Three Ways to Survive the Fourth Trimester

Have you heard of the fourth trimester? It’s not often talked about, but it’s just as important to understand and adjust to as the three trimesters of pregnancy. Learning what to expect from your baby in the fourth trimester can go a very long wasy to manage your own and your family and friends’ expectations on you as a mother and on your baby.

Plus, by understanding the fourth trimester and honouring it, you give you and your baby the best chance you can to bond and establish breastfeeding. These are two important factors in lowering your risk of poor mental health, especially postnatal depression.

What is the fourth trimester?

The fourth trimester is the first three months of your baby’s life, a period of enormous developmental change. It’s a time of adjustment from the small, comfortable, warm, enclosed world of the womb to the huge world outside. 

Your baby wants to be kept close, to touch your warm skin, to feel your breath, to hear your heartbeat, to smell your smell

There is a theory that human babies may be born before they're actually ready due to the size of their brain and correspondingly large head. If babies were allowed to gestate to full maturity they wouldn't be able to fit through the birth canal! As a result, newborn human beings are much weaker than most mammals at birth and their senses are not as sharp - their vision is blurred, their hearing is muffled and their sense of touch is overwhelmed. 

Whether the theory about the size of the head is true, it is definitely certain that human babies need extra nurturing to enable them to go through the period of such huge change and development. During this time your baby wants to be kept close, to touch your warm skin, to feel your breath, to hear your heartbeat, to smell your smell. These are what she is familiar with. The rest of the world overwhelms her.

Signs of a baby in the fourth trimester:

  • Refuses to be put down, especially when asleep

  • Falls asleep easily at the breast and in your arms but wakes up as soon as you put her down

  • Feeds a lot, especially at night

  • Cries a lot

This is why I hate people asking how baby is sleeping - she is probably sleeping exactly like a newborn baby should - little and often, with regular feeds. Just like any vulnerable baby mammal, being left alone is not conducive to her survival and hence she requires you to be a surface to sleep on.

How you can help your baby during the fourth trimester:

  • Re-create the womb!

  • Dark, warm room

  • Plenty of quiet time

  • Soft white noise

  • Bare skin-to-skin contact

  • Deep, warm baths

  • Feeding on demand and forgetting about routines

Whenever you’re in doubt - when your baby is crying for seemingly hours on end, when you just don’t know what to do, think back to the womb and cycle through these suggestions. At some point something will probably work and your baby will calm again.

How to cope as a mother in the fourth trimester

Getting rest as a new mum can feel impossible. Your baby requires feeding so very often, wakes up so very often, and cries so very often. It is exhausting, and can be demoralising when you hear about other babies who are apparently sleeping through the night or barely cry. 

I believe acknowledging the fourth trimester benefits the mother as much as it does the newborn because it ensures they slow down and get the rest they need. Just as a baby is born, so a mother is made. Just as the baby needs to learn how to be in this new world, so a new mother needs to learn how to navigate this new world.

In time, you will work out what works best for you and your bay. But in the early days, it’s easy to get lost in the here and now and wonder ‘will this every stop!’

To that end, I like to discuss the 3Bs of motherhood with my clients - the three things that I think can help you and your baby most to make your way through the fourth trimester and, importantly, get some damn rest!

1. Breastfeed

  • Better mental health: Establishing breastfeeding lowers the risk of postnatal depression

  • Better immunity: Breastfeeding lowers inflammation and keeps stress hormone levels low

  • Promotes bonding: Breastfeeding ensures you get plenty of skin-to-skin time which releases the 'love' hormone, oxytocin which in turn keeps stress hormones low

  • Get more sleep: Breastfeeding mothers get more sleep on average compared to non-breastfeeding mums, and report waking up feeling rested. Breastmilk contains hormones and substances that promote sleep for both mum and baby - that’s why your baby falls asleep at your breast, and why you feel sleepy when you breastfeed!

2. Bedshare

  • Baby is disturbed less: Safe bedsharing ensures your baby does not have to wait as long and is disturbed less when she needs a feed at night

  • You get more rest: Because baby is right next to you, you don't have to wake fully to feed and comfort your baby

  • Biologically normal: No mammal would leave their baby to sleep alone. Safe bedsharing keeps your baby in a stress-free environment, regulates her temperature and keeps her breathing steady.

  • Please check safe bed-sharing advice and prepare your bed before you attempt it. Do not sleep with your baby on a sofa. For guidance on safe bedsharing from the Lullaby Trust, please click here.

3. Babywear

  • Reassuring for baby: Baby can feel your breath, hear your heartbeat, smell your skin and regulate their temperature. The movement as you walk around mimics the gentle movement in the womb, and if you use a stretchy wrap, the swaddling effect makes her feel secure.

  • Gives mum a break: Being handsfree means you can get to the loo or go out for a walk.

  • Promotes bonding: Being able to smell and see you baby your keeping your oxytocin levels high and your stress levels low.

Most importantly, relax. Everything you Google in the first few months usually come back with ‘it’s normal’. Once you can appreciate and embrace the fourth trimester, learning to listen to your instinct will help to establish a good bond and internal conversation between you an your  baby, so that you can tune in to each other and tune out the excessive noise around you.

Stay on your own track. Listen to your instinct.

Next week I’m covering the effect of hormones on your mental health and how you can make simple changes to manage it.


If you are interested in working on your mood and mental health with me then just get in touch. Together we can talk about how you’re feeling, run some tests and make a plan using nutrition and lifestyle strategies to get you back on track towards health.