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4th Trimester

The nine months of pregnancy are divided into blocks of three months called ‘trimesters’.

This helps make it easier to describe all of the changes happening to the Mum and the baby at each stage and helps parents know what to expect.

Recently the three months after the baby is born has become known as the ‘fourth trimester’. This makes it easier to describe the many changes happening for babies and parents in the early days as the big adjustment to a new life begins

When babies are newborn they continue to change and develop at a fast rate physically and emotionally. The first three months is a period of a lot of change for parents too and it takes time to get used to.

It might sometimes feel like you should get back to ‘normal’ after your baby is born. Seeing these first few months as a time to recover, adapt and get to know your baby can take the pressure off.

Although the reality can be tougher than you expected you had probably been told about the practical changes a new baby brings. Some of the physical changes that happen after childbirth can come as a bit of a shock. 


  • You have just been through a big life event. Alongside the lovely ‘baby bubble’ having a new baby in the house is emotionally and physically demanding. It can put pressure on you and on your relationships. It will take time for things to begin to fall into place.  It can be a bit easier if you;

    • Keep your baby close to you. So that you can respond to them quickly and easily.
    • Remember you cannot spoil babies – there can be pressure to ‘get into a routine’ but newborn babies cannot manage this. Being led by your baby takes a lot of stress and pressure away. The most important thing is to take time to get to know each other.
    • Prioritise getting rest whenever you can. It is tiring having a new baby in the house. It is ok to have some pyjama days!
    • Eat well and get back to activity at your own pace. Now is not the time for big diets – recovery and sleeplessness are more manageable when you eat a healthy diet (read more *here*). Exercise is good for your mental and physical health too. Look at our page on getting slowly back to activity *here*
    • Talk about how you are feeling – you will have good and bad days. Try to be kind to yourself and talk to partners, friends and family. People understand it can be hard to cope sometimes.

    If everyday feels hard and it is getting in the way of you enjoying your baby speak to your midwife, health visitor or GP. You will not be judged and you don’t have to struggle on without support.

  • Leaving the warm, dark womb and arriving in a bright, noisy world must be a big shock. Babies have to get used to feelings like, hunger, discomfort and loneliness. Babies cannot meet any of their own needs and still aren’t quite sure who they can rely on. It is not surprising that it takes some time for them to settle down.

    From about two weeks of age until they are a couple of months old babies tend to cry a lot. Read more about this *here*.

    Your baby will want to be held a lot of the time. Being a separate little being takes some getting used to.

    Every baby is different. Taking time to get to know your baby and looking at things from your baby’s point of view can help you guess what they might need from you. When you are sensitive to your baby's feelings they learn to trust that they always have you on their side to help them.

    Calling the time between birth and three months ‘the ‘fourth trimester’ is a good reminder of all the changes that happen for babies. They rely on you to help them feel safe and get more confident.

    You can help your baby through this stage by;

    • Letting them hear your voice – one of the familiar things from the womb.
    • Keeping them close and holding them when they ‘ask’ is important. Just like hunger and discomfort ‘wanting’ a cuddle is an important need to meet. Skin to skin time can help babies settle.
    • Keeping the number of people who feed and care for them low so that they can build a strong, trusting bond with you.
    • Noticing the faces they pull and the sounds they make these baby cues are an important way of understanding what your baby needs.

    By the end of the fourth trimester your baby will have changed and learnt a lot. They will;

    • Be coping with milk feeds and be able to tell you when they are hungry.
    • Be beginning to know the difference between night and day!
    • Enjoy watching the world go by as their eyesight gets better.
    • Be used to the noises and smells and patterns to their day.
    • Enjoy using their ‘voice’ and letting you know how they feel.
    • Know you, trust you and reward you with their best smiles.

    The early days can be tough. Taking it slowly and giving yourself and your baby time to get to know each other takes time. Not putting pressure on yourself to be ‘super parents’ can take the stress away and make it a much more enjoyable time.


  • During pregnancy your womb grows to about 25x its normal size. After the birth of your baby it has to ‘contract’ back down to near its usual size (it never goes quite back to pre-pregnancy size). In the first few days you may experience ‘after pains’ that feel a bit like milder contractions / period pain. The pains can be a bit stronger as you breastfeed (Breastfeeding helps your womb return to size more quickly).

    • The after pains often seem a bit stronger after a second or more pregnancies.
    • Heat packs can help.
    • You could try paracetamol if the pains are strong.

    If the pains feel very strong or are worrying you talk to your midwife or call 111 for advice.

    Pains usually fade over first few days. By 4 -6 weeks the womb size is back to its new normal.

  • After your baby is born the blood and tissue left behind in the womb come away as a vaginal loss.

    It is likely to be like a very heavy period, containing bright red blood and some clots in the early days.

    It then changes colour and the amount reduces – it can last a month or longer.

    • You need the super absorbent maternity sanitary towels in the early days.
    • You should not use tampons until after your post-natal check as they can increase the risk of infection.

    There is advice on what loss to expect in the first days and weeks *here*.

    Speak to your GP, midwife or health visitor if you've got postnatal bleeding and any of these;

    • A high temperature over 38C
    • The bleeding smells unusual for you
    • Tummy pain that gets worse
    • The bleeding gets heavier or doesn't get any less
    • Lumps (clots) in the blood
    • Pain between the vagina and anus (perineum) that gets worse.

    It could be a sign of infection.

    Make sure you know the signs of a serious heavy bleed after giving birth (postpartum haemorrhage, or PPH). This is rare and needs emergency care.

    Call 999 if you've got postnatal bleeding and;

    • The bleeding suddenly gets heavier
    • You feel faint, dizzy or have a pounding heart.

    This could mean you're having a very heavy bleed (postpartum haemorrhage) and need emergency treatment.


  • The changes in hormone levels after pregnancy can cause ‘night sweats’ where you wake in the night sweating a lot. You might also experience this in the day. It tends to be worse in the first couple of weeks but can last longer particularly if you breastfeed.  

    • Drink plenty of fluids to keep hydrated.
    • Have a towel on the bed and spare nightclothes handy so you can get warm and dry quickly in the night.

    If you feel unwell alongside the night sweats, or if they are a big problem and / or goes on for a long time speak to your GP. Sometimes it can be a symptom of other things.  

  • During pregnancy the hormones mean that the usual natural hair loss slows right down.

    After delivery hormone levels get back to normal. This then cause you to shed the hair that you had held on to. It can feel like a lot of hair but it is a normal process and settles over the first year.

    • Treat your hair with care – avoid pulling and tugging it when brushing.
    • Only tie back gently.
    • Keep use of hairdryers and straighteners to a minimum.

    If you are worried that the amount of hair you are losing is causing bald patches discuss this with your GP.

Who Can Help?

You can contact the Healthy Child Programme by calling Just One Number on 0300 300 0123 or texting Parentline on 07520 631590. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays) and 9am-1pm on Saturdays.

If you are 11-19 you can text Chathealth on 07480 635060 for confidential advice from one of the Healthy Child Programme team.

Other parents who are going through or have been through this before can be a big help. You could join our online forum to speak to other Norfolk Parents below.

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