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Ask the Midwives

The Fourth Trimester


In our first Ask the Midwives post we had a look at some of the most commonly asked questions surrounding pregnancy and back in January we tried to answer some questions that you had in regard to labour and birth. We totally get that there are a ton of topics we could have discussed and lots of questions you might have had. It could take us months to answer them all! So if we haven’t answered a burning question that you have, get in touch with us. Or better yet, come to our antenatal classes where Hailey and I are always willing to answer any questions! So let’s talk about the fourth trimester…


The fourth what now?

The fourth trimester. Midwives, doulas and birth workers are increasingly aware of the ‘fourth trimester’ and the importance of this time for both parents and newborns. In many cultures and countries, the first twelve weeks after birth have always been a time of special importance. A time where women can physically recover and heal as well as emotionally adapt to the huge life change of becoming a mother. My sister-in-law is Chinese and when my nephew was born it was tradition (even in a big city like Bejing) to practice ‘Zuo Yuezi’, a home confinement of at least one month.Within that month it is strongly encouraged to rest, feed baby and feed yourself. As well as ensuring there is someone else at home, paid or otherwise, who can look after things like meal prep and cleaning. We still have a long way to go in the UK before we recognise the fourth trimester as an integral, transformative time. A time when our whole world view shifts, when we grieve the loss of an old life and begin to understand a new way of being. There is no rush to ‘bounce back’ after you’ve had your baby. Look after yourself. Go slowly. Enjoy the fourth trimester as much as you can, it is such a special time.


How long will it take me to recover from birth?

A great question. And another one we get asked all the time. It seems to me that people are keen to have a set time frame for recovery. As if by getting to week four or six or eight everything will just magically go back to the way things were before baby was here. You may recover quite quickly physically but perhaps emotionally it takes you some time to come to terms with parenthood and mothering. That’s totally ok. Women should have a six week check with their GP and by then we would hope that things have mostly recovered. If there were still ongoing issues at six weeks we might take a look at why that is and think about referrals to other health professionals like a women’s health physio for example. Recovery really varies from person to person - some women I have looked after will be back to their physical selves very quickly whilst others take a lot longer to recover. It isn’t always dependent on what type of birth you have had although obviously this might affect things too.






What ways can I prepare for the fourth trimester?

We give our birth preferences so much careful consideration but we often overlook the immediate postnatal period. It is probably a good idea to have a think about this before your baby arrives. Although it is difficult to fully understand how things might change it is a good idea to have a consider things like sleep and feeding. Will you take turns during the night to settle baby? How will this work if your partner is returning to work? Will you pump and share feeds? Formula feed? Or exclusively breastfeed? And if it’s the last one, what ways can people support you with this so you can feed baby without feeling guilty about all the other stuff! What about visitors? How and when will you tell people about the baby being born? I had my first son at home in 2018. He was born at eight twenty in the evening and we didn’t tell anyone until the following morning! I don’t think my parents were best impressed but it gave us time to just be together, as a three, without constantly looking at our phones and worrying about messaging people. I didn’t have the energy for all that and I needed my husband to be with me and the baby, and not glued to his phone!





How can I recover from birth when my baby absolutely refuses to be put down?

Some babies feed and wind and go down to sleep in their moses basket/cot/baby box without too much of a fuss. Many, many, many more babies do not do this. Your baby is an extension of you. Their environment has totally, completely and radically changed from the womb where they have been happily cocooned for the past nine months. A place that is warm, wet, noisy and where nutrients are pumped into their little bodies without having to feel hunger or wind or the need to do a poo! Is it any wonder that when babies are born they just want to be held, secure and warm? However, it is hard to heal and rest when you have a baby stuck to your chest 24/7. Perhaps get your partner to use a sling (the one in the baby box is pretty fab) and try some babywearing for a bit. Maybe ask a family member to come and cuddle baby while you catch some sleep. You might find putting the baby down for a wee snooze is more successful in the daytime so take advantage of that and have a nap then if that works for you. It is hard. Accept help and rest when you can.


When will life return to normal?

Normal in the pre-baby sense? Never. Sorry. That ship has sailed. Buuuuut you will find a rhythm that works for you and you will begin to get more rest eventually. You will also begin to get to know your own baby more and will be able to notice when they are needing fed or when they are tired or when that smile really means trapped wind…You will be able to meet friends again and you will feel like ‘you’ again but I would wager it’s a different version to the ‘you’ from before. Some women get into the swing of things very quickly. If you have any tips I am all ears. I am five years in and still wondering what normal looks like!




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