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What You Need To Know About “The Fourth Trimester”

Written by Sara Langer

Photography by Lisa Mayock and baby Lucian, Photographed by Maria del Rio

Creating a new life is not an overnight process, as we all know. Women’s bodies work hard to provide a safe and nurturing environment in order to grow a baby. The nine-plus months, or 40(ish) weeks, of pregnancy are split into three trimesters, each about 12-14 weeks long. Many women will track the milestones of their unborn babies in the womb as the weeks and trimesters go by, as well as the seemingly endless changes to their own bodies as their little one grows. Less talked about—and planned for—are the few months following the birth of your baby, often referred to as the fourth trimester, which is an important part of your pregnancy experience for both you and your baby. While you might be preoccupied figuring out how to care for your in-the-flesh newborn or getting your birth plan in place, it’s just as important to understand what your body will go through after the delivery and how you will need to care for it. To help address this special (and intense) 12 weeks post-delivery, we’ve rounded up some must-read tips to help a new mom navigate the beautiful and brutal fourth trimester.

Do your research. Taking some time to understand what your body will experience post-birth will make all of the changes come as less of a shock and help you to be better equipped to take care of yourself once your nugget has arrived. Ask your friends or family who have had babies to “give it to you straight” so that you have a realistic idea of what is to come—the good, the bad, and the ugly. If you deliver in a hospital, the doctors and nurses are likely to spend a lot of time making sure the baby is healthy and that you are prepared to take care of him or her once you’re on your own. Postpartum care for the mother, unfortunately, is often brushed over. So, don’t be afraid to ask questions and have the medical staff spend a few extra moments going over some of your own physical changes and the healing process and how you should safely be caring for yourself, not just your baby.

Honor your body and take it easy. To quote the 90’s classic, Look Who’s Talking, “You just pushed something the size of a watermelon out of something the size of a lemon!” Either that or you’ve had major abdominal surgery (C-sections are no joke). Your body has experienced some trauma—beautiful, amazing, and totally-worth-it trauma—but trauma nonetheless. The first days and weeks following birth (depending on your experience) will likely leave you in a good amount of pain and you’ll be less mobile. If possible, try to have a solid support system in place so you can rest as much as possible. The less physically active you can be, the faster you will heal. There will be plenty of diapers to change for the rest of your baby’s life, let someone else do that if you can. Focus on feeding the baby and yourself and sleeping as much as possible. There’s nothing wrong with staying horizontal during this time. The dishes and laundry are not as important as taking care of yourself.

There will be blood. Not only will you be experiencing some major soreness down there, there will be bleeding and then discharge for about six weeks, whether you delivered vaginally or via C-section. This discharge, known as lochia, is a result of the uterus shrinking back down to its pre-pregnancy size and shedding all of the extra blood vessels it stocked up on during pregnancy. Lochia will be bright red in the days right after birth and gradually become lighter, going from brown or pink to yellow and eventually clear. Make sure you have some comfortable underwear and stock up on pads and panty liners before the baby arrives, so you’re all set.

Going to the bathroom will be a little more challenging. During your pregnancy you were likely making trips to the bathroom pretty frequently, since your bladder lost a lot of its real estate to make room for baby. After birth, your body is readjusting to all the room it has again and the muscles that helped prevent leakage have been stretched and need time to retighten. You may find yourself leaking or dribbling a bit, especially after a sneeze or a good laugh. And while the pee might be coming out easier than you want it to, you may have the opposite problem when it comes to your rear-end. The narcotics used for epidurals and C-sections can really slow things down. Even if you didn’t use any medications, the pressure on your rectum while pushing can cause a lot of swelling, making it difficult to have a bowel movement. Your doctor or midwife will likely prescribe you a stool softener. Along with taking that, drink plenty of water and eat plenty of fresh fruits, veggies, and other fiber-rich foods to get things moving. The first couple of post-baby poops can be painful, but you just had a baby, you can do it! Letting it get backed up will only make things worse.

Your breasts will expand, deflate, and leak like it’s their job. When your milk comes in, your breasts will become engorged as your tiny baby is learning to feed. They can become rock hard and cause pain. A warm shower or cold compress (cabbage leaves are said to do wonders) can really help to alleviate some of that. Once you’ve gotten the hang of nursing or pumping, your breasts will likely feel as though they’ve deflated a bit and become very soft. Invest in some good nursing bras, but keep the tags on them until after you’ve given birth to make sure you’ve got the right size as your boobs can be all over the place at first. While your body is figuring out the supply and demand of your milk, there will be some expected and unexpected leaking. Make sure you have breast pads available, especially for your first trips out of the house. You can get disposable or reusable pads. We recommend always keeping a few in your purse or diaper bag.

Your baby will become an extension of your body. While you may feel like you’re ready to have your body back to yourself, you should be prepared to share it a while longer. After spending nine months inside of you, feeling warm and safe, having a constant supply of nutrition, being submerged in water, with noises muffled and mostly darkness, the outside world can come as a shock to your little babe. Just like your body is transitioning postpartum, so are they. Taking care of them in a way that reminds them of the womb will help keep them feeling happy and secure. Wearing them, feeding on demand, swaddling, and warm baths are all ways to simulate life in the womb. (Check out the “Five S’s” soothing methods noted here for calming your babe and making things womb-like). There’s no right or best way to care for your newborn, so figure out what works for both of you and don’t be too hard on yourself or your baby.

Find a routine that works for you. While some people might tell you they are successfully sleep training at 8-weeks-old or have their baby on a schedule at 1-month-old, don’t stress yourself out trying to make this happen. Babies are constantly growing and changing, especially in the first few months, so what works one day may not work the next and you are likely to get frustrated. That doesn’t mean you can’t start creating routines for your family, whether it’s a warm bath for baby and songs at night before bed, or taking a few moments for yourself to have a hot cup of coffee during your baby’s first morning nap. These routines create consistency and will help your baby when you are ready to try more of a specific “schedule.” It is also nice to give yourself something to look forward to each day.

Be patient and not too hard on yourself. You’re going to be sleep deprived, swollen, sore, and possibly covered in your baby’s bodily fluid from time to time (or constantly), but you’re a warrior! The world we live in today is full of images of moms getting their bodies back right away or going out for an iced coffee just days after baby is born. While social media is a great way to connect with other mothers, remember that most of us are all guilty of posting the good or the pretty and leaving the dirty diapers and piles of laundry for our eyes only. This may skew your perception of reality on what is expected of new moms. It’s a struggle and hard work and it may not be as pretty as your Instagram feed (which you might be spending a lot of time on while breastfeeding), but as time goes on it gets easier and the rewards are pretty unbeatable. You don’t have to love every second of it, but love yourself for everything you’ve done to bring this new life into existence and the time, energy, and affection you’ve put in to taking care of your babe.

Want more new-mama support tips? Check our our list of 20+ Ways To Help A New Mom.

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