The Fourth Trimester

Many people are familiar with the three trimesters of a pregnancy, but the concept of the “fourth trimester” doesn’t garner as many headlines. The fourth trimester refers to the first three months after a birth—the time of transition for a recently pregnant person and baby.

“Pregnancy and birth can bring up a number of emotional, mental and physical changes that can be challenging to navigate,” said Dr. Erin Stevens. “Most people don’t really know what to expect during this time, and it can be tricky to distinguish what is normal and what is not. Pregnancy care is reasonably focused on achieving a healthy birth so many don’t stop to think or ask about what comes next.”

Health issues—both new and ongoing—may occur during or following pregnancy, so it is critical to maintain access to quality health care.

Bleeding, pain, healing of tears or incisions, urinary problems, constipation, hemorrhoids, appetite changes, uncomfortable intercourse, clogged ducts, mastitis, hot flashes, mental fog, headaches, hair loss, weight fluctuations and fatigue can naturally be difficult to handle. For severe symptoms, seeking medical care is necessary to rule out life-threatening conditions.

Dr. Stevens adds that conversations about the postpartum period can be stigmatized due to a “societal pressure to simply be happy and glowy lest one create a perception of being a bad parent! It’s so important that we work to normalize the fact that everything might not feel or be ok during that time and that this does not reflect on the quality of parenting, care or love.”

She reminds that it’s good to know there’s help available during the fourth trimester and beyond, and that sometimes just hearing “this is normal and will likely improve” is encouraging: “All of this is why I wrote my book ‘Unexpected’ – to help people have some realistic expectations for this period of time to be able to cope better and identify what is and is not normal so concerning issues are not overlooked. We are here for you!”


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