Forest Trees

4th Trimester

It’s time to rest and recover

The 4th trimester is a period of three months following birth. It is a time where you as a mum will be transitioning from birth to recovery as your body adjusts to no longer being pregnant.
 

It is also a time where your baby will be transitioning from life in the womb to life in the world.
 

There is a lot happening during this period and it will be helpful to remember that ideally this should be a time for rest and recovery.

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These 4 months provide a timeframe for you to focus on nurturing both your baby and yourself so that you can restore your physical, mental and emotional resources, support your healing journey and have the energy to bond with your baby and thrive throughout motherhood.

Physical & hormonal changes

We have included lots of information below on how you can support yourself throughout your postnatal recovery. But first let’s take a quick look at what is happening during the 4th trimester so you know why it is so important to prioritise your rest, recovery and establish healthy habits and practices now.

 

The following are some of the physiological and hormonal shifts that will be common to most postpartum women. They will vary slightly depending on whether you had a vaginal or C-section birth or are breastfeeding or bottle feeding.

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Hormonal changes

  • The hormones Progesterone and Estrogen decrease which can cause low mood, the baby blues or postnatal depression.

  • The hormone Oxytocin increases which helps the uterus contract and promotes bonding with your baby.

  • The hormone Prolactin increases which promotes breast milk production.

  • The hormone Relaxin either drops (if not breastfeeding) which reduces the laxity in your joints and muscles, or is maintained (if breastfeeding).

Physical changes

  • Your vulva, vagina and perineum are healing.

  • Your cervix is narrowing and thickening.

  • Your womb is shedding its lining (lochia) and descending back down into the pelvis.

  • Your abdominal organs are shifting back into place.

  • Your C-section wound is healing and scar tissue is forming throughout the layers of your abdomen.

  • Your abdominal muscles are knitting back together.

  • Your ribcage is contracting and dropping back into place.

  • Your breasts are engorging and producing milk.

  • Your posture may be changing due to shifts in weight distribution.

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These are just some of the changes that take place that require time, energy and resources to heal safely and effectively.

Healing & recovery (what to put in place)

In order to best support yourself during the 4th trimester it’s important that you empower yourself with the self-awareness, knowledge and resources that will help you to nurture yourself and put into place wellness practices that promote healing and fortify you for motherhood.

 

There are also several aspects of health and wellbeing that you can focus on and put into place that will have a powerful and positive impact on not only your postnatal recovery but the rest of your life as a mum.

 

  • Prioritise the health and wellbeing of you, your baby and your family.

  • Get plenty of rest, sleep and be mindful of what you expend your energy on.

  • Understand the healing process and allow yourself ample time to rest and recover.

  • Eat a well-balanced wholefoods based diet, with plenty of hydration to promote healing.

  • Be aware of postnatal symptoms and know what to expect and when to seek help.

  • Attend your 6-8 week postnatal check and ask questions if you have queries or concerns.

  • Start a gentle and safe return to activity and exercise to best support your rehabilitation.

  • Reduce your exposure to physical and mental stressors as much as possible.

  • Let your partner, family or support network know how they can best help and support you.

  • Find and attend an in-person or virtual support group for mums.

  • Research and find trusted resources for postnatal wellness guidance so that you are empowered to make positive healthy lifestyle choices for you and your family.

Your 6-8 week postnatal check

You should have your postnatal check 6 to 8 weeks after your baby's birth to make sure that you feel well and are recovering properly.

Your GP surgery is required to offer and provide you with a postnatal check following changes made in April 2020. You can request an appointment for a check yourself, especially if you have any concerns.

This is a good opportunity to seek advice for any questions, concerns or issues that you may have. So, it's a good idea to make a list of questions to take along with you, including any concerning symptoms that you have been experiencing.

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Your postnatal check should be done with a GP. It will be separate to your baby’s 6 to 8 week health check and can be done immediately before or after your baby's health check so that you can get both done in the one trip. But it can also be done at a separate time if you would like it to be.

You can read more about what happens at your baby's 6 to 8 week check.

Information taken from: www.nhs.uk/conditions/baby/support-and-services/your-6-week-postnatal-check/

What happens at your postnatal check
The following is usually offered, though this may vary according to where you live:

  • You'll be asked how you're feeling as part of a general discussion about your mental health and wellbeing.

  • You'll be asked if you still have any vaginal discharge and whether you have had a period since the birth.

  • Your blood pressure will be checked if you had problems during pregnancy or immediately after the birth.

  • You may be offered an examination to see if your stitches have healed if you had a perineal tear, episiotomy or caesarean section.

  • If you were due for a cervical screening test while pregnant, this should be rescheduled for 12 weeks after the birth.

  • You'll be asked about contraception, offered some information and may be prescribed contraception medication if suitable.

  • If you're overweight or obese, with a BMI of 30 or more, you may be weighed. Your doctor should give you weight loss advice and guidance on healthy eating and physical activity.

Tell your doctor if...

  • You're feeling sad or anxious – looking after a baby can sometimes feel overwhelming. Do not feel you have to struggle alone or put on a brave face. It's not a sign that you're a bad mother. You need to get help, as you may have postnatal depression. Your doctor or health visitor can provide help and support.

  • You're having trouble holding in your pee or wind, or you're soiling yourself with poo. This is known as incontinence as is quite common after birth and can usually be reversed.

  • Having sex is painful or you are experiencing ongoing vulval, vaginal, perineal or pelvic pain.

  • You're not sure if you have had 2 doses of the MMR vaccination – if you have not had these, your practice nurse will offer them with a gap of at least 1 month between doses. You should avoid becoming pregnant for 1 month after having the MMR vaccination.

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How partners and family can provide support

During the 4th trimester you will benefit from the help of people who have your best interests at heart. If you have a partner, family member or friend who is supporting you then let them know exactly what they can do to best help you and ask for help when you need it.  You will often find that people are willing to help when they can.

 

Some of the ways that a partner or member of your support network can help are as follows:

  • Ask mum what she really needs help with and commit to providing it.

  • Read through these pages so that you can be mindful of what mum is going through and be mindful of her health and wellbeing needs.

  • Keep unwanted guests or visitors away if mum or the family want social respite.

  • Take care of baby for a few hours so that mum can rest, sleep or do a restorative activity for herself.

  • Bottle feed baby formula or expressed breastmilk if mum needs a break.

  • Prepare or cook well balanced nourishing meals, snacks, smoothies or drinks for mum.

  • Help mum get comfortable if she is breastfeeding or bottle feeding and bring her snacks/drinks.

  • Tidy up or do household chores tasks if mum needs/wants them done.

  • Offer to run errands and get tasks done outside of the home if required.

  • Remind mum to take care of herself or do something nice for her that she will enjoy.

  • Take care of the rest of the family/household so that mum can focus on recovery, bonding and settling baby in.

  • Make sure that you get time to bond with baby and mum as a family unit.

  • Empower yourself and mum by researching and reading up on health and wellbeing for your family.

  • Start to implement small healthy lifestyle choices and practices that will benefit you all as a family going forward and set a good example for your child: healthy food, hydration, less stress, going for walks, better communication etc.

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