When Hafsa, a What to Expect Community mom, had a baby, she was struggling to navigate the ups and downs of postpartum life as a working mom."From sleepless nights to emotional rollercoasters, I’m learning to find little moments of peace and strength each day," she writes. "I’d love to connect with others who understand these struggles and share tips on how to cope…"
Hafsa isn't alone in wanting to learn more about the postpartum period, otherwise known as the 4th trimester, which can also be explained as that hazy period where you’re recovering from pregnancy and delivery while simultaneously learning how to be a mom as your baby adjusts to life outside the womb.
Other moms in the Community also write about the adjustments they are going through with their newborns, too. "My baby wouldn’t sleep unless she was being held. We ended up with an arrangement where my partner would stay up with her until 4 a.m. and then we would switch," she writes. "I survived on tea, chocolate and Parks and Rec. It wasn’t easy, but at the same time, those moments of being alone with my sleeping baby were so special."
From hormonal changes, breastfeeding learnings and major changes to your regular sleep habits, there's a lot that goes on in the 4th trimester.
Here’s a look at what you and your little one may be going through, how to feel your best and when life will start to look a little more normal again.
The 4th trimester includes those first three months after childbirth, when you're experiencing physical, emotional and psychological transitions.
Your baby is adjusting to life outside the womb, while you are recovering from birth and adjusting to your new role.
Asking for help, prioritizing rest and nutrition, attending postpartum checkups and connecting with other new moms can make the 4th trimester more manageable.
What is the 4th trimester?
The fourth trimester (more commonly written as the "4th trimester") describes the postpartum period starting from your baby's birth until they turn 3 months old.
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The term is believed to have been coined by Harvey Karp, M.D., a pediatrician who theorized that human babies are born about three months too early.
After those nine months of pregnancy have passed, the thinking goes, that fetuses' brains are so big that babies may not fit through the birth canal if they stick around in the womb much longer. Even so, they’re still not quite mature enough to leave their cozy, cushy space — and it takes about 12 weeks for them to adjust to life on the outside.
That means your little one is going to go through a lot of changes in a relatively short time — from sleepy, sometimes fussy, scrunched-up newborn to (hopefully) calmer, happier, more alert 3-month-old baby. By 12 weeks, your little one can likely hold their head up to some degree and will become more interested in and aware of the world around them. The 4th trimester is a period of significant physical, mental and emotional development for your baby.
But it’s a time of change for you, too. As your body readjusts to no longer being pregnant, you’re learning how to care for a new baby — and navigating the major life changes that come along with it.
"This is not my favorite stage at all," says What to Expect Community mom ascanlan18. "I can't wait till he has a little personality and can sit up in his little seat and hang out with us. And then of course SLEEP. God, I miss sleep."
So what exactly will you and your little one go through? Here's the lowdown on that vulnerable few months after birth.
Postpartum changes moms experience during the 4th trimester
Especially in the early weeks after your baby arrives, your body is recovering from giving birth. Your hormones are in flux, your organs are shifting back to their former position and your breast milk is coming in.[1]
"The fourth trimester is a period with drastic physiologic changes related to the body's return to its nonpregnant state," says Shannon Smith, M.D., a board-certified OB/GYN, partner at Brigham Faulkner OB/GYN Associates in Boston, Massachusetts and member of the What to Expect Medical Review Board.
The time period can be difficult for many women. "Not only is your body healing from the delivery of your newborn, but many women are breastfeeding, which is another whole new physical experience," says Dr. Smith. "And finally, on top of all of that, you are experiencing intense mental health needs and fluctuations related to hormone shifts, life changes, lack of sleep and all the excitement/fears/challenges that come with becoming a mother and caring for a newborn.
You might have that normal postpartum bleeding and may be dealing with the discomfort of a healing perineal area and/or a C-section scar.
While many women are considered to have physically recovered from birth after six weeks, that doesn’t mean your body will feel or look just like it did before you got pregnant.
After all, it took you nine months to grow your baby. You can expect it to take at least that long for your body to go back to it's new normal. And if you’re breastfeeding, you might not feel completely back to your old self (or at least, something like it) until you’ve weaned.
"In the first month after delivery, gonadotropins (hormones that stimulate sex steroid release) and sex steroids (i.e., estrogen) are at very low levels," says Dr. Smith. "The degree to which breastfeeding keeps these levels suppressed for longer depends on the intensity of breastfeeding as well as maternal nutritional status and body mass."
Essentially, while hormone levels are kept low, your body, in effect, is in a hypoestrogenic state — very similar to menopause.
"Many women experience hot flashes, night sweats, dry vaginal tissue and similar symptoms as women in menopause," says Dr. Smith. "If your body has not regulated already, when you stop breastfeeding, your gonadotropins and thus estrogen levels will return to a premenopausal state, you will start ovulating and thus cycling again, and you will start feeling 'back to normal.'"
Feeling like your body isn’t your own can be challenging in and of itself. On top of that, you’re dealing with the fatigue that comes with caring for a newborn and the normal emotional ups and downs that accompany settling into life with your new baby.
Things also might not look exactly how you pictured they would while you were pregnant, and you might be missing aspects of your pre-mom life. It can be a lot to take in all at once! Just remember that you're not alone in whatever you may be feeling.
What your baby may be experiencing in the 4th trimester
While you’re experiencing a lot of new things during those first three months, everything is new for your little one. And after nine months in a warm, watery womb, adapting to life on the outside can be a little challenging, to say the least.
In those early days, it might seem like your newborn hasn’t quite gotten the memo that they have entered the real world. They may still curl up in the fetal position, and their movements are probably going to be jerky. Not to mention, your baby may easily become overstimulated and fussy
They may also mix up day and night, demand to be fed round-the-clock and snooze at random intervals. At this point, they really want to do is eat, sleep, go through diapers and be held!
"5 more weeks till we're out of the newborn trenches," says What to Expect Community member ctthorpe91. "I am praying that by the time we're done with the 4th trimester, my little bub will have made some improvements with sleep and his tummy. Kudos to those moms who enjoy this stage, but I just do not."
Luckily, your baby won’t stay like this for too long. As they grow (as much as a couple of pounds in weight and 1 ½ inches in length by the third or fourth month), they’ll go through other big physical changes too. Their arms, legs, hands and feet will start to unfurl, and as their muscles develop, those little movements will become more deliberate.
Your baby will also gradually gain control of that big, heavy head and start to lift it higher and higher. By 3 months, your little one will likely be looking around while leaning on their forearms during tummy time — and not long after that, may even begin to push up.
As baby's vision improves and the capacity for interaction grows, that little personality will start to take shape too. Over the course of the 4th trimester, your sweetie will go from newborn who gazes through cloudy eyes at you to a more bubbly infant who delights in playing, imitating some of your movements and facial expressions, and even smiling.
You can seize the opportunity to bond by making eye contact and "offering smiles and sounds that convey your love," says the American Academy of Pediatrics (AAP).[2]
"You'll find your baby delights in hearing your voice, seeing and feeling your body movements and watching your facial expressions."
And if those sleepless nights and seemingly non-stop feedings have you dreaming about getting in even a few hours of uninterrupted shut-eye, take heart. By the end of the 4th trimester, your baby will be on the way to a fairly predictable eating routine and something akin to a more consistent sleep schedule.
Tips for coping with some of the biggest 4th trimester challenges
These foggy, whirlwind days won’t last forever. But in the meantime, here are some strategies to help you make it through.
Ask for help.
Don’t feel like you have to do everything yourself. Let your partner or a close friend or relative help take care of the baby.
Even if you’re breastfeeding, they can take your little bundle at other times so you can sleep, as well as handle diaper and bathtime if you're comfortable delegating those baby care duties.
When someone comes to visit, give them something to do instead of feeling like you need to play host. Ask for them to bring groceries or a meal, do a load of laundry, empty the dishwasher, or just hold the baby so you can take a shower.
Know that it’s normal not to feel normal.
Intense mood swings and periods of weepiness are so normal after having a baby that they even have their own name: the baby blues. Pair that with the sleep deprivation, and you’ve got the potential for a serious storm of emotions.
Don’t beat yourself up for feeling this way, or for worrying that you aren’t doing enough. If you’ve managed to get some rest, eat something and care for your baby, you’ve ticked off all the important to-do's.
"The best advice I can give is to be kind to yourself, ask for help, and remember this period won't last forever," says Dr. Smith.
That said, while feeling more emotional during the weeks right after birth is common, feeling chronically sad, depressed, or overly anxious or having thoughts of harming yourself or your baby, can be signs of postpartum depression (PPD) or postpartum anxiety (PPA).
That doesn’t mean you’re losing your mind, are a bad mom or have done anything wrong — postpartum mental health issues like PPD are never your fault. But they are treatable, so if you think you may be suffering from PPD or another condition, reach out to your doctor for help.
Take care of yourself.
Covering the basics will go a long way towards helping you feel strong and energized.
Try to eat healthy foods like fruits, veggies, lean proteins, and whole grains, and limit the sugary snacks. Drink plenty of water — and if you’re nursing, be sure to get about 16 cups a day, notes the Academy of Nutrition and Dietetics,[3] which can come from "food, beverages, and drinking water, to compensate for the extra water that is used to make milk."
One way to help you get the fluids you need, according to the AND, is to drink a large glass of water each time you breastfeed your baby. Try to get out of the house when you can, too, even if it’s just taking the baby for a walk around the block.
If you aren’t getting the rest you need to function, ask your partner, family and/or friends for more support. Or if you're ready, try finding a babysitter you trust. Maybe someone can come over once or twice a week for a little while so you can nap. Ask your partner to take over a nighttime or early-morning feeding if you've introduced bottles.
Find a group for new moms.
Even with a supportive partner, family members and friends, you still might feel like you’re going through it all alone sometimes. Talking with other moms gives you a chance to share your feelings with women who understand exactly how you feel because they’re in the thick of it too.
But where do you start when you're trying to make new mom friends? Ask your pediatrician or OB/GYN to recommend support groups, find out about local parent Facebook groups or check bulletin boards at the grocery store, library or community center in your area. If and when your little one starts day care, that's a good way to meet other parents with little ones the same age too.
You can also just strike up a conversation with another mom when you see one out in the wild, like in your neighborhood or at the grocery store. Chances are, she’s as eager to talk as you.
Want to connect with other moms going through the 4th trimester? The WTE Community can also be a great place to connect with other moms.
Go to your postpartum appointments.
Seeing your provider for your postpartum check-up (and reaching out to them with any other questions you might have as you recover) is very important. These visits are an opportunity to talk about your concerns or challenges — both physical and emotional — and find ways to help you feel your best.
Make sure you are diligent about setting up your postpartum checkup with your OB/GYN, three to six weeks after giving birth, recommends the American College of Obstetricians and Gynecologists (ACOG). And if you need extra care in between, call your provider to set up additional visits if you can. ACOG also recommends having another follow-up exam within 12 weeks of delivery, so be sure to schedule that visit as well.
When does the 4th trimester end?
The 4th trimester ends around three months postpartum. Does that mean that you’ll look and feel exactly like you did before you got pregnant — and that caring for your baby will be a breeze 24/7?
Probably not. Adjusting to life with a new baby, whether it's your first, second, third or something else, is a gradual transition that will likely continue throughout that first year and beyond. And though your 3-month-old baby is vastly different than their newborn self, it goes without saying that your sweet little one has a whole lot of growing and developing still to come!
Plus things never quite "go back to the way they were" before you gave birth — parenthood changes you! — but you can look forward to feeling more like your old self in time. By 12 weeks postpartum, you can expect to feel much more physically and emotionally comfortable than you did initially. Your baby will likely be more fun and interactive, and at least a bit less fussy (fingers crossed) too.
Most importantly, you’ll have started to build the confidence and experience that will carry you through your journey as a mother. It's among the many rewards that make all those tricky parenting moments worth it!
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