What is the fourth trimester?

The fourth trimester is the 12-week period immediately after you have had your baby. Not everyone has heard of it, but every mother and their newborn baby will go through it. It is a time of great physical and emotional change as your baby adjusts to being outside the womb, and you adjust to your new life as a mum.

The term 'fourth trimester' was named by paediatrician Dr Harvey Karp in 2002 and suggests that you should try to recreate, for another 3 or 4 months, the kind of environment your baby had in the uterus.

How can I help my newborn adjust?

There are a number of ways you can provide comfort and help your newborn adjust to the outside world.

Swaddling and swaying

Babies spend 9 months in a confined and constantly moving environment. There are several ways you can re-create the sense of safety and security your baby felt before they were born. By swaddling your baby when you put them down to sleep, you will let them feel secure, and you might find they wake less frequently and sleep for longer.

‘Wearing your baby’ in a sling across your chest can feel familiar to them. But it’s important to make sure you use the sling correctly, since they can cause injury if not properly fitted.

Movement is also a great way to calm your baby. Gently swaying or rocking from side to side, walking whilst carrying them or even taking a quick car trip can settle your baby.

Skin to skin contact

Skin-to-skin contact, also called 'kangaroo care', is always encouraged in the moments after you give birth, but this type of contact should continue long after you have left the birthing room. Cuddling your newborn on bare skin is a great comfort to them. Your smell and the sound of your heartbeat is warm and familiar. This is also something your partner can do.

Feeding

Whether you are breastfeeding or bottle-feeding, if your baby is hungry, don’t wait for a scheduled time to feed them. Combine feeding your baby with skin-to-skin contact to reinforce close contact and comfort.

Bath time

Having a warm bath is often a relaxing and comforting experience for newborns. Floating in the water is like being in the uterus. It’s also a great way for you to bond, talk and sing to your baby.

What does the fourth trimester mean for mum?

For you, the fourth trimester is a time of great change. When the baby arrives, quite often the focus shifts to them and as a result, mums can overlook their own health and wellbeing.

Newborns take up lots of time. It’s very easy for new mums to be overwhelmed in the first few weeks by the demands of feeding, sleeping (or lack of), crying and looking after a baby. Combined with the physical recovery after giving birth and the changes to their hormones, it’s no wonder mums can feel exhausted.

Ask for help

In some cultures, new mums spend the first few weeks totally focused on bonding and recovering with their newborn. Other people, usually a family member like a mother, sister or aunty, will stay with them to do the other things around the house and help out with the baby when needed.

In Australia, however, most women go home from hospital after a couple of days and attempt to continue to do everything as before.

If you have a partner, encourage them to assist and participate in parenting as much as possible. The two of you are in this together and there are lots of things you both can do to share the load.

You don’t want a procession of people coming over, but a few family and friends can help by:

• bringing meals
• helping with household chores
• looking after your other children (if this is not your first child)
• looking after the baby while you rest

Accept help and don’t be afraid to ask.

Eat good, nutritious food

You will need lots of energy in those first few months, so eating a variety of healthy foods will help give you the boost you need. Some some light exercise will also help with your recovery and energy levels. But make sure to give your body time to heal and take it at your own pace.

Sleep when you can

It might sound obvious, but you need to sleep. It’s going to take a while for your baby to settle into a routine and even then, they will have you up at all hours of the night. If you can, try and sleep when your baby is sleeping, or ask your partner or a family member to look after your baby while you get some rest.

When to see your doctor or midwife

Your body has been through a lot over the past 9 months. Your physical recovery will take time, but it’s important to speak to your doctor or midwife if you have any of the following:

• heavy bleeding or passing of clots
• high temperature or fever
• offensive-smelling vaginal discharge
• a hard or painful lump in your breast
• an area around stitches that is red, hot or oozing
• pain, tenderness or a warm area in your legs

Mums are also recommended to have a postnatal check 6 weeks after having a baby. This is usually a good opportunity to review your health and wellbeing.

Many women also experience the ‘baby blues’ in the first few days after giving birth, but if these feeling are not going away, it's important you see your doctor as soon as possible. Postnatal depression affects 1 in 7 women in Australia, and it is nothing to be ashamed of, but you need to seek help.

Resources and support

• Talk to your doctor or midwife.
• Contact a maternal child health nurse.
• Visit the Australian Breastfeeding Association website, or call them on 1800 686 268.
• Call PANDA (Perinatal Anxiety & Depression Australia) on 1300 726 306.