So you've reached the 4th trimester, what next? Mums get real about what to expect

"Will I instantly bond with my newborn? Will breastfeeding hurt? What if I just can't stop crying? Can you die from sleep deprivation?"

Mums (and dads), we need to talk about the fourth trimester. Photo: iStock

The fourth trimester - yes, it's a thing.

Believe it or not, those 12 weeks immediately after giving birth are just as important for a mother's health as the first three trimesters. And we need to normalise everything - shitty or otherwise - that happens to mum and bub during this time.

"Oh please no," would be most women's response to first learning about the fourth trimester. Like the first three trimesters weren't challenging enough?

But no, these three months have nothing to do growing a tiny human inside you (and a tummy that never seems to stop stretching), but rather, a period of great physical and emotional change as your newborn adjusts to life outside the womb, and you adjust to your new title of Mum.

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Let the wild ride begin. Photo: iStock

Related: How to navigate the 4th trimester

What is the fourth trimester?

The "fourth trimester" of pregnancy was actually coined by US paediatrician, Dr. Harvey Karp. He says that essentially, babies are born three months too early. And for the first three months of life after birth they benefit from being cared for as if they are still in their mother’s uterus.

"I used to always tell my patients that babies are born too soon. I know what you’re thinking: Are you kidding? Too soon?! For many mums, the last month of pregnancy seems never-ending. Heartburn, an aching back, and the constant need to use the bathroom can take all the shine off the so-called pregnancy glow," Dr Karp wrote for Kidspot.

"But while you probably couldn’t wait to finally cradle your baby in your arms, your little one would have been thrilled to extend their stay inside the womb for a few extra months, had it been an option. Your baby’s brain was so large that you had to 'evict' them after nine months, even though they were still very immature. As a result, they aren’t quite ready for all that our world holds," he explained.

Related: Huggies launches exciting new nappy range

What to expect in the fourth trimester

Postpartum simply means after birth. As a first-time mum, I was surprised to learn that once you give birth, you are forever in postpartum. So that fourth trimester could also be characterised as early postpartum, and it is arguably the most challenging of all of the trimesters.

So mummas, be sure to go easy on yourselves, and your partner; you're both still figuring it out. 

From physically recovering and healing after giving birth, processing the birth itself, wild hormonal changes, figuring out the whole breastfeeding situation (if you can or choose to), dealing with sudden extreme sleep deprivation, and accepting a body that, yet again, looks nothing like your pre-baby body. It's all tough.

With bub, expect plenty of fussiness and crying from your newborn while they adjust to life outside the womb, where it was warm and squishy, dark and constantly moving. "They will push their new vocal cords to the limits with screams, naps might feel few and far between and only happen on you, and you’ll find yourself on an erratic sleep schedule," Dr Karp says. 

"To give your little one 'fourth trimester' care, you'll want to give her plenty of snug wrapping/swaddling, shushing, swaying motion, holding in the side/stomach position and opportunities to suck."

Dr Karp recommends the 5 S's - Swaddle, Side/Stomach Position, Sush, Swing, Suck. Ultimately, the aim is that everyone at home eventually gets to enjoy the sixth S - SLEEP! (More advice on the 5 S's can be found here.)

Advice from real mums who have been there:

Char, Sydney mother-of-two: "Nobody warned me that I should expect to not feel like myself for a solid six weeks after my first baby was born. I walked around in a sleep deprived haze, sobbed for hours when my milk came in that first time (my boobs felt like they were on fire and I could barely feed), endured those postpartum night sweats for weeks on end, and struggled to connect with even my closest friends who had no idea just how traumatic I found my first birth experience. 

"My best advice? It WILL get easier. You WILL find your rhythm. You will probably never feel like your 'old self' again, but you WILL find yourself again. Take it slow and be kind to yourself."

Dom, Sydney mother-of-one: "No one talks about your nipples! For me it was navigating breastfeeding and the pain I didn't know could come with it. The midwives constantly reassured me that once I got a good latch, it shouldn't hurt, but no one talks about how sensitive your nipples can get and that first fortnight was pretty painful. My lifesaver was the silverette discs that helped soothe them between feeds."

Rachel, Orange mother-of-three: "My fourth trimester for each baby was vastly different. With my first baby, I was so focused on being the perfect mother that I got caught up in the small things that didn't really matter - the clean house, the healthy dinners, not wanting to accept any help. With my second baby, I felt guilty and worried about not sharing the love and attention equally between my two daughters. Third time around I felt I could finally embrace all the imperfections and chaos and was able to let the small things go so that I could simply enjoy my baby and my two other children more. 

"My advice would be to take ALL of the help on offer, no matter how big or small. Don't pay any attention to what you read on social media from mothers who appear to have it "all figured out" (I promise you, they don't) - in fact, unfollow those other mums ASAP. And one more thing, being a new mother can be very lonely, so expect to feel that, but just know that it will pass."

Nama, Sydney mother-of-one: "Fourth trimester for me was an absolute joy. Born at 32 weeks, it was a pleasure to watch my son develop and become stronger every week. I'm not sure how I would have coped if everything had gone according to plan, but that emergency C-section was the game-changer in how I approached things when he came home after six weeks in the NICU.

"But definitely learning to eat with one hand - and be able to prepare basic food with one hand - was a skill I had to develop because my baby was clingy AF!"

Gabrielle, mother-of-three, doula and author of The Motherhood Space: "In these first few days and weeks postpartum - a sacred period of time known as the first forty days - allow yourself to be held, prioritise rest, make space for your body to heal and time to connect with your baby, which doesn't always happen instantly...

"Hormones and emotions are all over the place. You are doing your absolute best. Taking it minute by minute. Finding your rhythm. But it's so hard. It's painful. There is endless doubt. It's exhausting beyond belief. Your body is raw and unrecognisable. You love your body but pine for your old life. If you have older children, you miss them desperately and feel guilty you have such little time with them. And while you might on some level know these days are fleeting, when you are so deep in them, they truly feel never-ending."

And guess what? That's really ok. You're doing great, Mumma. So hang in there. 

Originally published as So you've reached the 4th trimester, what next? Mums get real about what to expect