During pregnancy, you slowly work your way through the first, second, and third trimesters until the exciting arrival of your baby. What you don’t necessarily hear a lot about is the postpartum period immediately following pregnancy.

Here’s what you might experience in the “fourth trimester” following the birth of your little one.

The fourth trimester?

Yes, the period after the birth of your baby has a name!

Those first 12 weeks after you deliver are informally called the fourth trimester. This time is just as important as any other in your pregnancy.

In fact, the maternal mortality rate is highest during these three months. Knowing what to expect and gathering support is important for your health and well-being.

What changes do women experience after birth?

Aches and pains are very common after having a baby. There’s a lot of physical healing you’ll deal with after a vaginal birth or a cesarean delivery. In addition, there are a number of changes your body undergoes as it returns to normal after nine long months of pregnancy.

1. Bleeding

The blood that you see after birth is called lochia. It is heaviest in the first few days after delivery. Lochia smells a lot like regular menstrual discharge: musty and stale. Women who deliver via cesarean delivery may only have light bleeding less than a day after birth. But you may experience lochia for a total of four to six weeks.

Your hospital will likely supply you with extra-large pads that work well in the worst period of bleeding. You may notice that your bleeding gets heavier with the more activity that you do, especially when you return home with baby. You may also see clots. All of this is usually normal.

Call your doctor if you are soaking through a large pad in an hour, or if you see clots larger than golf balls.

2. Breast discomfort

Whether or not you choose to breast-feed your baby, your breasts will undergo a number of changes once baby is on the outside:

  • Discharge or leaking milk may be an issue until your supply is regulated. If you don’t plan to breast-feed, this discharge usually goes away within a week or two.
  • Engorgement is another issue where your breasts may feel hard, warm, or particularly heavy.
  • Nipples may bleed or crack in the early days of breast-feeding. They are often a symptom of a poor latch or another nursing issue like a lip- or tongue-tie.

Though uncomfortable, these sensations are normal. Contact your healthcare provider if you develop these symptoms:

  • fever
  • redness
  • swelling
  • oozing
  • other signs of infection

3. Night sweats

Your hormones have the heavy task of helping to rid your body of excess fluids after birth. You may also find yourself going to the bathroom more often. As a result, you may have night sweats that make sleeping uncomfortable. This fourth trimester complaint usually starts to get much better in the days and weeks after delivery.

If you continue to sweat through your clothing at night for many weeks or have other concerns, contact your doctor to rule out infection or other medical issues.

4. Contractions

Before pregnancy, your uterus was about the size of an orange. By week 40, it ballooned to the size of a watermelon (or larger, if you carried multiples). What does this mean? Your uterus must shrink back down to its original size. This process happens more quickly if you are breast-feeding and usually takes around six weeks.

While your uterus shrinks, you may feel contractions that range from mild to painful. These contractions are also responsible for helping to stop the bleeding where your placenta was attached. The discomfort may be worse for moms who have previously given birth or those who are breast-feeding.

5. Incontinence and constipation

You may leak urine when your bladder is full or when you laugh, cough, or strain for the first weeks after giving birth.

Your first bowel movement may not come straight after delivery. Instead, it may take several days to come and feel quite painful.

If your symptoms don’t get better by the time of your postpartum appointment or sooner, reach out to your doctor.

Postpartum essentials and products

Many moms find it helpful to collect a toolkit to prepare for discomforts after birth. Keep some or all of these items in a basket in your bathroom so they’re at easy reach. You may also consider asking your friends what items helped them most in the weeks after delivery. Here are some tips:

  • Stock up on lots of extra absorbent pads for lochia.
  • Stow away some lanolin or similar salve for cracked nipples.
  • Use nursing pads in your bra to soak up discharge and milk leaks.
  • Feed baby frequently or pump to relieve breast engorgement. Take pain medication or apply ice packs if you don’t plan to breast-feed.
  • Work with a lactation consultant to identify any nursing issues that might lead to breast or nipple pain.
  • Try using medicated pads with witch hazel, like TUKS, to ease hemorrhoids.
  • Practice Kegel exercises to regain control over your bladder function.
  • Keep a change of pajamas next to the bed for night sweats.
  • Take ibuprofen, use a heating pad, or walk around for contractions caused by your uterus shrinking.
  • Drink plenty of water and eat a healthy diet with lots of whole grains, fruit, and vegetables to help with bowel movements. You might also take a stool softener, like Colace.

Where to find support postpartum

Surround yourself with support in the days and weeks after birth. Don’t try to do everything yourself if you don’t have to. Get in rest when you can, even if you must nap when the baby naps.

In other words: Make yourself a priority as you heal.

If you don’t have family or friends in the area, you might consider hiring a postpartum doula. They can help you adjust physically and emotionally in the fourth trimester. A doula’s goal is to “mother the mother” during this period of time. Postpartum doulas usually work with each family individually to assess specific needs.

These needs might include:

  • help with recovery after birth (emotional and physical)
  • housekeeping tasks and errands
  • help with basic newborn care and soothing techniques
  • meal preparation and shopping
  • sibling care
  • suggestions for pediatricians, breast-feeding support, and other parenting resources

Breast-feeding mothers may benefit from an appointment with a lactation consultant. This person is a nurse who specializes in breast-feeding. At your appointment, you can discuss any feeding issues you’re having with your baby.

It’s also a good opportunity to discuss any physical discomforts and get suggestions on things that might help, like different nursing positions.

Next steps

There’s a lot people don’t tell you about the months after giving birth to your baby. The good news is that most of the discomforts you’ll experience are temporary. Remember to take care of yourself. Reach out for help when you need it. If something doesn’t feel quite right, don’t hesitate to contact your doctor.

Q:

How can a new mom tell if she’s experiencing postpartum depression and what are some resources to help?

A:

Postpartum depression is a disorder in which a woman may experience extreme sadness or anxiety in the weeks to months following giving birth. The symptoms may interfere with your ability to take care of yourself or your family. Other common symptoms include feeling helpless or overwhelmed, crying for no reason, difficulty sleeping, feeling withdrawn, and having difficulty attaching or forming a relationship with your baby. If you have any thoughts of hurting yourself or your baby, seek immediate medical attention. If you are experiencing any of these symptoms, you should contact your doctor right away.

Helpful resources:

Katie Mena, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.