Did you know there is a fourth trimester of pregnancy? This term is commonly used to describe the first three months after birth, also called the newborn stage.
The fourth trimester is an exciting and happy time as you bond with your baby and delight in newborn cuddles. But the fourth trimester is a vulnerable time for both you and your baby, too. You'll be healing from birth and adjusting to your new family member.
Here are the changes you can expect in your body and your baby during this time.
The fourth trimester, sometimes called the 4th trimester, begins when your baby is born and lasts until they're three months old.
Although your baby is now outside your body, the fourth trimester is an extension of pregnancy in some ways. For example, your baby still craves the comfort of your warm body and the fetal position. They want to be frequently held and carried. At first, they may not know the difference between day and night.
Like pregnancy, the postpartum recovery period also comes with additional health risks for you. You are vulnerable to blood clots, bleeding, anxiety or depression, and preeclampsia in the postpartum period.
That's why it's important to prioritize self-care, limit stress, and know warning signs of symptoms that require medical attention. After the fourth trimester, you should be settled into life with an infant, as your baby's sleeping and eating schedule has improved, and you should feel more like yourself mentally and physically.
The American College of Obstetricians and Gynecologists (ACOG) recommends that everyone have at least two routine postpartum visits. The women's health provider who cared for you during your pregnancy will provide this postpartum care.
Your first postpartum check-up will occur in the first three weeks. Your second visit will happen within 12 weeks of giving birth.
If you have higher health risks – due to high blood pressure or a previous blood clot, for example – you'll need more postpartum visits. Your doctor will likely schedule the first visit within days of the birth.
You can expect your postpartum visits to involve:
Don't hesitate to mention any concerns or ask any questions you may have during these postpartum check-ups. Speaking up can make a major difference in your and your baby's health. Remember, your provider's priority is to ensure you feel heard and cared for.
During the early weeks, your baby will prefer the fetal position, snuggled in a swaddle with their arms and legs curled up.
Over the fourth trimester, your baby's legs and arms will unfurl. Their movements will become less jerky and more purposeful. They may even reach for toys by the end of the fourth trimester.
Your baby will want to be close to you and frequently be held, rocked, and carried. A baby carrier or wrap can help you hold your baby and have your hands free.
Skin-to-skin contact is comforting and calming for your baby for the first few weeks. Place your baby in their diaper on your bare chest, with a blanket over you both, a few times a day.
You don't have to worry about sleep training during the newborn stage. Newborns typically sleep a lot. They just wake up frequently. Your newborn will sleep about 16 to 17 hours a day at the start of the fourth trimester.
At first, your baby may only sleep one to three hours at a time, wake up, have milk, and fall back asleep. At first, the pattern won't change much between day and night. Your newborn may even be more alert at night.
Gradually, your newborn will sleep more at night, consolidating stretches to make for longer sleep sessions for them and you. Engaging with your baby more during the day and keeping nighttime quiet, with dim lighting, can help this process. By three months, many babies (but not all) sleep for longer four- to six-hour stretches during the night.
When your baby is around two months old, make a habit of putting them in their crib or bassinet when they are drowsy and not fully asleep. This method will help them learn to fall asleep on their own.
Experts, including the American Academy of Pediatrics, recommend exclusively breastfeeding your baby for the first six months. Breastfeeding has many benefits. Breastmilk is easier for newborns to digest than formula, and you can pass on antibodies that help your baby fight infection.
A lactation consultant can provide in-person or virtual support if breastfeeding is challenging or painful. They can help you ensure a proper latch, give strategies to increase milk supply, and more. Read more about UPMC's breastfeeding services.
Of course, many women don't breastfeed for a variety of valid reasons. Formula is a healthy alternative; it supplies all the important nutrients your newborn needs. Skin-to-skin contact can provide additional bonding time for formula-fed babies.
If you're breastfeeding, you will need to feed your baby every one to three hours at first. If you're formula feeding, you will need to feed your baby every two to three hours.
It takes six to eight weeks to recover from a vaginal birth or a C-section, according to the American Academy of Family Physicians (AAFP). You'll experience heavy vaginal bleeding, called lochia, for up to 10 days after birth. You may continue to have light bleeding or spotting for several weeks.
You may also experience constipation from post-pregnancy hormones and pain medication during labor. Drinking water, eating more fiber, and asking your doctor for stool softener medication can help.
As your uterus shrinks down, you may experience slight cramping. You may notice this pain when breastfeeding, as hormones stimulate the uterus to contract. If cramping is severe, it could be a sign of a health problem, so call your doctor or go to the emergency department.
Which trimester is the hardest is personal to you and your pregnancy. If you have pregnancy complications, you may enjoy the fourth trimester just because it provides a break from the stress and health issues. Or you may find the newborn phase more difficult than your pregnancy.
After all, you're sleep-deprived, your hormones are rapidly changing, and being the primary caregiver and food source for a newborn — especially the first time — is stressful.
Rest assured that it will get easier. You'll learn what works for you and your newborn and work through your feeding and other challenges. You'll also get more and more sleep as the weeks progress.
It can take more than six weeks for you to feel like yourself again, mood and energy-wise. It's common to have "baby blues" or feel overwhelmed, sad, or anxious in the first two weeks after birth.
If you have severe anxiety or sadness, or your baby blues don't go away, you might have postpartum depression.
Talk to your doctor if you have any of the following symptoms:
With your baby's frequent feeding schedule, you won't be able to do much more than take care of your baby in the fourth trimester. In fact, you shouldn't feel a need to do more than this – caring for a newborn is an around-the-clock, exhausting job. Try to rest when the baby sleeps, at least sometimes, rather than doing chores.
Enlist a partner, friends, family, or professionals to help with meals and housework. You can also consider hiring a postpartum doula or night nurse. They can support you and help with feeding, newborn care, and light household chores.
Try to limit visits mostly to those who will help you rather than expect you to host or entertain them. It's perfectly fine to ask friends or family members to delay their visit as you adjust to your newborn's schedule.
Nutrition is just as important now as it was in your pregnancy. Limit fried and sugary foods and drinks, and eat a nutrient-dense diet to help your body recover from childbirth.
It will also support your baby's health if you're breastfeeding. You'll need 300 to 400 additional calories a day if you're breastfeeding, according to the Centers for Disease Control (CDC).
Continue your healthy pregnancy diet rich in fruits and vegetables, lean meats, beans and legumes, and whole grains. You can now eat some foods you've been avoiding, like soft cheese and sushi, but continue to avoid fish high in mercury if you're breastfeeding, the CDC says.
Experts advise that you should not exceed one drink of alcohol per day if breastfeeding. The CDC says to finish consuming the alcohol at least two hours before you breastfeed. With this timing, the level of alcohol in your breast milk will be very low by the time you breastfeed again.
It often takes six to 12 months before you return to your pre-pregnancy weight, according to the National Library of Medicine. It's also common not to return to your pre-pregnancy weight.
Rather than trying to return to that magic number, focus on what's important – staying healthy for you and your baby. Experts recommend against trying to lose weight in the stressful first six weeks postpartum.
Breastfeeding means your baby consumes some of the calories you do, but it can also make you very hungry. Cutting calories during breastfeeding may affect your milk supply.
If you had a vaginal birth without complications, you may be able to start light exercise within a few days of giving birth. If you had a C-section, it can take many weeks to the end of the fourth trimester before you're ready to exercise beyond short walks. Your obstetrician can tell you when it's safe for you to introduce exercise.
When you're ready to start, the ACOG says to aim to exercise for 20 to 30 minutes a day. You may want to break this up into two sessions of 10 to 15 minutes each. Start gradually with walking and simple stretches, and slowly introduce strengthening and aerobic (or cardio) exercises.
You may find parent-and-baby yoga classes or stroller fitness classes in your area. These are great opportunities to increase your fitness and meet other parents who are experiencing the same joys and challenges as you.
You can also start kegel exercises as soon as you're ready, even within days of giving birth. This is where you contract your pelvic muscles — as if you're trying to hold your pee — and then release them. It helps to prevent urinary incontinence and other problems, like pelvic organ prolapse, after childbirth.
In the fourth trimester, or postpartum period, you face a higher risk of some health conditions. These include infection, excessive bleeding, a blood clot, or high blood pressure.
If you experience the following symptoms, contact your women's health provider. If your symptoms are severe, go to the emergency department.
Postpartum warning signs and symptoms that require medical attention include:
By UPMC Editorial Staff. Last reviewed on 2024-09-05.
