Your Complete Guide to the 4th Trimester

And now introducing the ultimate in pregnancy paradoxes: say hello to the 4th trimester.

What?

The fourth stage in a three-part journey?

Overshooting the mark, perhaps?

As it turns out, the mark may not be where we’ve always been told it was.

Understanding that pregnancy has a fourth trimester is a game-changer.

This period is all about making a passage into motherhood that prioritizes the health and wellbeing of mama and baby alike.

In this article: 📝

What is the fourth trimester?

Coined by pediatrician Dr. Harvey Karp, the term fourth trimester refers to the postpartum period straight after your baby’s birth.

Here’s the reality: the process of bringing a little being into the world doesn’t end on your baby’s birthday.

There’s still a whole other chapter to this book that involves ensuring that you land on your feet as a mama with a happy baby safely in your arms.

And this goes further than just making life a little easier for brand new mamas — although that is most certainly part of the equation.

OB-GYN Dr. Ilona T. Goldfarb argues that if attention is not given to this crucial period, there can be “disastrous consequences”.

In fact, Goldfarb explains, a lack of care in this phase is a contributing factor to the situation in the United States, where maternal and infant mortality is much higher than it is in other developed countries, with BIPOC significantly disproportionately affected.

Opening up dialogue around proper care in the 4th trimester is vital.

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How long does the fourth trimester last?

The fourth trimester begins at your baby’s birth and ends when they are around 12 weeks old.

It’s a complex time.

Sure, there is a euphoria that is attached to this period.

You get to stare into those gorgeous eyes for the first time, see that little peanut in the flesh, and, of course, get your newborn cuddles on.

But while this period features some blissful moments, it is also characterized by a whole lot of challenges.

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What can I expect in my 4th trimester?

Okay, mama — here’s the deal: you’ve just given birth and that’s not an experience to be taken lightly.

Vaginal birth can leave you torn and bleeding.

A C-section literally cuts you up.

So you need to take care of yourself, not just baby.

Eating nutritional foods, getting some (light) exercise, and doing whatever works for you to keep your mental health on-check — it's all important.

Let’s just take a moment for how very real this all is.

And then you have to head straight to the task of being a mama to a newborn without so much as a coffee break?

One of the biggest postpartum shocks to the system has to do with how much your baby actually needs you.

They need to be constantly fed, held, and nurtured — and they let you know their demands by exercising their brand new set of vocal cords.

Of course, this can be more than a little overwhelming.

Not only this, but your hormones are going haywire: estrogen and progesterone nosedive, while oxytocin and prolactin explode, leaving your emotions all sorts of everywhere.

Add a little sleep deprivation to the mix and it’s no wonder you’re left feeling overburdened.

It’s a lot.

As a result, as many as 75% of new mamas experience what’s known as the baby blues, while up to 15% suffer from more serious postpartum depression.

But postpartum depression can be treated, so if you are struggling with any of these symptoms, contact your doctor:

• Blues that you don’t feel like you can beat on your own
• Anxiety that is making you second-guess all the decisions you make
• Extreme tearfulness
• Feelings of excessive guilt
• A loss of interest in things you used to enjoy, including food

Postpartum depression can strike absolutely any mama, regardless of age, race, or location.

Don’t suffer through it alone.

Reach out for support — you deserve it, mama.

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You and your baby in the 4th trimester

Just as you embraced, fed, and protected your baby on the inside, you now have to do the same on the outside.

In fact, Dr. Harvey Karp (that’s the doc who gave the 4th trimester its name) argues that babies are “evicted from the womb three months before they're ready for the world.”

That’s why, he maintains, this phase should be very much incorporated into what we consider the gestational period of a human.

In the 4th trimester, Karp says, the idea is to simulate all the warmth, comfort, and care you were able to provide for your babe while they were inside you.

That way, it’s that much easier to make the transition to the big outdoors.

According to his 4th trimester theory, these “5 Ss” are good focus points for this period:

• Swaddling, which recreates the warmth and containment they experienced in your uterus.
• Side or stomach position to help soothe them. Holding your newborn on their side or stomach can go a long way to calm them. Another good position? Over your shoulder. (Just a note: babies should sleep on their backs. Side and stomach positions are for comforting purposes only.)
• Shushing, which essentially means some sort of white noise. They had quite the soundtrack going in your womb, complete with water whooshes and gravelly gurgles. The silence on the outside can be disconcerting.
• Swinging, or perhaps more accurately: jiggling. Your little one was quite used to rapid continuous movement in the womb. Now that they’re on the outside, small, quicker movements can help get them to sleep.
• Sucking, which is a very important part of introducing them to the feeding process.

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Does it get better after the 4th trimester?

Here’s the good news — yes, it does!

As your baby grows and develops over this stage, they become more and more ready to exist outside of the warmth of your belly.

And guess what?

At around 6 months, the golden age of baby-dom begins!

Sleeping and eating should become more regular and your baby will start performing some impressive tricks like sitting up.

And until then: let’s normalize dialogue around the 4th trimester.

Have the conversation — with the other moms on Peanut, with your family, with your friends, with everyone.

Keep going, mama!

You’ve got this.

And we're right with you, every step of the way.