Navigating the Fourth Trimester

Have you heard of this? Despite my extensive research before and during pregnancy this term and concept had evaded my consciousness. It wasn’t until I lamented to my midwife that my son never wanted to be put down that she explained this concept. The fourth trimester refers to the time from birth until the end of the baby’s third month.

The human infant is a perfectly designed organism; it knows when to sleep, when to eat, and how to cry out and signal its needs.

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The Transition from Womb to World

 It might be helpful to consider the situation from the perspective of the infant. Birth is an enormous transition. Tucked inside the womb, the fetus has never known hunger, never felt cold, and is never exposed to bright lights. Days are filled with rhythmic sounds and rocking motions. There is a constant supply of nutrition and the steady beat of mom’s heart. Now, on the outside, the infant must make an effort to get what he needs. Some babies adjust easier than others. Waking upon being put down is actually a survival mechanism; the infant cries to prevent abandonment. A newborn not only depends on its parents for survival, but for soothing. (Babies are not able to self-soothe until about 4 months of age.) During this time, baby’s brain and nervous system are rapidly maturing so that they can begin to cope with the outside world. After three months, the infant can lift its head and is more available for social interactions. About this time a baby begins to be able to tolerate longer periods of time away from a caregiver.

Of course! This makes total sense and somehow knowing that it was “normal” relieved some of my concerns. I wish that I had come across this sooner and been able to mentally prepare (as much as that’s possible) before his birth. There were times when I feared having a child attached to me 24/7 for the rest of my life! Being an introvert who values alone time, this thought was terrifying.

As a new mom adjusting to this new identity, memories and fears are likely to surface. Take note of these reactions, but don’t judge them. Let them inform you. Be patient with yourself. As Daniel Stern notes, “The birth of a mother doesn’t take place in one dramatic, defining moment, but gradually emerges from the cumulative work of the many months that precede and follow the birth of the actual baby.” Stern’s wife and co-author, Nadia Bruscheweiler-Stern, articulates in The Birth of a Mother, that as a woman becomes a mother, she develops a mindset fundamentally different from the one she held before. Reflective understanding of past experiences, trusting your instincts, and empathy for baby can serve as a guide in this transitional period. With increased understanding and empathy comes increased attachment. (I will write more on the importance of attachment in future posts.)

The Newborn Dance-2

Finding Your Way

Nothing invites advice like having a new baby around. Societal rules seem to hold implicitly that there is a right way and a wrong way to do things. They don’t account for the fact that babies and their parents are all individuals. What worked for someone else may not work for you. And for that matter, what worked for you yesterday may not work today. Give yourself permission to make mistakes, to follow your instincts, and block out the excess chatter.

Our Babies, Ourselves is, without a doubt, one of the most important books of my parenting journey. Meredith Smalls presents a world view of parenting and explores various biological and cultural influences. This text is extremely well referenced and examines studies conducted by anthropologists, ethnopediatricians, and child development researchers. It inspired me to put aside external expectations and to really think about how I wanted to parent.

Above all, keep in mind that you cannot spoil a newborn! In fact, it is love and affection that helps them to flourish.

Creating a Peaceful Fourth Trimester

  • Skin to Skin Contact

 Immediately following birth, mom and baby greatly benefit from uninterrupted time together. Skin to skin contact helps to stabilize heart rate, body temp, and stress hormones, while stimulating oxytocin (the feel good hormone). Weighing and measuring are no where near as important as skin to skin time. Babies kept skin to skin with mother for at least an hour after birth are less likely to cry, more likely to latch and latch well (resulting in less pain for mom), and more likely to be exclusively breastfed and breastfed longer. This practice also helps to colonize baby with mom’s bacteria, providing a reduced risk of allergies. In the case of a c-section, this can be done while mom is being stitched up.

Skin to skin remains important throughout the fourth trimester. Ways to get skin to skin: baby massage, bath time, bedsharing, and/or babywearing. They even have apparel that makes it easier to keep your little one close.

  • Bedsharing/Co-sleeping

Although somewhat taboo in mainstream American culture, this practice is common in many cultures around the world. Dr. James McKenna, a researcher at the University of Notre Dame and leading authority on mother-infant co-sleeping, wrote this beautiful article on co-sleeping as a biological imperative. He also provides safe co-sleeping guidelines that should be reviewed prior to practice.

It may be helpful to note that the terms co-sleeping and bedsharing are sometimes used interchangeably. In bedsharing the child is in the bed with a parent(s). Co-sleeping can refer to the child sleeping in the bed or directly next to the bed in a co-sleeper.

We practiced bedsharing for the first three months and then moved our son to a co-sleeper. I have to say, it was really great to not have to get out of bed for those night feedings!

  • Swaddling

Swaddling can be a great way to calm and comfort an infant. Keep in mind that proper technique is important as it can impact hip development. Detailed instructions and video demonstration can be found here.

  • Babywearing

There are so many carriers out there. Where do you start? I suggest seeking out your local Baby Wearing International chapter. For $35 yearly membership you can try out a new carrier each month. And they show you how to use it properly!

Early on I loved the Moby wrap. Once my son got older and heavier, we switched to an Ergo carrier.

Tip: Dance while wearing your baby! Turn up the music and get moving. It totally changes your mood and just might put baby to sleep. I relied heavily on Billie Holiday and Ella Fitzgerald. My husband found that two or three songs by Beyonce would send our son off to dreamland. Experiment to see what works for you.

  • Get outside

Like music, this has a mood boosting effect. Take a walk around your neighborhood. Or better yet join a hiking group. To find one, check out Hike It Baby or local Meetup group. If you can’t find one already running- start you own! I’d bet there are other mamas out their who would love to get out of the house and connect.

  • Let Go of Schedule and Follow Baby’s Cues

This doesn’t mean that you can’t have routines, just don’t feel like you have to follow rigid feeding and sleeping schedules as these will likely cause you (and babe) more stress.

There is no such thing as a baby; there is a baby and someone

Exhausted? Remember: Nothing is permanent

All of this might sound exhausting. And it is. But it is just a short phase in your child’s life and I promise you will find yourself marveling at how fast the time has passed.

In addition to the strategies above, it can be helpful to

  • Check your expectations- Our society tends to expect babies to sleep through the night way before they are developmentally ready. Letting go of unrealistic presumptions can help relieve stress and allow you to better enjoy this precious time.
  • Consider a postpartum doula- Services vary, but postpartum doulas generally care for baby or do some light cooking and cleaning while you rest (or shower).
  • Accept help- From your partner, family, neighbors and friends. Now isn’t the time to try to do it all.

How did you experience the fourth trimester? Anything I didn’t mention that worked for you? I’d love to hear from you!


Recommended Reading:

I really enjoyed reading these in the early weeks/months of becoming a mama. They helped me to feel less alone.

The Blue Jay’s Dance: A Birth Year

The Breastfeeding Cafe: Mothers Share the Joys, Challenges and Secrets of Nursing


Further Study:

Sleeping with your Baby: A Parent’s Guide to Cosleeping

Our babies, Ourselves: How Biology and Culture Shape the Way We Parent


The Fourth Trimester: Understanding, Protecting, and Nurturing an Infant through the First Three Months







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