What to expect in your fourth trimester

By Sabrina Rogers-Anderson

If you’re wondering how you missed the memo on the fourth trimester of pregnancy, don’t panic — your baby will be out by then!

Coined by renowned American paediatrician Dr Harvey Karp, the term ‘fourth trimester’ refers to the first three months of your baby’s life. It’s such a big period of adjustment for both mums and babies that a growing number of healthcare professionals believe it should be treated as an extension of pregnancy.

Here’s everything you need to know about what will happen from the day you give birth to the end of your baby’s 12th week of life. 

Caring for your newborn

According to Dr Karp, the best way to help your baby gradually adjust to the outside world during the fourth trimester is to replicate the environment and sensations they had in the womb. 

Settling

Dr Karp suggests using the 5S’s method to soothe and settle your baby:

1. Swaddling
2. Side or stomach position (for settling only; always put your baby to sleep on their back)
3. Shushing (or white noise)
4. Swinging (quick little jiggly motions)
5. Sucking (on a dummy)

You can also wear your baby in a carrier and give them skin-to-skin contact as often as possible to help them feel safe and secure. The idea that you can ‘spoil’ a newborn by holding them or cuddling them too much is a myth, so feel free to respond to their needs immediately.

Sleeping

Newborns sleep about 16 hours a day, and it’s normal for them to wake two to three times a night to feed. Try to go with the flow at this stage. Don’t worry about establishing a sleep schedule just yet. When your baby is four to six weeks old, they should (hopefully!) start sleeping longer stretches at night. According to the Australian Government’s Pregnancy, Birth & Baby website, sleep training shouldn’t be started before the age of six months (if you choose to do it at all).

Feeding

Newborns are always hungry because their tiny tummies can only handle a small amount of milk at a time. It’s normal for a newborn to need between six and 12 feeds per 24 hours — less if they’re bottle fed and more if they’re breastfed. Rather than sticking to a strict feeding schedule, it’s best to feed your baby on demand for the first three months. 

Bath time

Baths can be very comforting for babies. They only need two to three baths a week, but you can do it more often if they enjoy it. On days where you don’t bathe them, simply ‘top and tail’ — wash their face, hands, neck and bottom — with cotton wool or a washer.

Playing

You can start interacting and playing with your baby from birth to stimulate their development.

Playtime can include:

• making eye contact and smiling
• talking 
• reading books
• singing songs
• making funny faces
• doing tummy time.

Caring for yourself

Having a baby is a life-altering experience. You might feel exhausted from childbirth, overwhelmed by the demands of caring for a newborn and surprised by the range of emotions you’re feeling. 

Here’s how to look after yourself in the fourth trimester …

Your emotional wellbeing

The ‘baby blues’ affect many women in the week or so following childbirth. The feelings of sadness, anxiety and irritability are caused by fatigue and shifting hormones, and they generally only last a few days. If you’re still feeling low after two weeks, you could be one of the 1 in 7 Australian women who suffer from postnatal depression. Talk to your doctor or call Pregnancy, Birth & Baby on 1800 882 436 without delay to get the support you need.

Your physical recovery

In a world where we see celebrities rocking bikinis on the covers of magazines mere weeks after giving birth, we tend to lose sight of how long it takes to recover from childbirth. 

These facts will help put your recovery into perspective.

• You’ll bleed (known as lochia) for about six weeks whether you gave birth naturally or via caesarean.
• If you’re breastfeeding, your breasts might be engorged and leaky, and your nipples might be cracked for a few days to a few weeks.
• Even if you exercised and did pelvic floor exercises during pregnancy, you could still end up with conditions such as urinary incontinence, uterine prolapse or abdominal separation that may require the help of a physiotherapist or a pelvic floor specialist.
• Whether you had a natural childbirth or a caesarean, you should wait until all your scars are fully healed — and you’ve got the green light from your doctor — before returning to exercise (at least six weeks).
• You may have developed haemorrhoids during pregnancy or childbirth that could last for weeks or months (specialised creams can help).

The first three months postpartum are a marathon, not a sprint. Take the time you need to adjust to your new life and help your baby settle into the world. You’ve got this!

Read more

• Discovering the fourth trimester was a game-changer
• What you need to know about that first postpartum poo
• Breastfeeding in public: a guide for new mums