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The Truth About the Fourth Trimester of Pregnancy


A normal full-term pregnancy is divided into three trimesters of baby development in the mother’s womb. Each trimester comes with its own hormonal and physiological changes. As a new mom, the education about each trimester prepares you for how the baby affects your body and allows you to prepare for those changes. But the fourth trimester, the six-to-12 weeks after the baby is born, is an important time in both the baby’s development and the mother’s health that is largely ignored.

What is The Fourth Trimester?

The fourth trimester can be a vulnerable time for new mothers and should be viewed as a continuation of prenatal care. The American College of Obstetrics and Gynecology is now recommending that doctors view postpartum care as a part of maternal health. This new focus means that everyone is starting to recognize a healthy pregnancy goes beyond the birth of the child.

What Does Your Baby Need in the Fourth Trimester?

Welcoming a new baby can be a very exciting and confusing time for both mom and baby. The baby has been in the warm womb for nine months and is now exposed to new sights and sounds. Moms can help the baby feel safe and secure, by:

  • Swaddling for safe sleep
  • Gently swaying or rocking
  • Practicing skin to skin contact
  • Breastfeeding
  • Giving warm baths

What Does Mom Need in the Fourth Trimester?

When you think of motherhood, you think about an overwhelming sense of love and bliss. But the truth is, those moments exist in between a lot of hard work and many sleepless nights.

Caring for a newborn is hard, and sometimes it isn’t fun. A new mom can get overwhelmed and stressed at the constant attention a baby needs. Women experience physiological, social, and emotional changes, which often go unchecked and unnoticed. Typically, a follow-up with the doctor isn’t scheduled until six-to-eight weeks after birth, when a mother may already be in crisis mode.

In the fourth trimester, mothers are at risk for postpartum mood and anxiety disorders. In all the excitement about the birth, a new mom puts her own needs aside, which can have a negative impact on her mental health.

According to the American Psychological Association, roughly 14% of new mothers develop postpartum depression (PPD). Postpartum depression is severe depression or anxiety in the first weeks or months after childbirth. All new moms and their family members should be aware of the common signs of PPD, which include:

  • Significant weight loss or weight gain
  • Inability to sleep or increased sleeping
  • Agitation or mental slowness
  • Loss of energy
  • Feelings of guilt or worthlessness
  • Inability to concentrate
  • Recurrent thoughts of death; suicidal ideation, gestures, or attempts
  • Feelings of anxiety and worry
  • Withdrawing from or avoiding family and friends
  • Crying more than usual or for no apparent reason

PPD is treatable, and the sooner you seek help, the sooner you can start enjoying your new baby and start taking care of yourself. If you think you have PPD or know a family member who may need help, talk to your OB/GYN or your primary care physician.

Learn more about women's services at UPMC.