Marcia A. Cole and Nana Eyeson-Akiwowo, founders, Fourth Phase
Photo credit: Fourth Phase
For many expectant mothers, the period leading up to labor and delivery is among the most highly visible and celebrated times in their life. Marked by milestones like growing baby bumps, nursery registries and showers attended by family and friends, pregnancy is largely thought of by society as a time to rally around mothers-to-be with excitement, support and community. Sadly, this is not the case for many people.
Financial barriers to adequate prenatal care and resources present a serious threat, particularly to the world’s poorest mothers. Even in the United States, the maternal mortality rate is 17.4 deaths per 100,000 live births (as of 2018), and even higher for non-Hispanic Black mothers (37.3). Despite the pretty picture painted by baby showers and social media birth announcements, pregnancy is not always the joyous time many first-time moms anticipate. Adding to this unfortunate reality is the widespread stigma, confusion and lack of awareness surrounding the postpartum period. It’s this glaring gap in education and resources that Nana Eyeson-Akiwowo and Marcia A. Cole have set out to eradicate with their company, Fourth Phase.
Launched last year, Fourth Phase was created to help new mothers heal, feel and be heard. The Black-owned, woman-led company supports new moms globally who have given birth either vaginally or surgically with a curated Fourth Phase AfterBirth Box of certified organic, phthalate-free, cruelty-free, non-toxic and sustainably sourced products. Dependent on their delivery method, new mothers can choose between the Fourth Phase Vaginal Box and Belly Birth Box, each catered to the highest quality in physical and emotional postpartum care.
After her own difficult and horrific post-labor experience, Co-founder Nana Eyeson-Akiwowo saw firsthand the prevalence of “fourth trimester” ignorance. Giving birth as hospitals were reopening post Hurricane Sandy, she was standing in an elevator mid-contraction when a nurse dismissively asked, “can you hurry up?” Distracted by the stress and pain her body was enduring, Eyeson-Akiwowo relied on her husband to advocate on her behalf, demanding a new nurse. Thankfully, she delivered a healthy baby, but the impact of a less than supportive delivery experience had already made its mark.
A week after her delivery, complications continued. In the middle of her daughter’s naming ceremony, Eyeson-Akiwowo passed out and was rushed to the hospital. What she had been told by family members was normal postpartum bleeding actually turned out to be a life-threatening hemorrhage resulting from her delivery. Hospitalized and medicated for many days after the incident, she was unable to breastfeed her infant child, sparking a sadness she could not fully process. “It’s just a spiral of all of these emotions that you go through and you feel like you don’t have anyone to talk to,” says Eyeson-Akiwowo. “Even though my mom was there, she’s from a traditional space where women just deal…And I couldn’t get to the point where I could just deal.” Inspired by her own lived experience and frustration, Eyeson-Akiwowo then set out to create the answers she and other new mothers needed and deserved.
The concept behind Fourth Phase and the AfterBirth Box was born in 2018. Starting off as a curated box of other products already on the market, the brand vision evolved when Eyeson-Akiwowo teamed up with friend and former colleague, Marcia A. Cole. Both women are accomplished veterans in the publishing space, working for years as magazine and digital editors. Eyeson-Akiwowo and Cole are also founders of the nonprofit organizations, African Health Now and Passion Meets Purpose, respectively. Cole, who is also the CEO of media and marketing company, Ivy Digital, first began consulting on Fourth Phase as a friendly favor. After a strong pull to the project and mission, however, that favor quickly gave rise to a powerful partnership.
Cole’s zone of genius lies in creative spaces; identifying the white space to see what can be added, created or reinvented to disrupt industries in a way that benefits the consumer. Specifically, she has used her marketing and graphic design expertise to help design the Fourth Phase website, curate product names and images that carefully articulate the brand message. “We wanted to convey visually what that experience is like when a woman has her vaginal birth,” says Cole. “What that experience is like when she has a belly birth. [We are] very intentional around what type of imagery is being utilized. What story does the visual actually tell in addition to the choice of words?”
Her perfect counterpart, Eyeson-Akiwowo is the master of logistics and product testing. Starting off as a self-funded project, she took Fourth Phase from concept through branding, logo design and prototype development before receiving her first investment from a close friend and former intern. From there, she entered a pitching competition with hopes of winning a $10K investment. Investors in the room were so impressed with the concept and prototype that she ended up walking out with a $30K commitment in outside funding. From there, Eyeson-Akiwowo and Cole worked together to reimagine what was possible for Fourth Phase. Initially a collection of women-owned business products already on the market, they decided to make the jump to original product creation. What started off as just 3 products has since expanded to a line of 14: 12 Fourth Phase products, one collaboration product and one product by fellow woman-owned brand, Honey Pot.
For the Co-founders, Fourth Phase is bigger than products – it’s access, support and education about the “fourth trimester,” or the often-forgotten postpartum experience. “The fourth phase essentially refers to that 12 weeks to almost one year after a woman delivers,” explains Eyeson-Akiwowo. “When someone says the word ‘postpartum,’ [people] often think that the woman is depressed and [that] there is postpartum blues…That fourth trimester could include some sense of sadness, but it could also include just all of the things that are happening in her body. So, it’s just [the] not knowing. Why am I bleeding? Not understanding why my breasts feel this way; the emotional parts of it.” Cole adds, “I think [mothers] also need to know that some of those [pregnancy] conditions can carry over into the fourth phase. Preeclampsia doesn’t disappear once you have a child. You’re still at risk for having it during those first couple of weeks.”
Fourth Phase Box Products
Photo Credit: Fourth Phase
While Fourth Phase offers post-delivery support and care options for all mothers, the brand mission is also heavily informed by the founders’ specific experiences as Black women. “[There is] this ideology around Black women being strong,” says Eyeson-Akiwowo. “And so oftentimes, when Black women go to their health providers, their symptoms and/or concerns aren’t always taken seriously or given first priority. I think for Fourth Phase, what we want to do for women in general is advocate for women to say their truth, speak and be firm: ‘I know what’s happening with my body, and if this doctor won’t listen, I should be able to go to another doctor that will be able to help me, or find another kind of practitioner or healer.’” This same sentiment holds true for mothers around the world. In partnership with Eyeson-Akiwowo’s nonprofit African Health Now, Fourth Phase runs on a one-for-one program to benefit mothers in Sub-Saharan Africa. For every AfterBirth box that is sold in the United States, one is given to a woman in Africa as well as women in the U.S. experiencing homelessness.
In addition to the AfterBirth Box, Fourth Phase continues to lead the conversation on all things related to the postpartum experience. Through the company website, visitors are provided with real-life stories from new moms, as well as vetted advice from Doulas, Midwives and OBGYNs. By providing these resources, the founders hope to raise awareness among new and expectant mothers about the variety of support options available to them post-delivery. “[A new mother] needs a full team,” says Cole. “Family and friends are part of that team, but she needs a lactation specialist in case she is having trouble with breastfeeding. She needs a pelvic floor therapist in case something happened with her uterus and things drop. And she needs to be able to help that area of her body restore itself. She needs a postpartum doula who specifically would be there to help take care of her, help make sure that her family members, her partner and everyone [else] is on the same page.”
Eyeson-Akiwowo and Cole also aim to help shift the language surrounding these topics. In particular, they are especially passionate about changing the discussion behind surgical deliveries. “As former editors, we know how much words matter,” says Cole. “[We want to] create a space where we’re really clear about what postpartum means and add new terms like ‘belly birth’ into the lexicon so that it’s not just the C-section; it’s not just viewed as a surgical procedure that is very clinical and absent of heart.” Through subtle yet powerful details like this, Fourth Phase validates the experience of every individual mother and postpartum journey.
What advice do the Fourth Phase Co-founders have for new moms-to-be? Speak up – loudly. “Whenever you are feeling that your body is not behaving or responding in a way, be outspoken about that and ask more questions,” says Eyeson-Akiwowo. Ask your doctor what you can expect after delivery and how you should prepare. Ask if they have recommendations for a postpartum doula or a lactation specialist. Ask if you can have more than just that one visit, six weeks after delivery. As for loved ones of a new mother, pay close attention. “Really watch your friend, really watch your partner and notice the changes that happen in their behavior,” advises Cole. “If you know someone to be extremely luminous and [talkative] and they’re no longer that way, then something might be wrong…We’re not trained as a society to really watch someone’s performance. We blame their performance, we judge their performance, but we don’t actually watch and notice that, yes, something’s going on, and ask the question of “what’s happening with you? How can I support you?”
After nine months of research, product development, and targeted focus groups with new mothers, Fourth Phase is now a thriving brand and business spreading their mission of postpartum care worldwide. Perhaps their biggest feat was pulling it all off during the Covid-19 pandemic. In fact, Eyeson-Akiwowo and Cole – who live in different states – have not seen each other in person since 2018. Conducting all business via phone calls, Zoom sessions and Google meetings, the two credit their success to a strong shared vision, solid partnership and the convenience of technology. In addition to running Fourth Phase, both women continue their consulting businesses, nonprofit leadership and other entrepreneurial endeavors.
What’s next for Fourth Phase? The company plans to launch a blog as well as an afterbirth directory of doulas, midwives and other professionals who can help support women after they deliver, accessible via the Fourth Phase platform. They are also working on an app providing new mothers with downloadable affirmations, as well as new AfterBirth Box launches.
