The fourth trimester of pregnancy is an important but unknown concept for many. It is the period that starts after delivery and lasts for 12 weeks. During this period, the mother and baby become familiar with and adapt to life outside the womb, cultivating their social and emotional skills.

A Gap in Care After Childbirth

The current treatment of women after childbirth is a characteristic example of the care gap that exists, as little attention is given to the difficulties of breastfeeding and the risk of postpartum depression. Care after childbirth is often limited to one visit at 6-8 weeks, leaving mothers to face the physical and emotional challenges of the fourth trimester on their own.

Understanding the Challenges of the Fourth Trimester. What Happens in the Fourth Trimester?

Women, their partners, and their families experience significant physiological, social, and emotional changes during the fourth trimester. The potential pain caused by vaginal trauma during childbirth, surgical incision after a cesarean, haemorrhoids during the first two to three weeks, the physical and emotional challenges of breastfeeding, and insomnia are just a few examples of what a new mother may face.

This early period after childbirth is a period of great joy but at the same time a very 'sensitive' period. That's why it's crucial for us as gynecologists to provide close monitoring, support, and preventive guidance with the same warmth as the weeks before delivery. In this way, most women benefit from more careful monitoring during the fourth trimester.

Frequently Asked Questions and Concerns of New Mothers

• How will I know if my baby is getting enough milk?
  It's natural to have concerns about breastfeeding, but you should know that it's a skill that both you and your baby will acquire over time. You can monitor your baby's weight gain and look for indirect signs such as tongue movement and breast emptying to understand if you're breastfeeding adequately. You can also seek help from a lactation consultant for guidance and support.
• How can I manage physical changes after childbirth?
  Full recovery of the body after childbirth can take time. It's important to relax and let your body heal. You can try using ice for the perineum, taking warm baths, and using stool softeners to alleviate any discomfort. You can also ask your doctor for advice on exercises and stretches that can help with gradual recovery.
• How can I manage my emotions?
  The fourth trimester can be filled with emotional changes and it's normal to feel overwhelmed. Talk to someone: Whether it's a therapist, a trusted friend, or a family member, talking about your feelings can help you process them and find ways to cope. Be gentle with yourself. Remember that it's normal to have a wide range of emotions during this period and be generous with yourself and those around you.
• How can I cope with sleep deprivation?
  Sleep deprivation can be a major challenge for new mothers, especially during the fourth trimester. You can try to establish a sleep routine for you and your baby and ask your partner, friends, and relatives to contribute to household chores or baby care. The involvement and understanding of the partner are vital at this stage.
• How can I cope with the isolation of being a new mom?
  The fourth trimester can be a period of isolation for new mothers, especially if you are staying at home with a baby. You can try to meet other new mothers through online or in-person support groups, arrange visits or calls with friends and relatives, or find other new parents in your neighbourhood.

The Importance of Recognizing the Fourth Trimester of Pregnancy

It's time to give the 4th trimester the value it deserves. Personally, I encourage new mothers to schedule regular postpartum visits to discuss and find solutions to emerging issues, prioritize self-care, and not hesitate to ask for help when needed. Remember that your health is equally important as your baby's health and you deserve full support and understanding during this period.

Sources

https://www.cuimc.columbia.edu/news/mothers-guide-fourth-trimester

https://www.health.harvard.edu/blog/the-fourth-trimester-what-you-should-know-2019071617314