Postpartum Care: What Is The Fourth Trimester?
Pregnancy is often compared to a physical and emotional marathon requiring continued focus and endurance. It ends with labor and birth, a final surge of a woman’s willpower. We celebrate the end of this marathon with the gifting of toys and clothes. We record the baby’s weight, take photographs of each little movement, and send out announcements and social media posts detailing the newest arrival.
What is often not recognized, however, is that labor, delivery, and birth are more like a triathlon. The term ‘fourth trimester’ is becoming a popular description of the first 12 weeks after birth for this reason.
The baby and birth parent are often assumed to be two fully separate individuals as soon as the umbilical cord is cut. This is not entirely accurate. In medicine, the two are referred to as a ‘dyad’, meaning they are two parts of a whole. I often counsel mothers in my practice that they are still their infant’s home. In her arms and on her chest is the closest the baby can get to crawling back inside the uterus - something no mother would allow! Studies show that babies are calmed and physiology is stabilized on their mother’s chest. This is why spending time skin to skin is so important - temperature, breathing rate, heart rate, and stress levels are all regulated just by the baby being on mom’s body.
During the fourth trimester infants and their new parents go through many challenges and changes. This is a time in which infants go through multiple physical and developmental growth. It is also a time of many shifts for the birth parent including changes in their postpartum body. Many struggle with pelvic floor weakness, pain, healing of c-section and vaginal wounds from birth, changes in or lack of libido, postpartum depression and anxiety. New parents also experience huge shifts in self identity and relationship with their partner and the world around them. This is a time when mothers and new parents are vulnerable and need care and support. Unfortunately, it is also a time when new parents’ needs are often overlooked, something we need to change as a society.
We often hear it takes a village to raise a child. We don’t often recognize that a village, or support system, is also key to helping new parents successfully navigate this period of great change. During pregnancy we often focus on obtaining all the necessary - and not so necessary - baby items. Yes, decorating the nursery is fun. But much more crucial is identifying how you will find the care and support you need after your baby is born. Family and friends often play a big role in this. Talk to those you will turn to about what you will need from them - help with laundry and dinner, for example, can be invaluable. Having a list of professionals you can turn to is also key - from your pediatrician and OB to a postpartum doula, pelvic floor therapist, and lactation consultant, there are many resources to help you through this journey.
Many parents feel overwhelmed by planing for the fourth trimester. As a new parent I personally experienced this same feeling and realized the resources available to me and other new parents were simply inadequate. So over the past decade, I devoted my career as a physician to improving fourth trimester care. If you are feeling overwhelmed by the idea of the fourth trimester, then please reach out to discuss how Lindsay Moore MD can help you thrive during your postpartum.
