is generally accepted that it relates to the three-to-six-month period after the birth of a child (Matambanadzo, 2014) although this is debated in some studies (Bick et al, 2020;Knight et al, 2021;Stube et al, 2021). Postnatal midwifery care in many countries ends around six weeks after the birth and certainly in New Zealand this is described in the Decision Points for Midwifery Care as "six weeks or final postnatal; this timing provides for the completion of the midwifery relationship and feedback about the care given" (NZCOM, 2015, p.47).…”