Tips for Surviving and Thriving in the 4th Trimester

Lindsay Watkins, RD, IBCLC, and Shannon Jones, Take Control Health Coaches


You’ve made it through pregnancy and childbirth -- you are a warrior! You may think you’re past the hardest part, but the often overlooked, “Fourth Trimester” can be just as challenging, or more so for some women. Most books and articles focus on pregnancy, leaving many women feeling unprepared for the post-partum period.

Challenges in the fourth trimester can include physically recovering from childbirth, learning to breastfeed, hormonal changes, and managing visitors. All with very little sleep while caring for a new human!  Luckily new books like The Fourth Trimester: A Postpartum Guide to Healing your Body, Balancing your Emotions, and Restoring your Vitality are starting to emerge. Also, the American College of Obstetricians and Gynecologists recently changed post-partum recommendations to be in contact with a provider within the first three weeks, rather than six.

We’ve seen the importance and need for this new focus on post-partum health, we’ve put together some tips for surviving and thriving in the fourth trimester.

If Possible, Plan Ahead

If you’re reading this before giving birth, great! Prep meals in advance and put them in the freezer. Trust us on how worth it and helpful this will become! Nourishing soups, stews, chilis and casseroles freeze well. Also think about breakfast and snack foods like energy bites, muffins, banana bread, and even breakfast sandwiches or burritos.

Regarding visitors, talk with your partner in advance about how you’ll handle them, and what will be helpful to you in the early days when baby comes home.

Ask for Help

Make a list of things that friends and family can do to help you so you’re ready when they offer. Don’t be shy! Meals are helpful, but don’t be afraid to ask a visitor to do a load of laundry, or hold the baby while you nap or shower. Order groceries online, or have a friend pick up a few things on their way over. If you have a toddler, ask family or friends to take them for a visit so you can rest and bond with baby.

Take it Easy and Find a Post-Partum Physical Therapist

During pregnancy, muscles become tight, overstretched, and weak. Childbirth, either vaginally or via c-section, significantly stresses your body, so it’s very important to rest and recover slowly.  After nine months of pregnancy, most women are overly eager to return to normal activities to feel like themselves again. But it’s important to avoid injury by being patient and take the time to rest and recover. As you slowly get back to physical activity, listen to your body.

Physical changes that occur during pregnancy and childbirth can be significant. Getting back to an exercise routine too soon can cause separated abdominal muscles and other problems. Post-partum physical therapy can reduce the chances of these problems, and improve recovery time. It is a great way to support your physical health and build strength from the inside out. When you are ready to begin exercise again, others have found 12-minute Postnatal Core video and Injury Free Post-Partum Exercise helpful.

Seek Breastfeeding Support

Breastfeeding can be challenging and stressful, especially in the early weeks. If you’re having any pain, nipple damage, weight gain challenges, or just want reassurance, don’t hesitate to reach out to a lactation consultant. Most consults are covered by insurance. Ask your OB, pediatrician, or the hospital where you delivered for a referral. If possible, ask where to find help in your town before you deliver.

Drink, Eat, and Sleep

There is a saying, “You can’t pour from an empty cup,” and it couldn’t ring truer than when you have a new baby. Many things will have to fall by the wayside, but make three things a priority: hydration, food, and as much sleep as possible.

If you don’t have time for a full meal, keep a little basket of snacks and a water bottle on hand. Protein bars, nuts, dried fruit, dark chocolate, whole grain crackers, popcorn, crunchy chickpeas, or any non-perishable snack that sound good to you will work.

As soon as baby naps or sleeps, sneak in a nap or snack for yourself. Try not to worry about laundry or other tasks until after you’ve focused on these three most important needs. After a week or two, consider trying other activities that nurture you, like a solo walk, bubble bath, or whatever you usually enjoy.

Prepare for the Unexpected

Babies are adorable! But they are also fussy, gassy, and needy. Some more than others. Sometimes they eat more than the “8-12” times per day mentioned in the literature. They may cry for seemingly no reason, have gas, and fight sleep. They are usually just adjusting to life outside the womb. Having some tools on hand besides a breast or bottle to help soothe baby can be empowering.  Harvey Karp’s 5 S’s on how to put your baby to sleep in five steps, has been used by countless parents over the years. These techniques are research-based and really work!

Watch for Signs of Post-Partum Depression or Anxiety

Fluctuations in hormone levels contribute to what’s known as “baby blues,” which can be make you feel stressed, sad, weepy, tired, or lonely in the first couple weeks.  A certain level of this is considered normal but 1 in 7 women develop more serious post-partum depression which doesn’t go away on its own. To help you differentiate between the two, read the Mayo Clinic’s article on Postpartum depression. If you have any concerns, your OB is a great place to start.

Need some comedic relief during recovery or while sitting on the couch breastfeeding? Try The Letdown on Netflix or Ali Wong’s standup comedy routine, “Baby Cobra.”

The birth of a new baby is one of the most exciting, loving, and unforgettable times of your life. Being prepared for some of the possible post-partum “Fourth Trimester” surprises will help you navigate any speed bumps. Be sure to contact your Take Control maternal health coach any time before or after your pregnancy. We are here to answer questions or refer you to your doctor to make sure you stay healthy and happy during this exciting time in life.