The fourth trimester
The fourth trimester
What is the fourth trimester?
The fourth trimester is the 12-week period immediately after you’ve given birth. This is a time where great physical and emotional change happens for both you and your baby. Your baby now has to adjust to life outside of the womb, and you now have to adjust to your new life as a mother.
Why is there a fourth trimester?
Babies are born still hardwired into thinking they live in prehistoric times in a cave where a predator may come at any given moment. They don’t know they’re safe right now, they are hard wired with the need to be with their mother at all times to keep them safe. They don’t understand we don’t live in caves anymore.
It’s also important to note that object permanence (the ability for them to understand that when you leave a room, you will come back) has still not developed and will only develop around 6-10 months of age. So, when you leave your baby, they don’t know whether you’re coming back or if you even exist anymore. They have a great need to be with you at all times until they understand this.
Until the age of around 9 months when they develop object permanence, your baby think that they are still a part of you, they see you two as one being instead of being two separate people.
Human babies are the only babies born long before they’re actually ready to be born. Research suggests that babies are born 12 months too early, and that gestation should actually be 21 months instead of 9 months.
Some well-known anthropologists have claimed that it’s due to our big brains, bipedalism, and our small female pelvic outlets that have caused us to pay the price of being born too soon.
Human babies and their brains are extremely underdeveloped at birth, with them being born with their brain less than 30 percent of the adult brain size so that they can fit through the narrow passageway. They then continue development outside of the womb, with their brain size nearly doubling in the first year.
A second hypothesis was generated which claims that humans and other mammals give birth when fetal energy consumption threatens to over stress mom’s metabolic resources.
No one really knows for sure why human babies are born so early and so underdeveloped. But it’s good for parents to be aware of this so they can better understand why their baby may be extremely dependent on them at all times.
What can you expect during the fourth trimester?
For mom:
– Baby blues
About 80 percent of postpartum mothers have the baby blues, which refer to a short period of time after giving birth that’s filled with waves of sadness, anxiety, stress, and mood swings.
Though doctors can’t pinpoint the exact cause of baby blues, their timing tells us a lot. After birth, your body goes through extreme hormonal fluctuations to help you recover and care for your baby, such as the shrinking of your uterus back to its normal size and the establishment of lactation. These hormonal changes can also affect a postpartum mother’s state of mind.
This can be normal, but it should clear up by two weeks postpartum and it should never be severe. If at any time you feel worried, it’s best to contact your health provider.
– Healing after birth
The body also needs to physically heal. From normal healing on the inside of the womb where the wound of the placenta is, to the healing of things like episiotomies, caesarean sections and other complications and interventions. This will usually take at least 6 weeks, but it may take even longer for some mothers.
– Establishing breastfeeding
For some mother and baby dyads, breastfeeding may come very naturally, but for some it may be more of a learned skill for both mother and baby. Just like sitting and walking, breastfeeding may take some practice to get the hang of it.
The best you can do is be prepared for what to expect from breastfeeding and seek out the help from an International Board Certified Lactation Consultant (IBCLC) when you may want or need it. Always remember there is support out there and needing help is completely normal.
– Exhaustion due to frequent waking
A lot of parents expect babies to sleep through the night right from birth, but this is unfortunately a very unrealistic expectation. Babies need to wake very frequently and for good reason, they need to feed frequently, and the frequent waking also reduces the risk of SIDS.
For baby:
– Fussiness and crying
It’s normal for babies to be fussy and cry a lot during the fourth trimester. They came from a wet and warm world that was dark and safe, they never got dirty diapers or even had to wear diapers, they never got hungry, and they never experienced discomfort like they do know. Everything is new for your baby and that’s hard to take in at first, it’s a huge adjustment for them. If you make it harder by trying to separate them from you the entire time, this will cause them to become even more fussy and cry even more.
– Not wanting to be put down
As already explained about object permanence, babies have the need to be with you at all times. Not just next to you, but physically in your arms. They may be perfectly calm for as long as you hold them but as soon as you put them down, they may wake up or cry to be picked up again. This is normal behavior, and you can’t spoil a baby by meeting their needs.
– Infant dyschezia
While this is not directly related to the fourth trimester, it is something to be aware of. Infant dyschezia is when an infant strains and cries while trying to pass wind or stool. They will usually seem very fussy, almost like they’re in pain and they will probably want to breastfeed to help them with that as well. This is usually worse in the first 3 months (during the fourth trimester).
– Cluster feeding
Cluster feeding are periods of very frequent feedings clustered together. Babies do this for various reasons including the establishment of breastfeeding and the breastmilk supply, growth spurts and even for things like comfort and discomfort. Babies go through many growth spurts and mental development during the first few weeks to months and this can be especially hard if you’re not prepared on what to expect.
How can you make things easier?
– Give in
Learn to accept that you and our baby are brand new at this and you both need some time to adjust. You also have a lot of healing to do, both physically and mentally. Remember, this is only temporary. Once you accept this and slow down, it will become much easier for you both.
– Frozen or easy meals
Prepare easy to make or frozen meals before giving birth. This will make things much easier in the first few weeks while you heal and learn how to take care of your baby. This will be one less thing to worry about.
– Get help
Whether it’s help with the house or with anything else, if you need help, reach out. It will make your lives much easier. You’ll be surprised at the amount of support that may be available to you if you just ask for it.
– Bathing
Babies were submerged in warm water for 9 months. They’re not used to this dry and cold world. A nice warm bath is familiar to babies and is almost guaranteed to calm a baby right down, especially if the bath is with you while having some quality skin-to-skin contact.
– Outside
Whether it’s because of the change of scenery and environment, some fresh air or just the walking around part, going for a walk outside is almost always relaxing for a baby.
– Babywearing
Babywearing is a great way to keep both mother and baby happy. When babywearing, the mother can still move freely and do the things they need to do while their baby will be perfectly happy and probably napping while close to their mother at all times.
– Skin-to-skin care
Skin-to-skin care is very beneficial for babies. Not only are they very close to their mother, but they are close to the breast as well. Skin-to-skin has proven to be beneficial for both babies and mothers’ health. It helps to stimulate appetite, it regulates and stabilizes their blood sugar levels, temperature, their breathing and their heartbeat.
– Rocking and swaying
Babies are used to the many movements in the womb, swishing around in the water as you go by your day. Once they’re born, they still expect to move around with their mother. Movement is very soothing to them, and movement can very quickly calm a crying baby or keep a calm baby that way.
– Breastfeeding
Babies are born expecting to breastfeed. They have innate behavior and reflexes to help them initiate breastfeeding. Babies are meant to breastfeed very frequently, and they also breastfeed for more than just hunger, but also for things like pain relief and comfort. Most babies will be completely happy and content when they have unlimited access to the breast when they need it.
– Contact napping and co-sleeping
Humans, just like apes are carry mammals. This means we carry our babies with us at all times. Babies are born expecting to be close to you and the breast at all times including nap times and nighttime sleep. Contact napping and co-sleeping is biologically normal and can be done safely. Dr. James J. Mckenna explains the benefits of breast sleeping in his many studies.
– Support system
Having a support system is always important, but it’s especially important in the postpartum period as women are at higher risk of depression right after giving birth. As we all know it’s a very emotional time in a mother’s life and simply having the correct education and support can make the biggest difference in a new mother’s life.
Additional information and resources:
Humans are born too soon: impact on pediatric otolaryngology
