How To Manage The Fourth Trimester

Your Baby Is Adjusting To Life On The Outside

“It takes a newborn around 12 weeks to adjust to life outside the womb. By 12 weeks, your little one will be more interested in and aware of the world around them and will likely be able to hold their head up to some degree. Moving from the warmth, darkness, and quietness of the womb to a noisy, bright and often cold environment can be a big change for a baby. These first 12 weeks of its life in the world is about developing their senses and controlling their reflexes. When a baby is born their senses are limited and still developing. At birth they can see but their vision is blurred. They can hear but it’s tough for them to distinguish between individual sounds and voices. They can feel, but their mother’s womb, which is familiar, warm and secure, has been replaced with an unsettling open space. Your baby’s brain is like a sponge, soaking up everything that happens to them. The more their brain is stimulated, the stronger the connections in their brain will be.” – Dr Shazia Malik, consultant gynaecologist & obstetrician at The Portland Hospital

Your Body is Healing

“In the immediate stages of the fourth trimester, your body is recovering from birth. If you gave birth via caesarean, you will have needed stitches on the abdomen, whereas a vaginal birth may require stitching if you incur a tear or cut. The body will be working to heal and mend the skin in these places. Expect to feel sore in the first couple of weeks, especially when going to the loo following a vaginal birth. Drinking plenty of water will dilute your urine and make it sting less, and eating a healthy diet will prevent you from becoming constipated, as women tend not to have a bowel movement for a few days after the birth. This will also help you avoid piles, which are common post-birth.” – Shazia

Bleeding Will Happen

“Bleeding after the birth can be quite heavy at first, but will minimise within a few weeks. Use super-absorbent sanitary towels and avoid using tampons until your six-week postnatal check-up. Your bleeding should have stopped by six weeks, but if you have persistent bleeding or clots, get checked out by the hospital you delivered in or by your doctor. Bleeding tends to be lighter after a c-section, and much lighter if you breastfeed.” – Shazia

You May Still Look Pregnant

“After birth, your tummy will still be bigger than it was before pregnancy, which is due to the muscles and skin having stretched over the course of the pregnancy. However, during the fourth trimester the tummy will gradually reduce and return to your regular shape. Your tummy muscles will have been stretching to accommodate for your baby for nine months, so expect them to be soft for several weeks after birth. After pregnancy your body can still retain a lot of fluid, and it can take around two weeks for a woman’s body to lose the extra fluid it took on during pregnancy. During this time some women may find their legs and ankles are swollen, but with time your body will rebalance the fluid levels in your body. Drinking plenty of water will help with this. As will putting your feet up whenever you can.” – Shazia

Your Milk Will Take A Few Days To Come In

“If you are breastfeeding, your breasts will begin to swell and may be sensitive as you begin to produce milk. At first, the breasts will produce a yellowish liquid called colostrum for the baby, but by the third or fourth day, they may start to feel tight and tender as they start to produce milk.  The milk normally comes in around day three after birth, and you will notice prominent veins on your breast as they fill with milk. Taking painkillers such as ibuprofen is safe and can really help with the initial discomfort, as can wearing a highly supportive cotton bra. It’s common to get afterpains (cramps) whilst you breastfeed. These will settle in the first few weeks.” – Shazia

The Baby Blues Are Normal

“The first few months with your newborn are a rollercoaster of emotions. In the first month, the hormones that were supporting your pregnancy come crashing down, which can leave you feeling teary. Then, as the sleep deprivation and pressures of new motherhood kick in, feelings of anxiety can step forward. Within these moments, however, there are also pockets of wonder and joy for your newborn and new life. After the first month, you may notice an increase in energy levels as your hormones start to plateau. However, if your teary period lasts longer than two weeks, or you find yourself not feeling joy for your newborn, chat to your GP and midwife. Getting the support you need as early as possible helps with both your recovery and your baby’s development.” – Dr Jo Mennie, PhD in women’s health & GP at Dr David Jack

Sleep Deprivation Can Be A Challenge

“A lack of sleep tests your patience and your relationship. Work on how to communicate your needs and recognise, with empathy, when one of you needs a break. This will set you up for healthy communication as your little one grows. Be comfortable asking for help. Often the ‘village’ are trying not to overstep or can’t see your needs, which can leave you struggling on your own. Be specific in what friends and family can do, and if you don’t want to hand over your baby you don’t have to, there are still lots of things they can help with. Ask them to bring a supermarket shop, a meal, tidy the kitchen, or wash the bottles.” – Jo

Your Pelvic Floor Should Be A Priority

“It takes around three months for your ligaments and pelvic floor muscles to return to normal, so it’s important to be careful with what exercise you do. Walking and light yoga can help new mothers regain strength and improve your mood, but chat to a healthcare provider before beginning any workout routine after giving birth, especially if you had a c-section. If you had a vaginal birth, it’s common to experience mild issues with lower bladder control, but if you suffer with incontinence, ask your midwife to refer you to a physiotherapist for an assessment. It’s helpful to do your pelvic floor exercises when you feed, so it becomes habit – even if you had an uncomplicated vaginal birth or c-section.” – Shazia

Connecting With Others Will Give You Perspective

“One of the biggest challenges is the external noise and societal pressures on motherhood, especially with social media, which often shows us unrealistic versions of both motherhood and baby. It is normal for babies not to sleep well during the fourth trimester – sometimes even for the first four years. Having some friendly connections with women who have a slightly older child or toddler can help ground your reality of what to expect and what’s normal. If you did NCT, chat to the other mums – these groups can be a great support network in the first year of your baby’s life. Having a network within walking distance is also helpful as it can encourage you to get out every day. As they say, your baby is only little once, so try and remove this pressure and enjoy this moment of motherhood and connection.” – Jo