You’re likely familiar with the first, second and third trimesters—but did you know there’s a fourth? And it’s just as important for baby’s development and your health as the first three.

You made it through pregnancy—all three trimesters—and labor and birth. Now you and your baby are in the fourth trimester, a phrase used to describe the first three months after your baby is born. Some experts believe the fourth trimester should include the entire first year after baby is born, and for good reason. The fourth trimester is remarkable in so many ways. It is a time of life-changing transformations for you and your family, some of which come easily and some of which are hard-fought adjustments. The fourth trimester includes physical, emotional, and mental transitions.

Don’t underestimate the power of these transitions. Plan for all the support you can arrange from family and friends, in the ways that will work best for you, during this critical period. Learn what the normal physical and emotional changes are and signs of problems requiring your provider’s attention. Trust your instincts and call your provider if you feel something’s just not right with your physical or emotional wellbeing.

During pregnancy, as you plan for the fourth trimester, identify your personal superpower(s). A superpower is a strength you have that you can access when you are feeling overwhelmed and in need of a boost during the fourth trimester. Maybe it’s your sense of humor, your patience, your determination. Maybe it’s your ability to plan ahead in practical ways. One mom shared this about how she got through the fourth trimester.

The Sisterhood

“I had a good friend who had her first baby and was so lonely during the first months. She really felt isolated which led to her feeling down in the dumps. When I became pregnant with my first a year later, I wanted to ensure I would not get lonely. I am an extrovert and love being around people—they give me energy. I decided to call on several of my very good friends to ask them to be my sounding board and support system after the birth of my daughter. They all agreed, of course, and that gave me a chance to catch up with at least one adult each day and talk about my day and how it went. In turn, my friends kept me in the loop about their lives and organized meals for me for three whole weeks, so I did not need to cook. I would say that my willingness to call on The Sisterhood was my superpower.”

Normal Fourth Trimester Transitions

  • Post-birth bleeding may last 4 to 6 weeks, gets lighter each day after the first few days
  • Swelling in your legs due to IV fluids decreases after early days, legs should not be red or warm
  • Healing of the tissues of the vagina or a cesarean incision takes place over the first several weeks, but you should experience a steady decrease in pain and discomfort.
  • Emotional shifts: tearfulness, irritability, anxiety, feeling overwhelmed. These feelings should peak in the first week and improve by two weeks; if not, call your provider.

Post-birth Warning Signs

Contact your healthcare provider if you have:

  • chest pain
  • difficulty breathing
  • fever (100.4 F or higher)
  • a severe headache
  • heavy vaginal bleeding
  • seizures
  • a red or swollen leg, painful or warm to touch
  • incision that is not healing
  • thoughts of hurting yourself or your baby

See also: Baby Gear for Dad
How to Breastfeed if You’re an Adoptive or Surrogate Parent
Lactation Options & Strategies for LBGTQ Persons

Charlotte Wool, PhD, RN, is Associate Professor of Nursing at York College of Pennsylvania and an expert adviser to Healthy Mom&Baby.


Charlotte Wool, PhD, RN, is a nurse educator and expert advisor to Healthy Mom&Baby.

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