ABSTRACT The United States has among the worst maternal outcomes of developed countries, which are disproportionately experienced by Black birthing people due to the intersections of racism, social determinants of health, and inadequate health care delivery. Racial disparities in severe maternal morbidity (SMM) and maternal mortality (MM) are particularly stark in Pittsburgh and surrounding Allegheny County, where Black birthing people are more likely to die from pregnancy-related causes than in 97% of comparable cities. Notably, 80% of maternal deaths can be prevented, and 65% of maternal deaths occur in the postpartum period, which underscores why postpartum clinical care is critical to reduce maternal mortality. Current models of postpartum care are limited by: 1) gaps in health care delivery at the very timepoints at which people are vulnerable to pregnancy-related death; 2) health care delivery frameworks that are not culturally sensitive and have not been developed with community feedback; and/or 3) social determinants of health (e.g., low income), which our formative work has found prevent some Black birthing people from attending postpartum clinic visits. If thoughtfully delivered, postpartum care may identify physical signs and symptoms among birthing people that signal impending pregnancy-related morbidity and mortality. In this project, we seek to develop a novel, equity- centered model of postpartum care to reduce SMM and MM among Black birthing people in our region. We will build upon an existing model of maternal health screening that is carried out at well-child visits, and integrate a newer model of postpartum care, the “Fourth Trimester,” which includes early maternal physical examinations and anthropometric screening at well-child visits. Using qualitative research methods, we will seek feedback from people who receive care from the current postpartum care model, as well as feedback from clinicians and staff to identify barriers and facilitators to postpartum care. Next, we will engage with partners from the Community and Training Cores of the Equity in Birth Outcomes and Reproductive Health through Community Engagement (EMBRACE) Center, to develop a community-informed model of postpartum care and to train health care providers to provide equitable, anti-racist, and anti-oppressive clinical care. Finally, we will implement the new model of postpartum care over a multi-year period in family planning clinics, to assess the satisfaction of Black birthing people, and clinical and implementation outcomes. We will also pilot a novel cash transfer intervention among a subset of these people, responding to prior research that suggests that financial constraints not only contribute to acute stress in the postpartum period, but also undermine engagement with postpartum healthcare. Our objective is for our new model of equity-centered postpartum care to be scalable to other health settings, and for our development process to serve as a blu...