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Supporting Parents in the Fourth Trimester

8 min read | 13 January 2020

When we think of pregnancy, we typically think three trimesters. But today we want to chat about another pivotal period of time, following your birth- the fourth trimester.

Every new mama, and family will experience this period - and it is essential to get the necessary support to help your little family adjust to this new normal.

The fourth trimester is a period of intense learning, emotion & a general life shift. As a midwife, I believe that being prepared & educated to the best of your abilities, is key to feeling in control and coping with the transition. Today, we are discussing some topics that you don’t always hear about, that most Mamas will experience in the fourth trimester.

Afterbirth Body Changes

A woman's body is an amazing thing, did you know that before pregnancy your uterus is positioned very low down, near your pubic bone? When baby is fully grown, the uterus stretches from a closed fist size to the size of a fully grown baby. Once bub is born, the uterus contracts back to its pre-baby size, over the course of 6 weeks - however, most of the contracting is done in the first 24-48 hours after birth. You will notice when you breastfeed or pump that your uterus contracts and you feel ‘contraction’ pain again. Try a warm heat pack during this time, it can help with those strong afterbirth pains. Whilst they are uncomfortable, know that your body is doing exactly what is needs to.

Something else that can take the body some time to recover from, is a perineal tear. Whilst tearing or having an episiotomy is quite common in childbirth, it can take a long time to fully recover from. Be very gentle with yourself, wash the area with warm water regularly, be soft with your movements and use ice packs to help with swelling.

Bleeding after Birth

After birth, it is normal to bleed (this is called lochia) for up to 4-6 weeks, regardless of whether you had a vaginal birth or a C-section (though bleeding is generally less with a C-section). During your immediate postpartum period (the first 3-5 days) your bleeding will be heaviest as your uterus contracts down. Your midwife or OB will monitor your blood loss, if you are ever worried, always ask to be checked. Bleeding generally lightens after 1-2 weeks and is often just spotting after this time. Be sure to change your pad regularly to minimise the chance of any infections.

Learning to Feed

If you choose to breastfeed or pump, you may experience tender breasts while your milk comes in. Generally for the first 3 days after birth, you will have ‘colostrum’ otherwise known as ‘liquid gold’. This is thick, yellow coloured milk, and is incredible for your baby, housing all of your antibodies. Between days 3-5 your milk usually comes in - you may find baby is frantically feeding on day/night 3 as he/she lets your body know, they are ready for your milk to come in!

Breastfeeding is a LEARNT skill for you and your baby. Although it is natural, it is not always easy. You and your baby will find your rhythm, however it is very normal to feel overwhelmed and like this ‘natural’ event is one of the hardest things you have ever done. If you need help, remember there is ALWAYS help available, a lactation consultant or midwife can assist you.

Sleep Deprivation

The care of this brand new life can feel beyond exhausting. Be sure to get rest when you can mama - if possible, nap when bub naps, the washing can wait. Those first few days are filled with adrenaline, you may feel like you don’t even need to sleep- but be mindful that you most certainly do! Accept any help that is offered, this is a huge transition for you and your family.

If you find baby isn’t settling and you can’t even take a shower, try babywearing or swaddling baby nice and tight, this can give you some much needed quiet time while baby feels safe and secure.


You have just given birth, you are producing milk and feeding your baby, all while trying to recover (with a lack of sleep), talk about an emotional rollercoaster!

While your hormones are finding a new rhythm, you may feel very unlike yourself. This typically shouldn’t last much longer than a couple of weeks. You could be teary, happy, sad, joyous… all in one day. It can feel very difficult at times, but know that you and your body are doing an incredible thing.

Baby blues are very common for new mothers, however, it is important for you and your partner to be aware of baby blues progressing into something more. Postnatal depression is a very real and serious issue. If you feel that you may be experiencing this, speak up as soon as possible. Tell your partner, and book in to discuss this with your GP as soon as possible.

Feelings of Loneliness

The feeling that even though you have someone with you ALL the time, you still feel lonely. Suddenly, your whole life perception shifts and all that matters is this tiny human that didn’t exist 10 months ago. Building a supportive community around you is so essential at this time, it truly does take a village to raise a baby. If you can, try to schedule a daily outing once you are able, even if it is a simple walk through the park with a friend - this will help you mental state enormously.

You've got this, mama. When it gets too hard, don't be afraid to ask your partner, friends and family for help. Don't be afraid to rest and accept the help of a family member who's offering to cook or clean. Welcome all of the support with open arms. You will be so glad you did!

Aliza Carr, midwife, perinatal mental health specialist and founder of Bumpnbub.

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