A New Mom’s Guide to 4th Trimester

It comes as a surprise to new moms how hard the fourth trimester is. All we were told was that we won’t have enough sleep for a while, and admittedly, most of us brush that warning aside. 

Prior to the baby’s arrival, we were also too busy buying newborn essentials that we never thought about postpartum care. Mothers are wonder women anyway, right?

The truth is that the early weeks of motherhood are not exclusive to blissful moments. Most moms get overwhelmed and if you inspect what is happening, it’s easy to understand why. 

Let’s break down what we have during the 4th trimester.

What is the 4th trimester?

It is the time your baby is born up to the time he reaches three months. Pediatrician Dr. Harvey Karp calls this the “4th trimester” saying babies are born too soon, and that if given the choice, they would probably stay inside the womb much longer (but at that point they won’t fit in the birth canal). 

As of Dr. Karp, a baby’s brain is so big that a mom has to “evict” him after nine months, even when he is still mushy and immature. So much physical and mental development happens to a baby during their first 12 weeks that it should be considered an extension of pregnancy. 

For the mom, this is the period where your body recovers from childbirth all while taking care of your newborn.

So yes, the main people are mom and baby, and how critical this time is for them.

4th trimester for baby

Your baby is snug and safe and never hungry in your tummy. That is why being outside is a major change for him. As parents, it is your duty to provide for his needs and comfort him with love and support. To your baby, this world is too big and too cold, the complete opposite of the cozy and warm place of your womb.

Baby’s vision is also blurry in the beginning. His hearing is capable but still needs development. His limbs are almost always flailing if not swaddled as they still have no control over their movements.

The 4th trimester is the time your baby gets used to what is around him. His senses will develop and he will notice you and be able to interact with you soon. Babycentre wrote a great article about what happens to newborns during this time.

Your newborn will also be a bit of an overworked alarm clock with all the crying he will do.

Crying is how babies communicate. When they are wet, their diapers are soiled, or when they are tired or overwhelmed, they will let you know by crying. On a number of occasions though, it could be difficult for you to pinpoint what they need.

Over time and if you pay attention, you will learn your baby’s cues.

How can you soothe your newborn?

By consistently responding to your baby’s cries, you establish trust and make them feel secure. Contrary to what old stories say, meeting your newborn’s needs won’t spoil him. 

Here are the basic things you can do for your newborn.

• Skin-to-skin contact. Newborns still can’t regulate their temperature so the warmth of your skin makes the best blanket for them. When placed on the mom’s chest, babies are also stimulated to find mom’s breast and feed. Hearing your familiar heartbeat will also provide assurance that your baby is safe even when he is new in the outside world.
• Feed and burp. Watch out for your baby’s hunger cues (like lip smacking or sucking on his fingers) and feed him on the first sign of it. Usually just holding your baby in an upright position will make him burp. If not and gas seems to be a problem, you can do burp techniques like gentle massage or bicycling the baby’s legs. 
• Nappy change. Baby skin is delicate so make sure you change your baby’s nappy soon as there’s poo. When it comes to pee, some don’t mind wetness but don’t wait until the diaper is heavy to prevent nappy rash.
• Swaddle, sway, and sucking. Swaddling and swaying mimic the place and movement he is used to back in your womb. This makes it easier for your newborn to fall asleep. Another way to soothe your baby is by giving him a pacifier to suck on. This is why breastfeeding usually ends with a sleeping baby.
• White noise. Your baby is used to the noise inside your tummy such as your heartbeat, stomach grumbling, and your blood flow. You may find that turning on the vacuum won’t startle him but instead make him calm down and fall asleep. Spotify even has a white noise playlist.
• Mind the room temperature. If it’s too hot, there’s an increased risk of sudden infant death syndrome (SIDS). The ideal room temperature is said to be 20-22 degrees Celsius or, if it’s too cold for a lightly clothed adult, your baby most likely is cold and uncomfortable too. 

Other ways you can support your baby

• Smile, talk and sing. Engaging with your baby is the best activity he can have for his development. Keep in mind though that babies are easily overwhelmed. If you see signs that he is overstimulated (like turning his head away from you, being irritable, crying), take a breather and soothe him.
• Encourage tummy time. Aside from helping your baby develop strong neck and shoulder muscles, tummy time also prevent flat spots at the back of your baby’s head. 
• Sponge bath and a warm bath. If his umbilical stump is still drying and hasn’t fallen off yet, a sponge bath will do. Make sure to use a gentle body wash formulated for baby skin.
• Show black and white photo cards. You can pair this one with the tummy time activity. Babies see high contrast colors better so black and white patterns and images are the best fit. 
• Day and night. Regardless if it’s night or day, your baby will wake up every 2-3 hours in his first months. Still, it won’t hurt to keep his room bright during the day, and the lights low at night. 
• Don’t miss his pediatrician appointments. Aside from your baby getting his vaccine shots on time, his pediatrician will also be tracking his development. Questions will surely arise as you fulfill your new role as a mother. Take note of them and ask them away on your well-baby visits. 
• Take pictures. I know I don’t need to remind you. Your gallery is probably filled with baby pictures of the same angles and that is totally fine. 

Now, the list you have read might not look daunting to you. Baby needs you so you become the person he needs you to be. Easy switch? That’s what I thought too. 

Why is 4th trimester the hardest?

Here’s the formula:

Demands of a newborn + Your beaten and recovering body + Life changes and constants = You feeling wrecked

Your body is simply not in its best state to attend to the demands of a newborn. It is a period of huge adjustment for both you and the baby. And if you’re a first-time mom, you are brand new to this. 

You will realize very soon that newborns take lots of time and energy. Other challenges may come up also like when baby won’t sleep, or when he won’t stop crying, or when he won’t feed. 

For you, Mama, simultaneous changes are ongoing physically, mentally, and emotionally. It could drain you. 

A day after we got home from the hospital, after waking up many times in the night to breastfeed, I remember staring blankly at some corner of our house thinking, this is just the start? Three months of this? When can I have my life again? Oh, no, this is my new life.

Don’t get me wrong, I was grateful for the experience and all the new things I was learning. I was beyond excited that there is a little human breathing in our home. 

But I was also dead tired.

So if you feel wiped out, it is to be expected.  

4th trimester for mom

The weeks following delivery are critical for mothers’ well-being. The American College of Obstetricians and Gynecologists (ACOG) recommends that postpartum care be an ongoing process rather than a single encounter, with services and support tailored to each woman’s individual needs.

Beginning pregnancy, doctors or maternal care providers should develop a postpartum care plan that addresses the transition to parenthood and well-woman care.

What are moms recovering from?

To me, these are what make the 4th trimester the hardest. This list reminds me of how strong and enduring mothers are. 

Fatigue

Labor and delivery are no easy feat and can take a toll on a woman’s body. It was the only time (so far) I was convinced I can sleep for 24 hours straight. 

Body pains

As if exhaustion isn’t enough, you’ve got plenty of body aches brought about by the monumental task of giving birth. Here are the most common of them:

• Back pain. Chances are you already are suffering from back pain even before your bump grew the size of a watermelon. After delivery, the causes of back pain could be pregnancy hormones and strained abdominal muscles. I suffered from neck, back, and shoulders pain and am almost certain it was because of my posture when breastfeeding (and the anesthesia during my surgery probably). There’s also lifting and swaying your baby to sleep so if possible, assign the rocking to Dad. 
• C-section incision. They say the hardest part of delivering via cesarean is the recovery, and I wish I had believed it! The pain will make it extra hard for you to move even when you are taking pain relievers. This is also the time when sneezing, coughing, and laughing loudly can hurt you big time. Having an abdominal binder is super worth it. You may read about c-section recovery essentials here.
• Perineal pain. Pushing your baby out puts pressure on your perineum and it could be swollen after delivery. If you had a tear or your doctor performed an episiotomy, healing of your perineal area would take longer. Bowel movements could also be painful so stool softeners are often prescribed. Hemorrhoids are also common to have during this period. Check out these natural remedies that can help ease discomfort during postpartum.
• Dizziness and headaches. I don’t remember suffering from headaches but for the first three or four months postpartum, I was dizzy. Now that I think about it, why did I not tell my doctor about that? :/ I just took iron supplements thinking it could be iron deficiency anemia.
• Sore nipples. It is cool that babies have a sucking reflex and know how to latch (though they may still need your help). If you are breastfeeding for the first time, there’s a high chance you’ll develop sore nipples. The soothing and healing properties of a nipple balm can ease your discomfort faster.
• Uterine cramping. Even though your baby is out, your uterus will continue with its contractions to get back into its pre-pregnancy size. It doesn’t hurt like labor but it is not enjoyable either.

Sleep deprivation

Many new moms consider sleep deprivation the hardest challenge after giving birth. Newborns have tiny stomachs and therefore have to be fed every 2-3 hours. That means you have to forget sleeping through the night for a long while. You might think your sleepless school nights prepped you for this but I tell you, it won’t even come close.

Baby blues

Did you know that 4 out of 5 new mothers experience baby blues? It is feelings of sadness and irritability in the first few days up to two weeks after childbirth. Drastic hormonal changes are said to be the primary reason for mood swings and anxiety. New moms may cry a lot, feel angry and anxious about the many things happening in and around her. Frustration may stem from lack of sleep, from owning the new role and responsibilities of a mother, from a baby crying non-stop – the list could go on. 

TAKE NOTE: If after two weeks you still feel hopeless and you have no interest in taking care of yourself, you could be falling into Postpartum Depression. It is like baby blues but more intense and could interfere with daily life. Seek help and talk to your doctor. Don’t struggle alone and stay in the dark.

For me, a huge factor for my baby blues was delivering via cesarean. Even though I didn’t deny the possibility of going under the knife, my mind was convinced it’ll be a normal delivery. I had no known complications anyway.

The initial sadness upon learning I’ll have an emergency c-section was easy to get over. What I wasn’t ready for was the tough recovery and the many things I couldn’t do because of the pain in my stitched abdomen. 

Carrying him, rocking him to sleep, changing his diapers – all these I couldn’t do for about a month. I was like, dude this isn’t what I expected! I felt inadequate. 

Even though I was told to stay in bed and rest, I couldn’t resist house chores. I tried to conquer simple tasks but my body was adamant in telling me to take a break. After all, standing and walking were a challenge in itself. 

Oh wait, the list mothers go through isn’t done yet. Here are other challenges that could crop up postpartum.

Other common challenges

Note that most of these won’t last for three months. Some mothers also won’t experience all of these (except the bleeding and the house chores, though can we?).

• Breastfeeding. While this may seem second nature, there is a learning curve. During the early days postpartum, there is engorgement that could be uncomfortable or even painful as your milk supply comes in. Breastfeeding could also pose different concerns like low supply and mastitis. It is best to enlist the help of a lactation consultant and don’t let yourself suffer. Milk production also burns extra calories and it could make you feel parched and ravenous. It was crazy how, in the first weeks after giving birth, I felt like I was finishing a marathon when I was just sitting down nursing my son. The tip is to have nutritious snacks and glasses of water at an arm’s reach every time.
• Night sweats. Tends to happen when you are sleeping, it is your body getting rid of the extra fluids it had when you were still pregnant. Hydrate yourself and wear lightweight clothing.
• Swelling fingers. Extra body fluids are the culprit again and fingers may not be the only body parts that are swollen. My hands started getting puffy during the third trimester and I thought it would go away immediately after childbirth. My achy fingers went back to normal after a month I believe.
• Postpartum bleeding. Also known as lochia, postpartum bleeding usually lasts 4-6 weeks. Your body has to shed the residual tissue in your uterus regardless of whether you delivered vaginally or via c-section.
• Body transformation. Pregnancy and childbirth will transform your body. For mine, I noticed I easily get bruises. The hair loss, happened around three months to six months postpartum. You may or may not always be happy with how your body looks. You could be dismayed with your deflated pouch, or proud of your c-section scar. 
• House chores. Because the dishes, the clothes, the floor, won’t clean themselves. Still, take time off. Or maybe when the baby is sleeping, do one chore and then rest.   

Comedian Laura Clery made an honest video about how mothers can feel postpartum. My only question is, where is the lie?

This is not to say that dads are not having any of the difficulties. They are also sleep-deprived and confused and tired. (Thank you, Dads! And Grandmas!) 

How to prepare for 4th trimester?

So if you are reading this and the cat is not yet out of the bag, help your future self. As parents, we put most of our energy and attention into the welfare of our newborns. Remember that to better take care of them, we must take care of ourselves first.

• Being informed and ready. Read articles, watch videos, enroll in classes related to giving birth, recovery, and baby care. Aside from learning being fun, it will surely equip you with basic knowledge (how to swaddle; diaper changing tips) of your new role as parents.
• Have everything ready. Embrace the nesting season and organize the things you and your baby will most likely need. Later on, you can chill and focus on recovery and attending to your newborn.
• Store microwave-ready healthy meals. It’ll be better if someone will cook fresh food for you though. But if you can anyway, stock up on meals and snacks in the freezer.
• Have a designated nursing corner. And place everything you need at an arm’s length. 
• Exercise. Aside from boosting your mood, regular exercise can also reduce back pain and help your body get ready for delivery. Ask your doctor first what kinds of exercise will benefit you and your baby. 
• Be ready for possibilities. I believe I could have felt a lot better only if I had my mind set on giving birth via cs. If I paid attention to how the recovery will be.
• Do everything you think you want. Want to finish that kdrama series? Do it. Want to study or attend webinars? Do it. You likely won’t have time (and energy) for those after childbirth. 

How to cope during the 4th trimester?

Ahh, if you’re reading this while in the thick of sleeplessness, let me give you a hug. Listen to your body and be kind to it. You know what they say, self-care isn’t selfish.

And before I forget, congratulations on bringing another wonderful creature here on earth! 

• Focus on the basics. For you and your baby: eat, sleep, feed. Rest and recover because housework can wait.
• Ask for help. Or let others tackle the housework. Chances are your mom and close relatives are eager to lend a hand. Dads, be proactive and rock your baby to sleep. Nursing is hard work you know.  
• Eat healthily and take your vitamins. This shouldn’t be hard because ideally, you have been doing these for nine months. 
• Stay hydrated. Especially if you are breastfeeding.
• Take a bath. Although if the poll is between taking a bath or sleeping, I’d suggest you sleep. But really, showering works wonders. Don’t you just love the refreshing feeling you get? It makes you think you have energy again. 
• Massage. Some post-natal massages are packaged with lactation massage. Pamper yourself, you deserve it.
• Change of scenery. Healthy for both you and your baby. Be extra careful though because of the pandemic. Go somewhere with lots of trees, where air is fresh and clean.
• Exercise. When outside the house, pushing baby in the stroller counts. Get your doctor’s green light first and ask what kinds of exercise you are allowed to do for now.
• Attend your postpartum check-up/s. Just like how you religiously attended doctor’s appointments when you were pregnant, know that mothers need as much help, care and monitoring, especially in the 4th trimester.
• Chat up mom friends / Join support groups. Chances are they will gladly answer your questions and share what they learned. (They could reply too in the wee hours of the night)
• Make everything easy for you AND convenient. Don’t need it? Forget it. If it will make your mom life easier, go for it. If you are uncomfortable with having more people in the house, let them know you need space to rest. 
• Write in your journal or baby book. It might seem counterintuitive to use your time writing but you can take this opportunity to express how you are feeling. You’d be happy to see in the long run that your feelings and thoughts are getting better. Take the chance also to record your baby’s firsts.
• Manage your expectations. You can only do so much so let go of the dragging thoughts of not being able to do the usual things. Don’t worry about those looking for you on social media. They will understand if you can’t answer yet. Also, you are used to having your time and now it feels like you don’t have any. Like you are not getting anything done at all. Check out what I wrote if you find yourself desperate for me time.
• Understand that it will come to pass. It will get better – your body, your feelings, your thoughts. You need to work for it though so take baby steps. Your baby is rooting for you!  

Remember you are not alone. Somewhere out there are moms awake at 3 am, nourishing their baby and fighting back sleep. Smiling as their own bundles of joy sleep in peace and contentment from being fed and loved. 

You are doing a great job.

A piece of advice you’re probably tired of hearing but is just true and helpful: Sleep when the baby sleeps. You need sleep to function. A 15-minute nap could work wonders already.

Also, avoid lifting anything heavier than your baby.

TAKE NOTE: The 4th trimester is not all sadness and exhaustion. You will find funny things about motherhood if you use your humor. The internet is also full of parenting posts you can relate to and can give you a good laugh.

What happens after the 4th trimester ?

You and your husband will likely do better at parenting by this time. Aside from getting used to keeping a tiny human alive 24/7, your body has done some recovery too. 

If you are wondering whether decent sleep is within reach by now, it is safer to say not yet. Most babies sleep through the night (6-8 hours) at six months. But every baby is unique so let’s hope you both get your good night’s rest sooner than later.  

Learning won’t stop for both you (parents) and your baby. There will be times when you thought you discovered a hack that’s best for your baby, only for it to not work the next time. 

You will navigate your way. You will make decisions. Your priorities may change. Your plans may shift.

And that’s all part of your new role.

Thoughts

Sometimes 4th trimester will feel like a long tunnel that you just couldn’t wait to see the light at the end. It is normal. 

This is also why postpartum nourishment is important. As to this article by GoWell, lack of self-care will make us shift into survival mode instead of flourishing in this fulfilling role.

I have to include this part also: no two moms are alike. Even though we all get tired, how we respond to what is happening could be different. You may see a new family who seems to have it easy on social media. But you don’t know what happens behind the camera. They could be struggling too, but are not outspoken about it.

Or if they really are thriving then you should be happy for them. I’d say you may allow yourself a little room for envy but the best thing to do is ask them how they are doing it. We can all learn from one another.

Also, don’t underestimate hormones in a frenzy during the 4th trimester. They kinda call the shots.  

Appreciate what your body can do. It has been through a lot and will still work hard every day. Here are some tips to cope when you’re overwhelmed.

And don’t forget the reward for all these. You have your little one to dote on and stare at as much as you can.