Postpartum Guide for New Mothers: Fourth Trimester & Newborn care

Congratulations!

Your little one is here.

Up until now, pregnancy and childbirth were the biggest focus of your life. That was a significant chapter with pregnancy—and especially delivery—occupying all your thoughts. Now suddenly it's all behind you, and you've turned a new leaf—not just for yourself but for the care of a newborn. This phase, known as the fourth trimester, is where the baby adjusts to life outside the womb, and you transition from your pregnant self back to your pre-pregnancy self. It’s far from easy. Your body, mind, and soul have been through a lot. You have officially entered motherhood—one of the most divine relationships on earth.

I've been through the same journey as a mother. Even as a doctor who studied this in medical school, I can tell you that reading about it in books and actually living through it are entirely different experiences—though both are incredibly valuable. In this comprehensive fourth-trimester guide for new moms, especially first-time moms, I will blend knowledge from medical books with practical tips from my personal experience during the postpartum period and the first 12 months with a newborn. By the end of the article, I hope to make you feel empowered with knowledge to navigate your postpartum and fourth-trimester journey with confidence.

Understanding the Fourth Trimester

What is the fourth trimester in pregnancy?

The fourth trimester is a term popularised by American paediatrician Dr. Harvey Karp, which refers to the first 12 weeks after birth—a time crucial for both mother and baby. It is also commonly known as the postpartum or postnatal period.

Why is the fourth trimester important?

The importance of the fourth trimester for both mother and baby is multifaceted. The primary idea is to help the baby adjust to life outside the womb by creating an environment similar to what they experienced inside the womb. This postpartum period is also vital for the mother to recover physically, mentally, and emotionally from pregnancy and childbirth while coping with the demands of caring for a newborn.

Every major medical organisation, including the American College of Obstetricians and Gynaecologists, the Royal College of Obstetricians and Gynaecologists, the NHS in the UK, and the World Health Organisation, to name a few, emphasises the importance of continuity of care for both mother and child during this period. The support of a partner, friends, or family is crucial during this time, providing both physiological support to the mother and assistance with newborn care. It is also important to know when to seek help from healthcare professionals, as this is a delicate stage for both baby and mother.

Basics of Newborn Care

Newborn Development During the First Three Months

The first three months of life are a phase of adjustment to life outside the womb and of rapid growth and development. Understanding these changes, including newborn development and fourth-trimester milestones, can help parents support their baby’s growth and development during this critical phase.

How Much Weight Should a Baby Gain?

This is a very common concern for many parents. On average, infants gain 4 to 7 ounces per week in the first 4 to 6 months and usually double their birth weight by that time. (Source: AAP Nutrition Supervision).

It’s important for new parents to know that they shouldn’t worry if their baby loses weight in the first few days after birth—a drop of approximately 10% of their birth weight is expected. This is due to fluid loss, the breakdown of some tissue, and the cutoff of constant nutrition supplied through the placenta as feeding is established. Babies typically regain their birth weight within 7 days. Parents can support this baby weight gain by exclusively breastfeeding the baby for the first 6 months, which is enough to meet the nutritional needs to fuel this growth as recommended by the World Health Organisation (WHO). If breastfeeding is not possible, then infant formula should be used with advice from a healthcare professional.

How Much Does Length Increase?

This period of rapid growth also sees a lengthening of the baby’s body. Babies will grow approximately 1–1.5 inches in length each month during the fourth trimester. Their limbs, which were curled in the fetal position during pregnancy, gradually begin to straighten as their muscles strengthen and develop. This growth spurt is essential for laying the foundation for future motor development.

How to Monitor Growth of your baby?

Parents often worry whether their baby is growing optimally. Monitoring baby growth can be done in various ways. Various parameters like weight, head circumference, and length are measured by healthcare professionals and plotted on age appropriate growth charts to monitor growth. The World Health Organization (WHO) has set out growth standards as a guidelines and these are commonly used, however, come countries have their own growth charts against which newborn development can be gauged. In most healthcare systems, babies are typically followed up by health professionals and measured for the first few weeks.

Newborn Milestones in the Fourth Trimester

Motor Development:

Head Control: By the end of the third month, many babies can hold their heads up steadily when placed on their stomachs (during tummy time).
Grasping Reflex: Newborns begin to open and close their hands, and by three months, they may start to reach for objects.

Sensory Development:

Vision: Babies start tracking moving objects and recognizing familiar faces by around two months.
Hearing: Newborns respond to familiar sounds, such as their parents' voices, and may start to coo in response.

Social and Emotional Development:

Social Smiling: Around 6-8 weeks, babies begin to smile in response to social interactions.
Bonding: Strong emotional bonds with caregivers develop, and babies seek comfort through touch and familiar voices.

Supporting Your Baby’s Development

Tummy Time: To help with motor skill development, particularly head control, it’s important to give babies supervised tummy time each day. This practice strengthens their neck and shoulder muscles, laying the foundation for future milestones like rolling over and sitting up.

Interactive Play: Engage in simple games like peek-a-boo, talk to your baby often, and provide them with age-appropriate toys that encourage reaching and grasping. These activities support newborn development by stimulating their cognitive and sensory skills.

Responding to Cues: Pay close attention to your baby’s signals for hunger, tiredness, and the need for comfort. Responding promptly helps in building a strong sense of trust and security, which is crucial for their social and emotional development.

Close up of a newborn baby's face with eyes closed.

Credit: Photo by Lisa Johnson

Caring for a Newborn

Skin-to-Skin Contact: Do lots of skin-to-skin contact. This practice helps the baby feel secure, mimicking the womb, and strengthens the bond between you and your baby. It also aids in breastfeeding by stimulating the release of oxytocin—a hormone responsible for milk letdown in mothers. Oxytocin also increases feelings of love and bonding. Fathers can benefit from skin-to-skin contact too, as their brains release oxytocin during these moments, enhancing their bond with the baby.

Dressing the Baby: Dress the baby in one or two extra layers than yourself, depending on the weather. If it’s cold or you’re going outside, cover the baby’s head with a cap to keep them warm.

Safe Swaddling: Safe swaddling can soothe the baby and mimic the womb, but it’s essential to ensure that you swaddle safely. Consult your healthcare professional for advice on proper swaddling techniques.

Health Checks: Ensure that your baby is tested for hearing and jaundice soon after birth. These early checks are important for monitoring your baby’s health.

Umbilical Cord Care: Keep the umbilical cord clean and dry, and don’t apply anything to it. The cord will naturally fall off within a few weeks.

Feeding on Demand: Feed the baby on demand as often as they want. It might be useful to keep the baby in the same room as the mother during the first few months rather than in a separate nursery. This practice can help you respond more quickly to your baby’s hunger cues and create a strong feeding routine.

Nappy Care: Whether using disposable or cloth diapers, ensure you have a good supply. Newborns typically require 8-12 diaper changes per day. Always use fragrance-free wipes to clean your baby to protect their sensitive skin from irritants.

Diaper Rash Prevention: Use a simple fragrance free barrier cream and change nappies every 3 to 4 hours if wet, but immediately if soiled or dirty to avoid rashes. Most diapers have a wetness indicator line to help you know if a change is needed sooner. Allow your baby some diaper-free time each day by placing them on a dignity sheet or wipeable changing mat to catch any accidents. I often gave my baby diaper-free time after he had had a bowel movement, knowing it would be a while before he needed to go again.

Recognising Hunger Cues: Recognise and respond to hunger cues before your baby becomes upset. Common hunger cues in a baby includes signs like rooting (turning their head towards your hand), sucking on their hands, or making smacking sounds.

You can read the WHO guidelines on caring for a new born for further information.

How to Soothe Your Newborn

1.Check Basic Needs:

Ensure your baby doesn’t need a diaper change, feeding, or adjustment for comfort (such as being too hot or cold).
Addressing these needs is often the first step in calming your baby.

2. Gentle Soothing Techniques:

Try gently rocking your baby or holding them close. The warmth and security of your embrace can be very comforting.
Swaddling can also provide a sense of security, mimicking the snug environment of the womb.

3. Talk Softly or Sing to Your Baby:

Softly talking or singing to your baby can be very reassuring. Your familiar voice is comforting and can help calm them.

4. Use White Noise:

Consider using white noise or soft rhythmic sounds, which may remind your baby of the womb and help to calm them.

5. Additional Soothing Methods:

If crying persists, offer a pacifier to satisfy their need to suck, which can be soothing.
Taking your baby for a walk in a stroller or a ride in the car can provide the motion and change of scenery needed to calm them down.

6. Do Not Shake the Baby:

It can be distressing when a newborn cries, especially when you are tired. Remember, never shake the baby, as this can cause serious injury. If you feel overwhelmed, place the baby in a safe place like a cot and leave the room for a few minutes to calm down.

7. Patience and Observation:

Each baby is unique, so it may take time to discover what works best for your infant.
Patience and careful observation will help you identify the techniques that soothe your newborn most effectively.

8. Take care of yourself

Taking care of your emotional well-being is just as important as caring for your newborn. Staying well allows you to better care for your baby.

9. Seek help

Take help or support from a partner, family member, or friend during challenging moments. It can make a significant difference.

Newborn Bathing Essentials

When to Give the First Bath: Delay the first bath for at least 24 hours after birth as recommended by the World Health Organization (WHO). This helps preserve the baby’s skin and regulate body temperature. (Source: WHO Guidelines on Caring for Newborns).

General Bathing Advice for Babies:

Before the Umbilical Cord Falls Off: Until the umbilical cord stump falls off (usually within the first few weeks), give your baby sponge baths using warm water and mild fragrance-free soap.
After the Umbilical Cord Heals: Once the umbilical cord has healed, you can start giving regular baths a few times a week. Always support your baby’s head and keep the room warm to prevent chills. Try to use fragrance-free baby products to protect their sensitive skin.

Newborn Feeding Essentials

Newborns typically feed every 2 to 3 hours, including at night. However, this can vary greatly from baby to baby. Some babies take smaller, more frequent feeds—like mine did. It can be hectic for the mother, but remember, this is just a phase and it will pass. As your baby grows older, feeding schedules usually improve significantly.

Growth spurts and cluster feeding

One important aspect that first-time mothers may not be aware of is growth spurts and cluster feeding. Typically around 3 weeks, 6 weeks, and 3 months—coinciding with major developmental milestones—babies go through short growth spurts. During these times, they tend to become fussier and feed more frequently than usual. In my case, it felt like my baby was feeding almost all day! Those days were exhausting as my baby would want to feed every half hour or hour. I remember feelings of inadequacy creeping in—I doubted myself, my milk supply, and my capabilities as a mother. I’m sharing this so that other moms going through the same experience can find solace in knowing that this is normal and happens to other mothers too. Not everyone experiences this, but it can be quite taxing. The key is support—from your partner or someone close—who can take care of household chores, bring you drinks and snacks, and lend an ear to listen to your thoughts and reassure you.

Breastfeeding Guidance

The World Health Organisation (WHO) and all medical literature recommend breastfeeding exclusively for the first 6 months. Breast milk contains all the vital nutrients in the correct proportions for the baby. In addition, it also contains antibodies that strengthen your baby’s ability to fight infections. You can feed your baby directly by suckling or express your milk using a breast pump and give it in a bottle.

How long can breast milk last?

Breast milk can usually last for up to 4 hours at room temperature (if the temperature isn’t too hot), 4 days in the fridge, and 4 to 6 months in the freezer. To reheat, use a bottle warmer or water bath—do not microwave directly.

Vitamin D and breastmilk:

Breast milk doesn’t contain vitamin D. If you live in a place where your baby gets enough sun exposure (since our body can make vitamin D from sunlight), that should be sufficient. Otherwise, it’s best to give vitamin D drops to your baby after consulting with your doctor.

Breastfeeding Tips from a Mom:

Remember, breastfeeding should be a comfortable process.
Gain knowledge on different latching positions and try them out to find the ones you are most comfortable with.
Ensure a proper deep latch so that your nipples don’t get sore.
Use plenty of pillows to support your back, arms, and baby.
Feed in a comfortable posture, preferably on a feeding chair.
Eat enough food (breastfeeding requires an extra 500 calories per day) and stay hydrated—adequate water intake is crucial to maintain milk supply. Your milk supply can decrease on days when you’re dehydrated or haven’t eaten enough.
Use nursing bras for ease and comfort
Use breast pads in case of leaks
Ask your partner to help you both physically and emotionally.
Don’t hesitate to get professional help from a lactation consultant or healthcare professional if needed.

Formula Feeding Guidance

If breastfeeding isn’t possible for any reason, the only recommended alternative during the first 6 months is infant formula. It is specially designed to meet the nutritional needs of the baby and often contains added vitamin D, so you don’t need to give additional vitamin D drops. However, it doesn’t contain the antibodies that breast milk provides for immunity.

Formula Feeding Essentials:

If the mother cannot breastfeed or chooses not to (though breastfeeding is highly recommended), the only other option for a newborn is infant formula in a baby feeding bottle.
It’s important to wash and sterilise all feeding equipment thoroughly to ensure there are no germs, as a baby’s gut is extremely delicate and lacks the protective flora present in adult guts.
Follow the instructions on the formula packaging correctly and discard any remaining milk in the bottle after a feed, usually within 1 to 2 hours of preparation (check packaging for exact recommendations).
If water is needed to prepare the formula, it should be boiled to ensure it is clean. You can boil water and place it in a flask for quick preparation.
Practical Tip if you are practicing combination feeding: If your baby both breast and bottle feeds, use a slow-flow teat so that the baby has to suck harder to get milk, mimicking the breast. Otherwise, some baby's start preferring the bottle due to ease of flow.

Choosing the Right Formula for Your Baby

Selecting the right formula is crucial for your baby’s health, especially if breastfeeding isn’t an option or if you’re supplementing. Here’s a brief guide:

Types of Formula:

Cow’s Milk-Based: The most common and well-tolerated, these formulas are fortified with essential nutrients.
Soy-Based: Ideal for babies who are lactose intolerant or have a milk allergy. It’s also a good option for vegan families.
Hydrolysed: Designed for babies with allergies or digestive issues, these formulas are easier to digest due to their broken-down proteins.
Specialty Formulas: Prescribed for specific medical conditions like premature birth or severe allergies.

Forms of Formula:

Powdered: Economical but requires mixing.
Liquid Concentrate: Easier to prepare.
Ready-to-Feed: Convenient but more expensive.

Consult Your Paediatrician: Always consult your paediatrician before choosing a formula to ensure it meets your baby’s specific needs. Your baby’s comfort, growth, and health are the top priorities, and the right formula can support their development effectively.

Newborn Sleep Patterns in the First Three Months

What’s Normal: Babies up to 3 months usually sleep for 14 to 17 hours a day according to the World Health Organisation (WHO). This sleep is scattered in short spurts throughout the day and night, leaving very little time for the mother to rest. In the first few months of life, their sleep pattern is irregular because babies do not produce melatonin—the hormone released by our brain at night that helps regulate sleep. During this time, babies rely on maternal hormones, as melatonin is present in small amounts in breast milk. If you use expressed breast milk, be sure to label the time on it if using it later. Ideally, milk expressed at night should not be used during the day and vice versa. Therefore, breastfeeding helps regulate sleep patterns due to the presence of the mother’s melatonin hormone.

According to the American Academy of Paediatrics (AAP), melatonin production starts to increase between 3 to 4 months of age, contributing to more regular sleep patterns as babies begin to differentiate between day and night. As they grow, their sleep patterns start to consolidate with longer stretches at night and more distinct periods of wakefulness during the day. By around 3 months, some babies may begin sleeping for longer periods at night, although it’s normal for nighttime awakenings to continue as their sleep patterns gradually mature.

Tips on Coping with Sleep Deprivation in the Fourth Trimester

Sleep When the Baby Sleeps: The most important thing is to sleep when the baby is sleeping, though it’s easier said than done. Ask your partner, family, or friends for help with other chores and jobs so that you can actually sleep when the baby is sleeping without having to worry about other things. This will include taking lots of naps during the day.

Manage Expectations: Understand that your baby’s sleep pattern will be irregular, and don’t keep high expectations. Do not expect to sleep 8 hours at night with a newborn!

Share Nighttime Duties: Ask your partner to share nighttime duties. If you formula feed, you can split the time and get undisturbed sleep for a few hours each. If you breastfeed, your partner can help with other tasks like nappy changes at night.

Be Patient: Coping with lack of sleep will be tough, but know that this is a small phase, and your baby’s sleep will improve in a few months.

How to Establish a Sleep Routine for Your Newborn

Create a Calm Environment: Dim the lights, keep noise low, ensure a comfortable room temperature, and try using white noise. White noise is comforting for babies as it mimics the sounds they are used to hearing inside the womb, such as blood vessels and the mother’s gut.
Set a Bedtime Routine: Babies love consistency! Establish a bedtime routine that includes a gentle massage, a warm bath, changing into comfortable cotton clothes, reading a book, singing lullabies or using white noise, and feeding the baby.
Consistent Bedtime: Put the baby to sleep at the same time each night.
Encourage Self-Soothing: Try to put your baby in their crib when they’re drowsy but still awake. This helps them learn to fall asleep on their own and self-soothe if they wake up during the night.
Practice Safe Sleeping Habits: Follow the safe sleeping guidelines explained below.
Be Patient and Flexible: Know that this is just a matter of a few months, and then things will start improving.

Safe Sleeping Advice for Newborns - 8 Tips

Safe sleeping is crucial for your baby, as unsafe sleeping practices are associated with Sudden Infant Death Syndrome (SIDS), also known as cot death.

Safe Sleep Space: Put the baby to sleep in a safe place like a cot, Moses basket, or crib where the baby is safe from falls.
Use a Firm Flat Surface: Ensure the baby sleeps on a firm, flat surface or mattress.
Sleep Position: Place the baby on their back to sleep, and make sure they can breathe easily. WHO recommends making a baby sleep on their back for the first year of life. This practice is also recommended by the NHS in the UK.
Use Breathable Bedding: Use a cellular blanket or sheets for the baby so they can breathe through them if their nose is accidentally covered while sleeping.
Feet to Foot: Place your baby’s feet touching the foot of the cot. This prevents them from sliding down under the blankets and potentially covering their face.
Clear the Cot: Ensure the cot is clear of any soft toys, pillows, or other items that could obstruct breathing.
Use a Bed Net: In areas where mosquitoes and malaria are a concern, use a bed net.
Co-Sleeping Safely: If you want to co-sleep, consider using a safe bedside crib or bassinet. If you prefer to have the baby in your bed, consult your local healthcare provider and ensure you take all the necessary precautions: ensure there’s enough space, the baby doesn’t share your blanket, the bed is against a wall, and there’s no risk of falls. Make sure you do not smoke or consume alcohol before sleeping.

How to Set Boundaries with Visitors After Birth

Naturally, friends and family will be excited to meet your baby, but this is a crucial time for you to rest, recuperate, and bond with your newborn. It's important not to feel shy about communicating clearly when you’re ready for visits and to limit the number of visitors to what is comfortable for you. Don’t hesitate to step away to a private space if you need to feed your baby, and let your partner or someone else entertain the guests. Visits should be scheduled based on what’s best for your family, and it’s perfectly okay to prioritise your well-being and that of your baby during this critical time. Most people will understand and respect your needs.

Managing Family Expectations During Postpartum

While help from family is invaluable during the postpartum period, it’s important to set realistic expectations and boundaries that suit your comfort level. Family members may naturally want to be involved in baby care, but it’s up to you to decide how much involvement is helpful. It’s completely okay to ask for help with chores and baby care, and equally okay to want some privacy. Prioritise your well-being, rest, and the bond with your baby, making decisions that support your needs.

How to Handle Unwanted Parenting Advice

When dealing with unwanted parenting advice, focus on finding your own parenting style—one that aligns with your family’s unique needs and values. Trust your instincts and seek out resources or advice that resonate with your approach. The best strategy is to listen and politely thank those offering advice but ultimately do what you believe is best for your baby. Setting gentle boundaries with those who offer unsolicited opinions allows you to maintain confidence in your parenting choices.

When to Seek Help for Your Newborn

It's essential to know when to seek help for your newborn as early intervention can make a significant difference. Here are some situations where you should contact your healthcare provider:

Difficulty Latching: If your baby can’t latch properly while nursing or bottle feeding, this could lead to inadequate nutrition and needs to be addressed promptly.
Feeding Issues: If your baby loses a lot of breastmilk or formula out of the side of their mouth while feeding, it may indicate a feeding problem that requires attention.
Lack of Social Interaction: If your baby won’t smile at people or doesn’t show interest in social interactions by a certain age, it could be a sign of developmental issues.
Motor Skills Concerns: If your baby doesn’t bring their hands to their mouth or is unable to hold their head up while on their tummy, these could be signs of delayed motor development.
Danger signs: high temperature, difficulty breathing, fast breathing, persistent jaundice beyond 2 weeks, lethargy, floppy or any other concerns
Hearing Issues: If your baby has no response to loud noises or isn’t tracking people and objects as they move, these could be signs of hearing issues that require medical evaluation.
Unable to cope: If you are unable to cope with caring for your baby, it is okay to seek help from your partner, friends, family or health care professional
Warning Signs: If your baby is not feeding well, has fast breathing, a high temperature, is not playing as usual, or seems lethargic; if their stool becomes greenish in colour; if you are concerned about their hearing, vision, or weight gain; or if they are persistently yellow (jaundiced) beyond two weeks, these could be signs of a serious condition and warrant immediate medical attention.
If you notice any of these signs or have any other concerns about your baby's health or development, it's crucial to contact your paediatrician or healthcare provider as soon as possible. Early detection and intervention can provide the necessary support and treatment your baby may need.

Basics of Mother Care

Physical Recovery After Vaginal Birth

Physical recovery after a vaginal birth involves several key aspects that are crucial for a new mother’s well-being.

Caring for Stitches or Episiotomy: If you've had stitches after tearing or an episiotomy (cut), bathe them daily by showering with plain warm water or taking a bath and then pat dry. This will help with pain relief and infection prevention. The stitches will usually dissolve on their own, but seek medical help if they become too uncomfortable or sore.
Managing Perineal Pain and Swelling: Use ice packs and warm sits baths to alleviate discomfort and reduce swelling in the perineal area.
Pelvic Floor Exercises: Engage in gentle exercises to restore muscle strength and improve bladder control after delivery, which can prevent complications like organ prolapse later in life. You can put reminder notes around the house to help you remember this crucial recovery tip.
Rest and Nutrition: Prioritise rest and maintain a nutritious diet to support your body’s healing process and boost recovery.
Monitor for Signs of Complications: Watch for signs of infection, excessive bleeding, or severe pain, and consult a healthcare provider if any of these occur.
Stretch marks: Stretch marks are very common post pregnancy. There are ways to improve the appearance of stretch marks but the most important thing is to embrace your body and practice self-compassion.

Physical Recovery After Caesarean Section

Scar Care: Keep the incision site clean and dry to prevent infection. Follow your healthcare provider’s instructions on wound care. There are ways to improve the appearance of scar that are effective. I have discussed this in detail and provided cost effective tips in my article on postpartum skincare essentials.
Pain Management After Caesarean: A C-section is major abdominal surgery, and you might experience post-operative pain. Use prescribed pain medications that are safe for breastfeeding.
Limit Physical Activity: Avoid lifting heavy objects and strenuous activities for at least 6 weeks to allow your body to heal properly.
Gentle Movement: Take short, gentle walks to promote circulation, prevent blood clots, and aid in recovery, but avoid movements that strain your abdominal muscles. Ask your partner for help with tasks like picking up the baby from the crib.
Rest and Nutrition: Prioritise getting plenty of rest and maintaining a balanced diet to support healing and boost your energy levels.
Monitor for Signs of Complications: Watch for signs of infection such as redness, swelling, or discharge at the incision site and contact your healthcare provider if any issues arise.

Postpartum Bleeding

After giving birth, it is normal to experience vaginal bleeding. This bleeding primarily originates from the area in your uterus where the placenta was attached, but it can also come from any cuts or tears that occurred during delivery. Bleeding is typically heaviest immediately after birth and gradually decreases over the following hours. Over the next few days, the bleeding will continue to lessen. The colour of the blood should transition from bright red to brown over the course of a few weeks. This type of vaginal bleeding, known as lochia, usually stops by the time your baby is around 12 weeks old according to most medical literature, including the Royal College of Obstetricians and Gynaecologists (RCOG).

When to Seek Help for Heavy Vaginal Bleeding

Heavy vaginal bleeding, or postpartum haemorrhage (PPH) in medical terms, is defined as bleeding after birth that exceeds the expected amount. According to the RCOG, bleeding that exceeds 500 ml, or about a pint, is considered excessive. This can occur within 24 hours of birth, known as primary PPH, or between 24 hours and 12 weeks after birth, known as secondary PPH. It is crucial to seek medical attention immediately if you experience a heavy or abnormal bleed to ensure your health and safety.

Bowel and Bladder Care in the Fourth Trimester

Going to the toilet after birth can be challenging, especially if the area is sore or you had stitches. To make it easier, drink plenty of water to dilute your urine, which can help reduce stinging. If you had a C-section, you likely had a catheter inserted during the procedure. You won’t usually be discharged from the hospital until you’ve been able to urinate on your own after the catheter is removed. Pelvic floor exercises are important as they help strengthen the muscles at the base of your pelvis, which aids in bladder control and can prevent complications later on.

It’s normal not to have a bowel movement for a couple of days after birth, but it’s essential to eat lots of fruits and vegetables and maintain a good, high-fibre diet to avoid constipation and straining, particularly if you’ve had vaginal stitches or a C-section.

If you experience difficulty with urination or leaking, it’s important to seek help from a healthcare professional. Additionally, if constipation doesn’t resolve with dietary changes, consult your doctor who can prescribe safe medication to help.

Emotional Well-being After Giving Birth

Mood Swings and Hormonal Changes

After giving birth, your body undergoes significant hormonal changes. The levels of hormones such as oestrogen and progesterone, which were elevated during pregnancy, drop rapidly after delivery. This sudden shift can impact your postpartum emotional well-being, leading to feelings of sadness, irritability, or anxiety.

Effective Ways to Cope with Baby Blues

According to ACOG, "Baby blues" typically set in about 2–3 days after childbirth and usually improve without any treatment within a few days to 1-2 weeks. It's estimated that nearly 80% of women experience some symptoms of baby blues. These symptoms can include feeling anxious, depressed, sad, or upset, as well as experiencing anger toward the baby, partner, family, or other children. Other signs include crying for no apparent reason and self-doubt about whether they can handle caring for their baby. Understanding how to cope with baby blues is essential for your mental health after birth. Following these tips for mental well-being after giving birth mentioned below can help you manage baby blues.

7 Tips for Mental Well-being After Giving Birth

1. Ward Off Feelings of Inadequacy: Remind yourself that you are a good mother and that every mother is best for their child. Reading inspirational quotes and practicing self-care for new moms can empower you and strengthen your confidence.

2. Capture and Cherish Moments: Take photos and videos of your baby's milestones and revisit these moments during tough times. It's a great way to uplift your spirits while also enhancing your mental well-being.

3. Seek Support: Open up to your partner about how you're feeling. Their reassurance and help with newborn care can make a big difference. Building emotional support from loved ones is one of the best mental well-being tips for new mothers.

4. Prioritise Rest and Self-Care: It’s easy to neglect your own needs after birth. Set aside time for yourself—whether it's a bath, a nap, or simply some quiet moments to relax. Incorporating self-care after childbirth is essential for maintaining your physical and mental health.

5. Bond with baby: see below

6. Exercise: Doing light, safe exercise like walking is essential for a healthy mind and body. Exercise releases endorphins (happy hormones) and elevates mood.

7. Meditation and mindfulness: Practicing meditation in the form of a prayer, yoga, mindfulness is food for the soul - essential for a healthy mind

Postpartum Depression

Unlike baby blues, postpartum depression (PPD) starts 1-3 weeks after childbirth and may last up to a year. The reason behind it is the sudden sharp drop in hormones that were maintaining pregnancy (progesterone and oestrogen). A number of other factors like fatigue, lack of support, emotional factors, lifestyle factors and history of depression also play a role.

Symptoms include intense feelings of sadness, anxiety, or despair that can affect your daily activities. Learning how to manage postpartum depression is crucial, as it can significantly impact both you and your baby. Treatment can include self-help techniques, therapy or medication if necessary. For more information read the ACOG article on postpartum depression here.

When to Seek Help: If you notice symptoms of postpartum depression, feel suicidal, feel that you ca not care for the baby or find yourself unable to cope it's important to seek professional help. Treatment can include self-care for new moms, therapy, or medication if necessary.

Bonding with Baby

Bonding with your newborn baby is crucial for both you and your baby. It helps you cope better and enjoy caring for your newborn while providing your baby with the nurturing environment needed to foster secure bonds and support healthy physical and mental development. Here are a few tips:

Skin-to-Skin Contact: Hold your baby close to your skin as much as possible. This not only strengthens your bond but also provides comfort and warmth.
Eye Contact: Make eye contact during feedings and when you’re interacting with your baby. This helps establish a deep emotional connection.
Responsive Care: Respond promptly to your baby’s cries and needs. This builds trust and reassures your baby that they are safe and loved.
Talking and Singing: Regularly talk or sing to your baby. Your voice is soothing and familiar, which can calm your baby and strengthen your bond.
Gentle Touch: Gently stroke your baby’s back, arms, and legs. This physical touch is comforting and helps your baby feel secure.

Postpartum Self-Care essentials

Prioritise Rest: Ensure you get plenty of rest to support your body's healing process after childbirth.
Eat a Balanced Diet: Focus on a nutritious diet that provides the energy and nutrients your body needs for recovery.
Stay Hydrated: Drink plenty of water to keep yourself hydrated and support overall health.
Incorporate Gentle Physical Activity: Engage in light exercise, such as short walks, to boost energy levels and improve your mood.
Practice Self-Compassion: Give yourself time to adjust to the new demands of motherhood and be kind to yourself as you navigate this period.
Ask for Help: Don't hesitate to seek support from loved ones when you need it, whether it's for baby care or household tasks.
Take Time for Grooming: Simple acts of self-care, like brushing your hair, taking a shower, or changing into fresh clothes, can make a big difference in how you feel.
Embrace Scars and Stretch Marks: Celebrate your body’s strength and resilience by embracing your scars and stretch marks. These are symbols of the incredible journey you've been through. For tips on caring for postpartum skin, including scars and stretch marks, read my article here.
Engage in Relaxation Activities: Dedicate time each day to activities that help you relax and rejuvenate, such as reading, taking a bath, or meditating.
Prioritise Mental Health: Focus on maintaining your mental well-being by using the tips mentioned above, such as seeking support and practicing self-care.

Life in the First Few Weeks After Birth

Life in the first few weeks after birth can be both challenging and exciting as you navigate the joys and demands of caring for a newborn. You’ll likely experience a mix of emotions, from overwhelming love and happiness to exhaustion and uncertainty. The adjustment to a new routine, including frequent feedings, diaper changes, and sleepless nights, can be intense, but it’s also a time of incredible bonding with your baby. As you get to know your little one, you’ll start to recognise their cues and establish a rhythm that works for both of you. It’s important to take things one day at a time, lean on your support system, and remember that it’s okay to ask for help. Amid the challenges, cherish the precious moments—those first smiles, cuddles, and milestones that make this period so special.

When You Should Seek Help for Yourself

As a new mother, it’s crucial to monitor your own health and well-being. Seek help if you experience severe or persistent pain, heavy vaginal bleeding, or signs of infection such as fever, excessive swelling, or unusual discharge from your C-section incision or vaginal stitches. Additionally, if you feel overwhelmed by feelings of sadness, anxiety, or despair that interfere with your daily life, it could be a sign of postpartum depression. Don't hesitate to reach out to a healthcare provider if you experience any of these symptoms, as early intervention is key to ensuring your recovery and well-being.

My Postpartum Story

With my first baby, I ended up having an unplanned C-section following a failed induction of labor—so I got to experience both labor pains and a C-section. Although taken aback by the sudden change in plans, I managed to stay emotionally strong by focusing on all the little good things that were happening. My husband was my biggest pillar of support, helping me cope with both the birth and caring for a newborn.

Having had a Caesarean, I started moving about as soon as I could, continued light activity throughout the first 12 weeks, but avoided straining. We invested in a safe bedside crib (Snuzpod) that helped me pick up my little one for feeds with minimal strain.

Establishing breastfeeding was a struggle as my baby had feeding issues initially, so I pumped to maintain and increase my milk supply. We sought help from the infant feeding team and experimented with different feeding positions.

My family came over to support me. My husband and family played a crucial role in taking care of the baby and feeding him a bottle of expressed breast milk or formula while I slept or took some well-deserved "me time."

We made sure to have little cozy celebrations along the way— like decorating the house for a welcome home or having a small intimate dinner party with just my husband and family who were visiting. The idea was not to invite people and make it a big deal but to give ourselves a chance to dress up, eat, enjoy, take pictures, and make memories. We took small videos and pictures throughout to capture memories of the birthing experience, small celebrations, and our bonding with our newborn. We also took monthly pictures to track our little one’s growth. I found joy in quickly editing a few videos into short vlogs to look at and feel happy.

Yes, there were rough days when I cried for no reason or felt inadequate—when my baby would cluster feed all day and I felt like giving up. But my husband’s support was crucial, and I would always remind myself during tough times that it was just a matter of a day or two and then the happy days would come again—and they did.

Final Thoughts: Key Takeaways from the Fourth Trimester Guide

Embrace the Transition: The fourth trimester is a period of profound change for both you and your baby. Understand that this is a time of adjustment where both of you are adapting to new roles—your baby to life outside the womb, and you to the demands of motherhood.
Prioritise Self-Care and recovery: Your physical and emotional well-being are crucial during this period. Prioritize rest, eat a nutritious diet, and don’t hesitate to seek help when needed. Remember, taking care of yourself is the first step to taking care of your baby.
Nurture Your Bond: Skin-to-skin contact, responsive care, and spending quality time with your newborn help foster a strong bond that is vital for your baby’s emotional and physical development.
Follow Your Baby’s Lead: Every baby is unique. Pay attention to your baby’s cues for hunger, sleep, and comfort. Trust your instincts and respond with care to build a foundation of trust and security.
Establish Routines: While flexibility is key, gradually establishing routines—whether in feeding, sleep, or play—can provide a sense of structure and help both you and your baby navigate this new phase.
Seek Support: Don’t hesitate to reach out for support, whether from your partner, family, friends, or healthcare professionals. Surround yourself with a support system that understands and respects your needs during this crucial time.

I hope you found this comprehensive guide to the fourth trimester and newborn care essentials both helpful and empowering. Remember, it’s essential to be kind to yourself during this period—you’ve undergone significant changes and deserve all the care and compassion possible. Your baby loves you unconditionally, just as you are. Embrace the journey of the fourth trimester, focus on your well-being, and take the time to create cherished memories with your little one.

If you know other mums navigating the challenges of the fourth trimester, please share this guide with them so they too can benefit from these valuable tips.