Did you know there’s the 4th trimester of pregnancy? You read that correctly, the 4th trimester. Don’t worry; it doesn’t mean you’ll have to carry your baby longer. It’s more of an extension of pregnancy once the baby is born and it’s an extremely crucial time in you and your baby’s life.

What is the 4th trimester?

Pediatrician and author of The Happiest Baby on the Block, Dr. Harvey Karp, conceived the 4th trimester theory. It is the philosophy that even after a baby is born, they would still prefer to be in utero. And therefore, caregivers should mimic the womb as closely as possible in the first months of a baby’s life. Coinciding with these early months, medical professionals recognize the importance of maternal health directly following pregnancy.

How long is the 4th trimester?

The 4th trimester is a time of adjustment for both mom and baby and it is defined as the first twelve weeks after pregnancy.

When the 4th trimester starts, the baby will encounter significant shifts in her world. She will suddenly need to regulate her own body temperature and be introduced to new sounds, sights, and sensations outside her previous fluid-filled environment. She will display crying and fussiness to show her discomfort in the outside world. You can help make the abrupt change a gentle transition.

The 4th trimester mom

Before we delve into ways to help your baby navigate her new outside world, it’s important to recognize that caring for yourself is the only way to ensure you’re able to give the best care to your newborn. The Fourth trimester book by pregnancy and postpartum expert Kimberly Ann Johnson offers new moms a natural approach to tackling the early postpartum stage.

She focuses on preparation for birth, strengthening relationships, caring for your baby, and how to safely reintroduce physical activities after birth. Attending to these needs during the fourth trimester of pregnancy will best support your well-being and, ultimately, the baby.

How to focus on your care

1. Sleep

Throughout the 4th trimester, sleep is difficult to come by. Your time is consumed by attending to your baby’s every need on top of everyday home and life tasks. A way to alleviate some of the load is to share baby responsibilities with someone such as a partner, family member, or friend.

If you have difficulty relinquishing baby duties to others, accept offers of help on other tasks and sneak in an all-important nap. Another tip for maximizing how much sleep you’re able to get is making preparations in advance so that you can go to sleep as soon as you’ve gotten your baby to sleep. Rest will help you reset and tackle parenting with renewed energy.

2. Exercise

Another way to reset and improve energy is exercise. If you have no complications, it’s considered safe to begin your postpartum fitness journey with low-impact exercises a few days after vaginal birth or when you feel ready. If you experienced severe tearing, complications, or cesarean delivery, consult your doctor about when it’s safe to add exercise to your routine.

Your 4th trimester body is still experiencing drastic hormonal, emotional, and physical changes. Give yourself some leeway in losing your pregnancy weight. It took 40 weeks to gradually put the weight on; it will take time to gradually take it off.

3. Emotional support

It is vital to have friends or loved ones to lean on after the baby is born. It helps to have someone to talk to, spend time with, and gather advice from, especially if you and your partner disagree on parenting methods. Accept the advice that works for you and let go of the other well-meaning words of wisdom.

You are doing everything you can in this demanding period of motherhood, but mentally, it can feel like you aren’t doing enough. This vulnerable mindset can be emotionally draining. Couple that with hormonal changes and physical exhaustion, it can be the perfect storm for postpartum depression.

Symptoms of postpartum depression include sadness, excessive crying, difficulty bonding with your baby, withdrawal from loved ones, lack of enjoyment, loss of appetite, hopelessness, sleep difficulties, and thoughts of self-harm or harming your baby. If you experience feelings of harming your baby, yourself, or others, you should contact your doctor for help immediately.

If other symptoms persist for more than 2 weeks, get worse, or make caring for your baby or carrying out everyday tasks difficult, you should seek professional help. You may feel shame or embarrassment in admitting you have depression, but it is estimated that about 1 in 8 women experience postpartum depression symptoms. You are not alone and the sooner you get help, the sooner you can feel better.

4. Sex

Being intimate after giving birth can be a source of anxiety. You might not feel the energy or desire to have sex and fear how it will feel after delivery. Still, the human body is miraculous at rebuilding itself and intercourse is possible relatively quickly. It is suggested that you wait 4-6 weeks after delivery before having sex to ensure that your body has had time to heal.

After pregnancy, the main physiological changes to your body include pelvic floor weakness regardless of how your baby was delivered and vaginal dryness and/or sensitivity due to hormonal changes. Some tools to arm yourself with when becoming sexually active again are Kegel exercises used to strengthen the pelvic floor, lubricant to help with dryness, and time to combat tiredness and anxiety.

5. Nutrition

During the 3 trimesters of pregnancy, your diet needs were for both yourself and the baby. Your nutritional needs during the 4th trimester are changed, even if you are breastfeeding or pumping. Most moms will need 1800-2200 calories per day. But if nursing, they will need an additional 500 calories each day.

Keep in mind that nutrition provides that oh-so-necessary energy. The 4th trimester is not a time for losing more calories than you are replenishing. Choosing foods that will reestablish your nutrient stores, which may have been depleted during pregnancy, are ideal. Recommended foods include fruits, vegetables, lean proteins, and whole grains while avoiding foods higher in saturated fat, salt, and sugar.

Making your needs a priority can be difficult with a new baby, but doing so will allow you to do your best job as a mom.

How to assist your 4th trimester baby

Your baby will need your attention nearly nonstop. In The Happiest Baby on the Block, Dr. Karp suggests that if you approach the 4th trimester with a mindset that your baby is a “fetus outside the womb,” you’ll be able to calm the baby more effectively.

When you consider what life is like for a baby before she is born, you realize how drastic leaving the womb might be. In the womb, your baby is suspended at all times with constant tactile feedback on her skin. Baby sucks almost constantly and receives nutrition automatically.

According to Dr. Karp’s theory, mimicking these sensations ensures you’re providing familiar comfort to your baby. He calls them the five S’s of soothing the baby: swaddle, side-stomach position, shush, swing, and suck.

Suggestions for mimicking the womb

• Hold baby in the “tiger in the tree” position. This hold allows them to hang from over your arm in a suspended carry. To achieve this position, support the baby lying face down across one of your arms, their head at your elbow, and firmly hold the top of one of the legs. You can place your opposite hand underneath the first for extra support.
• Swaddle baby in a blanket or other swaddling garment. When wrapped in a swaddle, your baby feels surrounded similarly to how they were enclosed in amniotic fluid. Swaddling allows for less interrupted 4th trimester baby sleep because when your baby’s arms are tucked in close to their body, they’re less likely to startle and awaken.
• Create shushing sounds. Your baby is used to a symphony of whooshing fluids. You can recreate the sounds orally or with a sound machine. Some caregivers even swear by a vacuum. Interruptions in sound can cause the baby to startle. Constant or repeated noise can reduce how often your baby wakes.
• Create opportunities for your baby to suck. Newborns may nurse for comfort, not expecting to eat, but because they are used to the suckling motion they performed in utero. Babies may also prefer their thumbs or a pacifier to soothe.
• Anticipate looming developmental leaps. This means that you can prepare to give increased means of comfort when your baby reaches new developmental milestones. Babies tend to reach these leaps around the same ages and are often more difficult to please than usual as they gain a better understanding of their world (which can be overwhelming!). During the 4th trimester, babies experience developmental leaps around 5 weeks, 8 weeks, and 12 weeks. You can expect more fussiness, longer feeds, and a change in their sleep.

In sum, the 4th trimester is arguably the hardest. Yes, it is a wonderful, joyous, soul-moving time filled with baby gurgles, sweet snuggles, and awe-inspiring yawns. But it can also be extremely stressful and physically demanding, and even the smallest detail—happy or sad—can drive you to tears. Your body is no longer on autopilot caring for your baby, but armed with advice for how to care for yourself and the baby during the first three months after pregnancy, you can both transition into your new roles beautifully.