We’ve all heard about the first, second and third trimesters in pregnancy.  

The first 12-weeks, when every day can become a blur of dry heaving and exhaustion, the second trimester when the sweaty glow from non-stop retching is replaced by that incredible pregnancy glow.  

Then there are the final 12-weeks, when your body no longer feels like your own, where socks are no longer a practical part of your wardrobe and your due date can’t come quickly enough.  

But what about the fourth trimester?  

Believe it or not, it really is a genuine thing and you should ignore it at your peril.  

Coined by an American paediatrician, Dr Harvey Karp, the fourth trimester refers to the first 12-weeks after baby is born as they adjust to life in the big, bad world.  

And actually, when you think about it, it kinda makes sense.  

Throughout the pregnancy, meeting your little one is all expectant parents can think about.  

Now put yourself into the teeny, tiny shoes of a newborn baby who has been evicted from the warm and safe confines of their mummy’s tummy. 

Sounds, smells, the touch of clothes on their skin, feeling hungry for the first time – it is overwhelming for their senses – and it can be overwhelming for parents as they help their babies settle into life on the outside, so to speak. 

We’ve spoken to Ally from Doulas of Northern Ireland who offer advice on how to make those first few months with baby as easy as possible. 

What is the fourth trimester? 

The fourth trimester is a concept which lasts from birth to when the baby is three months old.  

It is a period of changes and adjustment for both baby and parents, as the baby gets used to life outside the womb, and the parents get used to caring for a newborn.  

Not only is the mother’s body physically recovering from the birth of her baby, but she is being reborn as a mother, and needs to be supported and nurtured too.  

She will experience cramping for around six weeks as the uterus contracts and post-birth bleeding can also continue for up to six weeks.  

The other organs gradually move back into their pre-pregnancy positions.  

There is also a huge change in hormones which can affect the mum physically and emotionally too.  

Oxytocin, for baby-bonding, and prolactin, for breastfeeding, levels soar, whilst progesterone, which regulates emotions, and oestrogen drop dramatically.  

These changing levels can cause hair-loss, dry skin, morning sickness, along with feelings of anxiety, being overwhelmed, worry and sadness. 

This sadness may occur in the first two weeks, but medical advice should be sought if lasting longer than that.   

For the baby, used to being in a warm, dark, confined space with the constant sounds and movement of the mother’s body, outside of the womb is completely unfamiliar to them.  

So, the fourth trimester is when they adjust to all the new things in the world, learning to cope with their senses – seeing, hearing, feeling hungry, learning to feed, feeling cold. 

So, what should parents expect? 

In some cultures, such as Asian and Latin American societies, the fourth trimester is a special time where the close family will practically take over the running of a household in the first few weeks to allow the mum to recover and bond with the newborn, keeping them close together.  

However, our culture often seems the opposite – expecting the mum to be back to ‘normal’ within a few days, and the focus of help can often be on the baby, separating the mum and the baby to ‘give mum a break’.  

It is important to give mum support and time to physically recover, but a baby will be more settled, and particularly where establishing breastfeeding is concerned, if the support keeps them together as much as the mum wants.  

Practical support is often best, letting mum get plenty of rest without having to worry about housework, meals being prepared and cooked for the family, to help her physically recover. 

We advise only taking the baby to give mum a chance to catch up on sleep or enjoy a warm shower or bath. 

A newborn baby’s stomach is around the size of a walnut, and so whether breast or bottle fed, they will only need small amounts, frequently, which means that they’ll wake frequently.  

Breastfeeding is a skill that both mum and baby have to learn and may take time for them both to get accomplished at it.  

Ultimately, whilst it can be a strange and uncomfortable sensation at first for the mum, it should never be painful and mum should seek extra support to help get the breastfeeding back on track.  

Midwives can provide advice on latching, and most trusts provide breastfeeding peer-supporters who have breastfeeding experience themselves to provide mum-to-mum support.  

For more complicated issues, there are lactation consultants at the trusts and privately who can offer support.  

A lot of Sure Starts also offer breastfeeding groups where you can get to know other mums going through the same experiences as you in a shared, safe space.  

Fourth Trimester Local Women Magazine

What happens once baby is three months old? 

By the end of the fourth trimester, the baby may well have settled into a routine and not waken as frequently. 

They may have started to interact with those around it.  

However, every baby is unique and develops at different paces, and in different ways. 

But if you are concerned about your baby in any way, don’t hesitate to speak to a healthcare provider.  

A great reference to read are books and blogs by Sarah-Ockwell Smith, who goes into a lot more detail about the fourth trimester. 

What can parents do to ease the transition period? 

For baby, the key thing to remember is that mimicking the womb environment will be of great comfort to them.  

Although not common in our culture, swaddling or wrapping the baby to mimic the confined space of the womb will often help babies settle.  

Gentle swaying will mimic the movements and a shushing noise can mimic the familiar sounds.  

Skin-to-skin and generally being held is something all babies love, and helps with the bonding as you soak up each other’s scents. 

It can be done by the whole family.  

One of the easiest ways to achieve this is by baby-wearing – newborn wraps keep the baby close to you, confined and experiencing the natural movements of your body, and as an extra benefit gives you your arms free to get on with daily tasks if needed.  

For the parents, we would recommend planning ahead with friends and family for some extra support – pre-preparing a meal, popping to the supermarket, or putting a load of washing on can help take daily household pressures off the mum and dad so they can concentrate on each other and their new baby.  

Pre-preparing some meals and even a frozen loaf that can be defrosted from the freezer, and having a good stock of washing powder, nappies and baby wipes (reusable or disposable) can help keep the stress levels down.  

A postnatal doula can support you to be the parent you want to be. 

She will care for you, share her knowledge, take time to listen as you and your family all get to know your new baby.  

The postnatal period is a time of change and adaptation, not only for your baby, but also for parenthood.  

What do you know now that you wish you’d known when you first became a mum? 

I wish I’d had a postnatal doula myself to be honest. 

It was a big shock to be discharged from the hospital with a newborn baby, with the expectation of myself and my partner knowing how to care for him.  

Those early weeks are a bit of a blur as we struggled with sleep deprivation and trying to create a new normal way of life.  

We didn’t have much in the way of family support and so looking back I don’t feel I was able to treasure the early days as much as I could and should have done. 

I definitely didn’t give myself the time I needed to recover so my physical recovery took longer than it should have.  

That’s the main reason that I became a postnatal doula – to be able to give other mums that support during those early days.  

They are so precious, especially for a first-time mum, who has been reborn herself into the role of a mother which is literally life-changing.  

It deserves to be treated as a special time and not an afterthought, secondary to the pregnancy. 

After all it is the start of a precious new life.    

Here at Doulas of Northern Ireland, we are professional, experienced and friendly, and offer specific postnatal packages to suit your own personal circumstances.  

Services may include help and support with feeding, bathing, changing and soothing your baby, taking care of your baby while you have a shower or bath, spending time with older children, looking after older children while you spend time with your baby, helping with light housework, cooking, laundry, and helping with pets. 

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