Women's Health

Supporting Moms in the Fourth Trimester

Mothers and babies receive a lot of attention from providers during the three trimesters of a pregnancy. But for moms, the fourth trimester is a different story.

May. 6, 2022 5   min read

Most people know that pregnancy consists of three trimesters. Each stage of a trimester is important to the growth and development of a baby. Consistent visits to an OBGYN provider to monitor the health and progress of the mother and her baby are part of most pregnancies.

Once a baby is born, pediatricians continue to give them regular checkups and appointments so they can keep an eye on their development in the days and weeks after they are born. At the same time, mothers typically have a single follow-up appointment with their OBGYN in the weeks following the birth of their child.

Franziska Haydanek, DO, is an OBGYN with Rochester Regional Health and discusses the needs that new mothers have during this post-birth period – which is now being referred to as the fourth trimester.

What is the fourth trimester?

Marking the transition from pregnancy to postpartum, the fourth trimester is the 12-week period of time following the birth of a child. These first weeks are a time of change, learning, and new experiences for mom and baby.

Mothers are going through significant changes in their own bodies, having just given birth and now caring for an infant. These changes are not only experienced physically, but also emotionally, mentally, and socially.

With all of this taken into consideration, the American College of Obstetricians and Gynecologists (ACOG) recommends all women have contact with their OBGYN providers within the first 3 weeks of giving birth. After finishing up an initial assessment, providers are strongly encouraged to follow up with continued care as needed.

Providers are also encouraged to end continued care with a comprehensive postpartum visit no later than 12 weeks after a woman gives birth.

A whirlwind of change

Any mother can attest to the fact that the first days and weeks after giving birth are a tumultuous stream of sleep deprivation and adjustments to a new normal. Women are often learning how to feed and care for their newborn – which requires nearly all of their attention.

At the same time, new moms have just gone through a dramatic change in their own bodies. For the past nine months, their body has nurtured the growth of a baby – and that baby has been brought into a new environment very quickly. A mother’s body goes through trauma during labor & delivery. Because of that, women may be dealing with vaginal soreness, cramping, bleeding, and/or hemorrhoids – and that short list does not include the complexities and time needed for a C-section recovery. As a result, mothers are often trying to recover physically from that experience while also paying attention to their babies.

Combining this new reality with new emotions or feelings that often arise can be overwhelming – and completely understandable.

Considering all of these new changes, providers are encouraged to consider more frequent postpartum visits with new mothers. During these visits, the ACOG recommends several areas of screening, such as:

  • Physical recovery from birth
  • Adequate sleep
  • Emotional well-being
  • Infant feeding and care
  • Sexual health
  • Contraception
  • Chronic disease management
  • Health maintenance
  • Pelvic floor physical therapy referral (as needed)

Ensuring pregnant women are educated and able to receive the care they may need in the postpartum period can make a big difference in their overall health – and, as a result, the health of their baby.

“There are a huge number of changes that a woman goes through in the first days after she gives birth,” Dr. Haydanek said. “Having someone to talk with about your own health in that time can be both reassuring and empowering.”

Support new mothers

If your partner, friend, or loved one is a new mother, they are likely adjusting to significant changes and experiencing the physical, mental, and emotional demands that come along with those changes.

Take the time to reach out to them, giving them space to talk, vent, or whatever else they may need. Sometimes moms just need a listening ear – either over the phone, over text, or in person.

If they are open to being visited, ask if you can bring over a meal or other needed items. Offer to help with a specific household task if they are open to receiving help. The decision ultimately lies with the mom, but letting them know they are cared for and supported can be integral to their mental and emotional health.

A new mother’s partner, close friends, or loved ones are also the ones who see more serious signs that may indicate the need to reach out for support from a health provider. That can include hints that point toward postpartum depression. Roughly 1 in 8 women experience symptoms of postpartum depression in the U.S., according to research by the CDC.

Common symptoms of postpartum depression include:

  • Severe anxiety
  • Feelings of hopelessness, shame or inadequacy
  • Drastic mood shifts
  • Panic attacks
  • Difficulty thinking clearly or making decisions
  • Pulling away from family, friends and baby
  • Loss of interest in hobbies
  • Trouble with sleep and appetite
  • Thoughts about suicide or harming the baby

“Everyone needs someone else who can look out for their health,” Dr. Haydanek said. “Having someone who knows you well and can recognize when you might need to talk with or be seen by a provider – especially when you are in such a vulnerable place – is a sign of trust and compassion.”

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Franziska V. Haydanek, DO
Obstetrics
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