The Fourth Trimester- Advice and Information
What is the fourth trimester?
The fourth trimester is the term coined for the first few months following the birth of a baby. Most mammals are born able to walk and be self-sufficient in some ways- humans are not. This is because if humans gestated to that point of development they would be too big for their mothers to birth! The fully developed human brain takes up a LOT of space, and the narrowing of human hips over time due to walking upright, combined with the increased size of our skulls and brains means that a baby has to be relatively underdeveloped at birth. It’s also partially why our skulls aren’t fully fused at birth, both to make the birth process easier and to accommodate the rapid brain growth in the first few years of life. Our brains practically double in size from birth through toddlerhood. Even an episiotomy couldn’t help with that! Because of this, human babies are born virtually helpless, entirely dependent on their mom for survival. On top of having a brand new person who needs them for everything, new moms are also recovering from a monumental change both physically and mentally. The placenta detaching from the uterine wall leaves a massive wound that takes weeks to heal. The skin is stretched, and contractions continue after the baby is born to help the uterus return to its normal size. Everything is sore, you’re exhausted, and often also trying to feed this new baby which can be uncomfortable, even painful, and downright exhausting. On top of this, there’s often a parade of people who want to come to meet the baby (who wouldn’t, babies are adorable!) and the mom usually feels immense pressure to host and be “on” when all she really wants to do is close her eyes and rest. It’s stressful! There are also the huge changes in hormones post-birth that can significantly affect mood, and the shift in routine and trying to establish some semblance of normal with a new person in the family who has borderline constant needs. The fourth trimester is a pivotal time for mom and baby to bond, and the baby is often most comforted by recreating the feeling of being in the womb. This means swaddling, movement, humming or heartbeat noises, and being close to momma as much as possible, preferably skin to skin. On top of all the things a new mom is already trying to do, she is also biologically driven to be close to her child. In other parts of the world, in the first months after a baby is born other people take over a majority of the mom’s responsibilities so she can focus on recovering and bonding with her new baby. Meanwhile, we largely expect mothers to return to normal once they’re home from the hospital. For moms, their health during this period is largely neglected. There’s the 6-week check, and some places do a 3-week check, but otherwise, most women are simply sent home with a pamphlet that says to look for warning signs of postpartum depression and call if there's an abnormal amount of bleeding. This is a stark contrast from how closely you are followed in the final part of pregnancy and can leave a lot of people thinking that once the baby is born mom should be back to business as usual in a few days. This is completely unrealistic, no matter how the baby enters the world. Another hallmark of the fourth trimester is that at some point mom will almost certainly feel what is referred to as “baby blues”. It’s an intense drop in mood caused by shifting hormones, and while it’s normal it's also very scary to experience. I remember crying for 12 hours straight when my daughter was about a week old with no real idea why and being scared something was wrong with me. I almost called the nurse line! I just couldn’t stop crying. I had no idea that was normal as long as the feeling went away! So, what do mom and baby really need during this period when their main focus should be creating a connection and healing together? How can we help facilitate a smooth recovery for mom and baby? We broke it down below.
For Moms
You did it! You brought an actual life into this world. You will never be the same, and that’s a good thing! You aren’t the first and you won’t be the last woman to undertake this journey, so we’ve compiled a list of tips from veteran moms for new moms on how to best take care of yourself, what to do and what to let go of.
Your baby, your rules. Don’t be afraid to set boundaries and ask for what you need
What your baby needs most is you- there’s no ‘right’ way to do things
It’s okay to be tired, or want a break. That’s normal and you're not a bad mom
“No” is a complete sentence
If you can’t rest when the baby does, that’s okay. Try to carve out some time when you are able to get sleep
If you can hire a postpartum doula you should- they’re amazing
Accept help when it’s offered
Your brain might lie to you and tell you you’re failing- you’re not. It’s supposed to be hard and you are so much more capable than you realize
Ignore the people insisting you need a routine right away- it’s more stressful to try and make a newborn adhere to a routine than to go with the flow
Get outside when you can- it helps
Ice pads and dermoplast are really great for the pain and soreness after birth
Anxiety and fear are normal, they will get better, but if it’s impairing your functioning you should call your doctor to discuss
Trust your gut- if you think something feels off, schedule an appointment before your 6-week check
Google can be great, but don’t end up doom scrolling through people’s horror stories or worst-case scenarios. If research is making you more anxious, step back
Warm baths with baking soda can help promote healing, and if you’re sore it just feels nice
Do your best to eat and drink. If you’re breastfeeding, it will make the process easier, and if you’re not your body still needs fuel! It will help with your mood and speed your healing to make sure you have adequate nutrition. Ensures can be a great resource if drinking one for breakfast or snacks is an easier way to get things in!
A maternity belly band (like the one you put over jeans once they stop buttoning) can help with the uncomfortable feeling of your belly being empty but still in the way, particularly when trying to sleep on your side
There is no “right” way to feel. For some moms, there’s an instant connection with the baby, and for some, it takes a bit of time. Both are normal! If you’re worried you're not feeling emotions the way you should, like a kind of numbness, it’s worth asking your OB about, as sometimes that can happen. Generally, though, There’s a wide spectrum of emotion and reaction
There are a lot of methods out there for parenting, and the plain truth is that they can all be right depending on the family! Use what techniques feel best for you, and don’t worry if your style isn’t the same as your friends. Be it co-sleeping, baby-led weaning, cry it out, or whatever other methods- no family is exactly the same
If you have no help cleaning, sometimes it can help to clean while you do other things so you don’t feel like you’re spending all your baby’s downtime cleaning. Sweep or wash a few bottles while you’re waiting for milk to warm up, or wipe things down while the baby does some tummy time in your view. You can let some things go, and it’s okay if your house isn’t in perfect order, but for some people having the mess around them is more stressful than trying to keep up with it
Don’t lose yourself in all the changes- it’s good to carve out time to do something you enjoy and to remind yourself of your identity outside of motherhood
For Partners
Congrats on your growing family! Sometimes partners can feel overlooked or worried that the baby will take their place in their significant other’s heart. That won’t happen- so there’s no need to fret. It is so important for you to be involved, supportive, and patient right now. You are probably looking for all the ways you can be most helpful now that the baby is here, to help your family bond and grow stronger. Look no further, we’ve got tips from moms right here.
Have the conversations about your expectations of each other in parenting BEFORE the baby is born. How will night feedings and diaper changes be split up? Who will make sure bottles are washed or clothes are laundered? Maybe you’ll have specific times where you are “on duty”. Make sure you both understand how you’re envisioning things will go BEFORE the baby arrives.
Don’t wait to be asked to help- offer. Offer to change a diaper or vacuum, or make dinner. Offer to take care of the baby so mom can shower. Don’t make her ask you, because it will start to make her feel guilty and needy. Better yet, just do the things instead.
Be patient and sensitive. Comments about her being hormonal or irrational are not helpful. She is in a lot of discomforts physically and emotionally and she needs you to be kind and supportive.
If you’re not sure how something should be done, just ask. Either she will have an idea already or you can solve the problem together.
Don’t ask her “are you thinking of hurting the baby” any time she confides that she is sad or anxious. It will make her feel terrible and send the message that her feelings only matter if they will affect the baby. If you are genuinely concerned this is a possibility, ask about her mental state in a different way such as, “What is on your mind?” or “Have you had any thoughts that scare you?” Most cases of postpartum depression do not lead to postpartum psychosis in which the mother hurts her child. That is INCREDIBLY rare, and while it is important to look out for, the fear that people will assume she might hurt her baby could prevent a mom from expressing that she is struggling
Don’t comment on her body, at all. She is well aware of how it looks, and it is really disconcerting and uncomfortable adjusting to living in an unfamiliar body, even if it’s normal
Be sure to notice all the things she does and tell her when you’re feeling amazed by her. A lot of partners find seeing a mom with a baby fills them with a whole new kind of love for her, and watching her have the baby leaves them in awe. Tell her these things! Right now she is sensitive and your support and encouragement are so, so important
Do little things to make her feel seen- run her a bath, surprise her with her favorite candy, do her least favorite chore. Small things to brighten her day make all the difference.
Advocate for her. If you know she doesn’t want visitors and you’ve got family being pushy, be the one to tell them your boundaries. If you know she wants people to wash their hands before they hold the baby, make sure that happens. During delivery, know her wishes so you can help advocate for her- labor is vulnerable and intense and you having her back will help so much.
For Loves Ones
A new baby in the family is a super exciting event for everyone, and most loved ones are eager to help however they can! Every mom is different, so what they need most can vary too, but we compiled ideas, thoughts, and tips from real moms to give you a starting point so you can be a real resource for the new parents. Direct quotes will be in quotation marks.
“Don’t help with the expectation that you’re going to get baby time in return. If the baby is cranky or cluster feeding or finally asleep for the first time in hours we might not want to pass them off.”
“Make yourself useful and reassure the mom that you don’t expect her to cook or clean for your visit. It’s just too much for her to do at that point”
If the baby cries, make sure to offer them back to mom. It can be very anxiety-provoking for a new mom to hear their baby crying and not be actively soothing them.
Think before you offer advice. Even if it’s well-meaning, it can often come off like you don’t think they’re doing a good job.
Don’t just respond to them sharing their feelings by talking about someone else you know who had a baby. If they are talking to you and opening up, it’s important to validate their emotions and ask if they just want to vent or if they want help problem-solving.
Ask before you bring your own kids over. Kids are very high-energy, and it can be a lot to take in when you’re at home with a small baby. Some moms might be okay with it, especially if they have older kids, but always make sure to ask.
Respect boundaries and don’t take things personally. It’s very stressful as a new parent to know your loved ones are upset with you over a boundary you tried to set. Even if you’re disappointed or had something different in mind, it’s important to respect their wishes. If they don’t want hospital visitors, do not show up at the hospital. If they want a few days alone to adjust, let them do that. Don’t take offense to things like that. New parents are doing their best and they should be allowed to make decisions about when and where people will meet the baby.
“Watch how the parents take care of the baby and do things that way”. You may have put every one of your babies on their stomachs to sleep, and they may have been just fine, but if the parents want the baby placed on their back to sleep then that is what you need to do. Follow their lead. When they see that you are paying attention they will feel respected and loved, and much more likely to trust you with the baby. It’s a sure-fire way for mom to actually be able to relax!
Notice if something is wrong and ask if they need help
Do not comment on mom’s body at all, in any way
If mom is using a pacifier, don’t talk about how bad they are. If she’s bottle feeding, don’t say ‘breast is best. If she’s breastfeeding, don’t tell her to cover up. Being a mom is hard enough without all the unnecessary judgment
If your response to a mom not wanting to do something, or wanting to do it differently than you did is “we did it and we were fine”, it’s best to not say anything at all. Besides the fact that that statement is rooted in survivor bias, it is unhelpful and unsupportive to the new mom who is working so hard to be the best mother she can. Support her in how she chooses to raise her baby. Chances are she has done an extensive amount of research and painstakingly debated over how she wants to do things.
New babies are exciting for everyone involved. Something about the tiny bundle of potential and hope is captivating to all of us. When a baby is born, so is a mother, and that transition into a new stage of life is so full of joys and challenges- often at the same time. Did you learn something new from this article? We hope this information enables partners and loved ones to be supportive and helpful. We also hope new moms feel reassured, validated, and seen.
Be sure to check out the first part of this series, Postpartum Stories from Real Moms.