closing the gap

4th Trimester Resource Center

a focus on physical and mental wellness

New Addition!
Family Birthing Place

The 4th Trimester Resource Center provides focused attention on mothers and infants during the postpartum period for timely education, care and assistance. As an extension of the KVH Family Birthing Place, the 4thTRC works in coordination with care providers and community partners in service of postpartum families.

509.933.7593 /

Follow Through Care

You have trusted us to care for your family prenatally and through labor and delivery. We are committed to continuing to serve your family as you transition into your 4th Trimester.

What is the 4th Trimester?

The 4th trimester is the transitional period between birth and 12 weeks postpartum. This is a time of intense physical and emotional adjustment for the mother-infant dyad and the family.

Mother-Child Dyad?

The term dyad simply refers to a pair of individuals. Combining the care of the mother and infant improves outcomes and provides more opportunity for support. When caring for the mother-infant dyad, we consider the two of you as one, your baby as an extension of you. Your wellbeing is a critical component of your infant’s health.

What does “closing the gap” mean?

Intensive focus on women’s health prenatally is at times unbalanced with infrequent contact postpartum. Our intention is to expand support for your physical and emotional wellbeing during your 4th trimester. We will help close the gap by building relationships with families and increasing contact with follow-through care.

We Need Your Help

Relationships are a two way street. We are committed to being a trusted resource for your family. We will reach out to you but please don’t hesitate to contact us if you need support, a referral, or even just someone to listen. We are here for you.

mother and baby, post partum black and white photo

while we typically define the postpartum period as the first 12 weeks after birth, the whole first year is a high-risk time for new mothers. This is especially true if you had complications during pregnancy or delivery.

— Dr. Angelica Glover
Fellow of the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine

Powered by the nurses of AWHONN, Healthy Mom&Baby magazine and website is nurse-expert-authored health and wellness advice, from preconception and pregnancy to labor, birth and parenting.

Lactation Support

We are proud to provide lactation support free of charge as a public health service to the families in our community. Our goal is that every mother has the information and support she needs to feel confident feeding her new baby.

To schedule a consultation with an International Board Certified Lactation Consultant (IBCLC) contact Lactation Services at 509-962-7388.

Local Resources


When will I be seen at the 4thTRC?

You will be scheduled for an in-person follow-through appointment at the 4thTRC after you are discharged from the Family Birthing Place. Timing of this appointment may vary. This appointment will not replace scheduled postpartum visits with your OB provider.

Telephone contact will extend through the 4th trimester.

When will I see my provider?

Scheduled visits with your OB provider will occur at two weeks and six weeks postpartum. The timing and frequency of these appointments may vary depending on your individual needs.

Your newborn will be seen frequently to assess growth and wellbeing.

Are these services available before I deliver?

KVH offers a range of childbirth and family preparation classes including education for new and experienced parents, siblings and grandparents, and individualized consultations. All classes are offered virtually. Click here to register.

Does this service cost anything?

No, we are proud to provide 4th trimester follow-through care free of charge as a public health service to the families in our community.

Can I receive these services if I didn’t have my baby at KVH?

Yes, your provider may give you a referral to receive care at the 4thTRC.

What are the hours of the 4thTRC?

The 4thTRC is open for calls or scheduled appointments Saturday-Wednesday. Hours may vary.

Warning Signs

when to get help

“A woman knows her body. Listening and acting upon her concerns during or after pregnancy could save her life.”

— Dr. Wanda Barfield, Director of CDC’s Division of Reproductive Health

Maternal Warning Signs / when to get help

If at any time you are experiencing a new or unusual symptom or have any concerns, please call your healthcare provider.

These POST-Birth Warning Signs were developed to help you quickly identify when you need to seek immediate care.

Call 911 if you have:

  • Pain in chest
  • Obstructed breathing or shortness of breath
  • Seizures
  • Thoughts of hurting yourself or your baby

Call your health care provider if you have:

  • Bleeding, soaking through one pad/hour, or blood clots the size of an egg or larger
  • Incision that is not healing
  • Red or swollen leg that is painful or warm to touch
  • Temperature of 100.4° F or higher
  • Headache that does not get better even after taking medication, or bad headache with vision changes

Newborn Warning Signs / when to get help

If you have questions or concerns do not hesitate to call your baby’s healthcare provider.

Even experienced parents may feel worried as they adjust to a new baby’s habits, needs, and personality.

Call 911 if your baby has:

  • Blue lip color
  • Difficulty breathing or turning blue

Contact your healthcare provider if your baby has any of these signs or symptoms:

  • Temperature below 97.5º F or above 100.4º F
  • Yellowing of the skin or eyes
  • Eating poorly or refusing to eat
  • Repeated vomiting
  • No wet diaper for 12 hours
  • No stool for 48 hours
  • Low energy or hard to wake up
  • Changes in typical behavior
  • An unusual or high-pitched cry
  • An uncommon or severe rash
  • Patches of white found in your baby’s mouth
  • Redness, drainage or foul odor from the umbilical cord
  • Frequent bowel movements with excess fluid, mucus or unusually foul odor
  • Signs of dehydration: Dry or cracked lips, Dry skin, Dry or rough tongue, Increased sleepiness or irritability

Postpartum & Mood Disorders

“Parents of every culture, age, income level and race can develop perinatal mood and anxiety disorders. Symptoms can appear any time during pregnancy and the first 12 months after childbirth. There are effective and well-researched treatment options to help you recover. Although the term “postpartum depression” is most often used, there are actually several forms of illness that parents may experience.”

Postpartum Support International

It’s estimated that 85% of women experience baby blues, the emotional ups and downs that can come with the transition to parenting. Common symptoms experienced by postpartum families are irritability, moodiness, anxiety, tearfulness, trouble sleeping, and poor concentration. Bringing a baby home, learning their rhythms, discovering your new routines can feel overwhelming in the first few weeks. It is a major life adjustment whether this is your first or fifth baby.

At times these feelings are persistent and you may not quite feel like yourself. Postpartum depression or anxiety affects up to 20% of mothers and up to 10% of fathers. It is the most common complication of pregnancy and birth.

How Are You?

Here are a few questions you can ask yourself to see if it may be time to reach out to your healthcare provider for support.


If you have had ANY thoughts of harming yourself or your baby, or if you are having hallucinations, please call your healthcare provider or 911 immediately or go to the nearest emergency room.

Postpartum Support International is an organization that connects mothers and their partners to mental health providers all over the world. They host online support meetings that help you connect with other parents, talk about your experience, and learn helpful tools and resources.

You are not alone and you are not to blame. Help is available. You will get better.

Helpline 1-800-944-4773

Text in English 800-944-4773

Text en Español 971-203-7773

Perinatal Support Washington is a network of parents and professionals who specialize in supporting people throughout the reproductive period. They offer a variety of services that are specifically designed for you from short term referral services, peer support, and more formal services such as an online therapy program.

Helpline  1-800-662-4357

Text HELP4U to 435748

SAMHSA provides suicide prevention information and other helpful resources to behavioral health professionals, the general public, and people at risk.

National Child & Maternal Health Education Program

Pregnancy can be an exciting time in a woman’s life, but it can also bring challenges. Many women experience the baby blues after giving birth, and some women develop symptoms of depression that are more intense, long lasting, and can interfere with daily activities. Mothers with depression feel sad, hopeless, and have little interest in doing things they once enjoyed.

National Crisis Text Line

Text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.

National Suicide Prevention Lifeline

Call for yourself or someone you care about; free and confidential; network of more than 140 crisis centers nationwide; available 24/7