by Suzanne John, Endorsed Midwife & Lactation Consultant | 2024
Pregnancy brings many surprises, so whether it is your first or your sixth, each experience will be different. Generally, throughout your pregnancy, you are well supported, through Midwives, G.P’s, Obstetricians and the Hospital, so it is very easy to just concentrate on those nine months and forget all about the fourth trimester.
What is the Fourth Trimester?
The fourth trimester is the name given to the period immediately following birth, and the 12 weeks beyond, even though you are not pregnant anymore. This phase is crucial to both child and parent development, as they adjust to the new dynamics and changes.
Dr. Harvey Karp, paediatrician in 2022, originated this theory that babies were born 12 weeks premature, due to the size of the baby’s brain. Any longer than 40 weeks pregnancy, they would be too large for a mother to deliver.
The term “The Fourth Trimester” emphasises that the baby still needs the level of care and closeness, like that in the uterus. Your baby needs to adapt to the outside world, for this to be a smooth transition, this period needs to be understood and supported.
The needs of the newborn, food, love, warmth, protection, sleep, your baby will let you know what they want. Your baby is an individual, you will attune to your baby, reading their cues, so they can start to anticipate their needs. Attunement is developed and internalised over time, connecting with each other. Kerstin Uvnas Moberg 2014 in her book, Oxytocin: The Biological Guide to Motherhood describes how oxytocin helps mothers access inborn female competence that helps them transition to motherhood and establish a good connection with their children. Oxytocin is a signalling substance in the brain that when released during skin to skin contact and breastfeeding it induces important physiological and psychological adaptions in the mother and infant.
What can we expect during this fourth trimester
There are no rules, in these first few months of life.
The way I describe this trimester is:
Your baby is born premature; you now need to emulate the uterine environment.
In utero, your baby slept when they wanted, had warmth, comfort, security, awake periods and a constant supply of nutrients. Your baby wants to be back in this environment, being with/on you is as close to this perfect place as they can get.
Until you’ve had a baby, there is no way of understanding what to expect during this trimester.
Plus, there is so much emphasis on sleep, probably the number one topic of conversation for new mothers.
Depending on your source of information, the average time that a baby will sleep in a 24-hour period is around 9.3 – 20 hours! Every baby is different.
Dr. Karp recommends recreating a womb-like environment as much as you can, for the gentle adjustment into the outside world for baby. Close as possible to you, skin to skin contact, nutrition, protection, warmth, soft gentle noises, gentle movements, swaying and swaddling, all offer a secure environment. Swaddling is helpful for security, so when you do put them down, they ‘might’ wake less often.
The mother’s body is also going through a recovery process, which can result in physical discomfort and a rollercoaster of emotions. Anxiety, frustration, overwhelmed, and sometimes difficulty bonding.
It does not mean you have to go through this alone.
According to COPE, 1 in 5 mothers and 1 in 10 fathers will experience perinatal depression. Your mental health is a vital part of you and your baby’s development. If you are feeling low persistently, you should reach out for immediate support.
Seeking help is a sign of strength and is the best way to ensure your family’s wellbeing.
Breastfeeding Issues
We have all heard “Breast is Best”, yet one thing that is a shock to many new mothers is how difficult Breastfeeding can be. It is often referred to as “the most natural thing in the world”, yet it does not come easily to many new parents.
Breastfeeding is a new skill, just like when you learnt to walk. It takes practice and patience. It does come with frustrations, discomfort, and feeling of uncertainty.
Breastfeeding can evoke an advice overload from well-meaning friends and relatives. What works for you, might not work for others. If this is the case, trust your instincts and seek support from an IBCLC-Lactation Consultant. IBCLCs help you filter through the noise and bring you back into focus what really matters to you. They help you navigate your way through both major and minor breastfeeding issues, such as milk supply stresses, mastitis, challenging latching issues, helping you learn a good technique that is NOT painful. A painful breastfeeding experience is likely to be a short one, and a reason to give up.
Understanding this period, following the birth of baby can help parents anticipate and prepare for the unique needs of both newborns and themselves. Support is crucial. This can be in the form of family, friends, healthcare providers or lactation consultants.
If your lactation consultant is also an endorsed midwife, they offer a Medicare rebate to help with the cost of having this expert support, within the first 6 weeks following the birth of baby.
About the Author
Suzanne John
Endorsed Midwife, Lactation Consultant
0405 884 320 | [email protected]