# Fourth Trimester-A Web-based Tool For Postpartum Care To Address The needs Of Underserved Women

> **NIH NIH R43** · ORANGE SQUARE DESIGN, INC. · 2020 · $168,215

## Abstract

PROJECT SUMMARY/ABSTRACT
The postpartum period is a critical time, and more than half of all maternal deaths occur postpartum. Black
women are 3-4 times more likely than white women to experience maternal mortality. In the US, 1 in 4 women
do not have a timely postpartum visit, and adherence is even lower for women on Medicaid managed care
plans. Our Parent Grant (R43MD014923) was funded to develop a program that educates and supports
mothers in the ‘fourth trimester’, to address the physical, cultural, and knowledge barriers to quality postpartum
care. The COVID-19 crisis presents novel health and economic challenges for this vulnerable population.
Because of the myriad challenges COVID-19 presents, and the ways in which it will transform postpartum care,
it is our responsibility to revise the scope of our project to address COVID-19 in our research and to add
features to the tool we are building to address immediate concerns and needs related to this crisis. The
challenges of the current pandemic will have a lasting impact for minority and economically at-risk populations
because fundamental health disparities persist, further inhibiting already limited access to timely and
appropriate care. Racial and ethnic minority women are more likely to have gaps in health insurance coverage,
a situation further complicated by the higher proportion of unemployment during the pandemic and ensuing
economic crisis. In addition, there are over 30 million small businesses in the US hard hit by this dual crisis –
many of which are in the healthcare sector. They are critical for providing services to this vulnerable population
and are most at risk of losing their businesses during times of economic instability. Research focused on the
concerns, needs, and health of underserved women, and the development of digital tools to reduce gaps in
care which specifically address barriers exacerbated by COVID-19, are essential to protect the health of
mothers and their babies. Our strong relationships with community groups and healthcare providers, and
support of the RI Department of Health, Brown University, Goldman Sachs 10KSB, and Social Enterprise
Greenhouse, enable us to immediately begin to broaden our scope to learn more about the COVID-19 impact
on underserved women and the provider community that supports them. We propose to expand our scope to: •
conduct qualitative research activities to obtain specific input regarding the COVID-19 pandemic and economic
crisis from pregnant and recently postpartum women and conduct interviews with the healthcare support
network during the COVID-19 crisis; • expand the scope of the prototype to include specific content responding
to feedback on needs related to COVID-19; and • systematically assess the impact of the prototype on key
health outcome measures through a modest pilot study. We will focus on resilience as a key outcome and will
measure related factors such as depression, anxiety, healthcare utilization, and postpartum ...

## Key facts

- **NIH application ID:** 10161246
- **Project number:** 3R43MD014923-01S1
- **Recipient organization:** ORANGE SQUARE DESIGN, INC.
- **Principal Investigator:** Lisa D Marceau
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $168,215
- **Award type:** 3
- **Project period:** 2019-09-23 → 2021-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10161246

## Citation

> US National Institutes of Health, RePORTER application 10161246, Fourth Trimester-A Web-based Tool For Postpartum Care To Address The needs Of Underserved Women (3R43MD014923-01S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10161246. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*