A survival guide to the fourth trimester

What is the fourth trimester?

We hear a lot about the three trimesters of pregnancy but women and their partners are not prepared for the critical time period that desperately needs our attention: the fourth trimester.

The fourth trimester is the first 3–4 months after birth where parents are finding their feet and baby is adapting to life earthside. It’s a time of great physical and emotional change as your baby adjusts to being outside the womb, and you adjust to your new life as a mum. This transition period is a time of great upheaval for the whole family and it’s important to be kind to yourself as you find your way through this phase.

It’s essential to think of this period as a continuation of your pregnancy. During pregnancy we are kinder to our bodies, we listen more to what it’s telling us, we nourish our bodies better, we slow down and rest when we need to (or when we can) and take care of ourselves. In the fourth trimester we should continue to do this. Our body needs time to heal, we need to adjust to a new sleep pattern, our emotions need time to regulate, and we need time to learn our new role as a parent.

Our babies are also adapting to the crazy shift they must endure when they arrive earthside. These first 3-4 months are a transition period for them. Their whole world, everything they’ve ever known has disappeared. So, the fourth trimester is really a period your baby needs their parent’s empathy, understanding and bodies to help them adjust to their new reality.

Babies in their fourth trimester

Human babies are born relatively immature. Compared to almost all other mammals whose babies are born and a few hours later walk away from them, our little ones are neurologically and physically dependent on their caregivers.

Consider this:

In utero babies experiences a very different world. It’s a soft, warm, dark and confined space. They know where the boundaries of their world are, and they’re in constant contact with their mother’s body – a noisy place with a soundtrack of heartbeat bowel sounds and voice throughout the day. Her body is never still for long, so the baby is moved and rocked within it.  A baby in the womb is never hungry or thirsty as they’re being fed through the placenta 24/7. They’re naked and in a pool of water so the sensory input on the skin is very mild, in fact the constant sensory input varies very little day to day.

Once born, the outside world is a sensory assault on their bodies. It’s bright, with very loud sharp noises and it feels big. They have no idea where their world ends. There is air on their skin, and they are clothed. They experience temperature fluctuations and different smells. They now must signal to someone else to have their nutritional and thirst needs met as hunger is now something they experience. They are held far less, and they have less movement daily than they did. They are placed on surfaces that are hard and cold and their sensory input is ever-changing and varied day to day.

Is it any wonder that they sometimes take a few months to adjust?  The fourth trimester is their transition period, their adjustment period. As parents, our role is to provide a bridge to support them as they adjust. This will look different for every family and every baby, but the premise is the same. We aim to give them back some of their old world:

  • By swaddling we provide them boundaries
  • By bathing we give them back the warmth and the water
  • By rocking, walking or car rides we give them movement
  • By providing white noise we replace that soundtrack
  • By baby-led feeding we ensure their nutritional and fluid requirements are met
  • By doing skin to skin we are again holding them, giving them warmth, a heartbeat and our breathing moves them (this can also be said for babywearing).

Having a few ideas like these in your toolbox may help reduce the length of baby’s unsettled periods and make that fourth trimester just a little easier on you all.

What can I expect in the fourth trimester?

Becoming a parent is a transformative and acutely vulnerable time. Not only have you birthed a baby, but you have also birthed a mother and a family, what an amazing thing! There are social and psychological changes that happen as you find your way through the first few months, discover what being a parent means to you and discover what your new role involves. It demands a heavy emotional and physical toll at times. No matter how you birthed, you are healing. If you are breastfeeding, you may find you are struggling to find your rhythm which can be stressful and tiring.

In the first few months we can see an increase in depressive symptoms and anxiety in both partners. There are sometimes strain in relationships as you both adapt and learn what your new role involves and the disruption to sleep that comes with a newborn baby places further pressure on mental health and relationships.

What you expected being a mother would look and feel like sometimes doesn’t match up with reality and sometimes that can take time to process. I often hear people tell me “Enjoy every moment,” and I fight hard not to role my eyes. You are going to find parts of parenting hard to like, let alone enjoy – and that’s ok. But during this fourth trimester it is important to be kind to yourself and let go of expectations.

So, what can we do to make this transition easier on ourselves?

  • Ask for help and utilise your support networks.
  • Make a list of things that you feel will make the transition period easier. Things like household chores, meal drop-offs, wrangling other children and looking after the new baby while you catch up on much-needed sleep.
  • If someone offers help take them up on it.

Jemma’s story is a great example of asking for help.

Make sure that you are prioritising your sleep wherever and whenever you can. Broken sleep can impede physical healing, and negatively impact mental health and relationships. Even the hardest day parenting is a little more manageable with a decent amount of sleep behind you.

Maintain good nutrition. Healing needs good nutrition, and your body just runs better with good fuel. So, during the fourth trimester make a concerted effort to nourish your body (and if breastfeeding, your baby) properly.

Self-care is not selfish, it is in fact essential. Take time to do some gentle exercise as you heal, make time to maintain social relationships and absolutely set aside time to do what you love.

Above all remember you are not alone; you are doing a great job and if you need more support chat to your GP or child health nurse.

One for Women offers comprehensive postnatal support with our team of GPs, lactation consultants, women’s health physiotherapists, early childhood program and dietetics. To find out more, contact us.

If you are struggling with your mental health at any time throughout this journey PANDA is also available on 1300 726 306 for perinatal mental health support.

Blog written by Lauren Hughes. Lauren is part of the Child Health Team at One for Women and is also a qualified midwife. She feels strongly about the support and continuity of care that One for Women, and her role as a Child Health Nurse provides to new mums. 

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