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  • Writer's pictureMeg Henderson

5 Things You Should Know About the 4th Trimester

Fourth trimester – you say? What?! I thought pregnancy was only 3 trimesters!

You are correct, but us mamas need to start thinking of that precious time with a newborn as an extension of our pregnancies…at least the healing part! By definition, the “4th trimester” encompasses the first 3 months your new journey into motherhood and the first 3 months of your sweet little one’s life earthside. It’s a time for mamas to connect with their littlest ones, for siblings to meet for the first time, bond, snuggle, rest, sleep, heal, and allow others to take care of YOU.

Screech! STOP!

BUT this is not my reality you say… “I have other kids to take care of, no family in town, my husband travels, there’s a pandemic…"

Here’s the thing, we don’t get to just pick up where we left off at the end of pregnancy.

Your birth story is unique and your body need time to heal from childbirth just like any other "injury"! Soft-tissue injuries, depending on their severity, take approximately 6 weeks to begin healing. Now, imagine a cut on your arm. If we pulled on it and stretched it every day, do you think it would heal quickly or without a big ole’ scar? NO WAY! Our bodies just birthed a tiny human and a large organ (hello 1.5lb placenta), which is an amazing feat in and of itself, and we expect things to just “bounce back” in 6 weeks, all the while lifting heavy car seats, older siblings, vacuuming, and running up and down the stairs? I’m describing my first time in the “4th trimester” rodeo. I did waaay too much, even with only 1 newborn, and did not allow my body to heal. Top that off with a need to return to work at 6 weeks postpartum…and I wondered why I struggled to regain strength after son #2, 4 years later?! I never really regained my strength in the first place!

Here are 5 things to consider during the 4th Trimester:

1. Healing time.

After birth, your body needs 6-8 weeks minimum to begin to heal. Your healing time might look very different if you just delivered baby 3#, pushed for 10 minutes, and had a grade 1 perineal tear vs a mom who labored for 36 hours, pushed for 3 hours, and delivered her baby via emergency c-section. We have to take all of those factors into consideration so comparing your journey to another mom’s is NOT ok. If we do “too much” too fast, we can’t expect our body to play along and heal at the same rate. So, realistically, push back that 6-8 week mark to 8-10 weeks if you’ve been chasing around another kid or two! Oh, and embrace those mesh panties and homemade pad-sicles—they do wonders for the healing process!

2. Breathing.

Just because you are trying to let your body rest, heal, drink plenty of fluids, eat the colors of the rainbow…oh and take care of a newborn, it doesn’t mean we have to avoid all exercise like the plague! You can start working on diaphragmatic breathing during your first week postpartum, in sidelying, or lying on your back! Start with an inhale through your nose, letting your rib cage expand 360* and your belly and pelvic floor relax, and then exhale through your mouth, letting your belly fall back to its starting positions. This is the first step in retraining your core, but it can also do wonders for stress relief!

3. Isometrics.

These bad boys are going to help you slowly rebuild the foundation of your physical house and also work out any kinks in the timing of your core system…meaning do the muscles turn on when they’re supposed to? At the end of pregnancy, our bodies are basically just getting the job done…using any strategy we can to haul the extra belly around, get in and out bed, you know what I’m talking about! We need to retrain the core system (diaphragm, pelvic floor, transverse abdominis, and multifidi) to make sure they are all working together as team players again. Ultimately, this will help us to avoid symptoms like leaking, pain, and more!

Here’s what you can practice: Incorporate your diaphragmatic breathing with an isometric contraction of your pelvic floor and TA, aka the CORE BREATH. Inhale, expand the ribs, belly, and pelvic floor. Exhale, draw the pelvic floor in and up as if you are practicing lifting a blueberry, while drawing belly button in slightly without moving your pelvis. Sounds easy…now go try it!

4. Posture.

As new mamas in the 4th trimester, there are not many times when we are without baby! We are rocking, shushing, carrying, changing, feeding, snuggling, baby-wearing mamas. Not that you need reminding, especially if you are at the end of your pregnancy or a new mama, your posture changes at the end of pregnancy due to the size of the baby belly. This posture doesn’t just magically disappear when baby is born—now you are carrying the weight on the outside! And that weight wiggles, move, and probably fusses when you put them down!

Tip: Have a friend or family member snap a candid picture of you from the side while holding your little one and take note of a few things.

  • What are your shoulders doing? Are they rolled forward or in line with your ears?

  • How is your head positioned? Is your chin tucked or is it sticking out forward?

  • Is your bum tucked under and you have FAS (Flat A$$ syndrome)?

When you’re holding baby, try to think about growing tall - keeping your ribs stacked underneath of your pelvis, shoulders back, knees slightly flexed, and chin tucked back. In this position, you can actually use your glutes and those deep core muscles you’ve been working on isometrically! Check this video out for more explanation! Try using proper pillow support while feeding also to prevent upper back and neck pain.

5. Postpartum is FOREVER.

Pregnancy and birth are really amazing miracles. Our bodies are strong and resilient, and The 4th Trimester is just the beginning of learning what we are capable of as women and mamas. We need support from all of those around us, not only to help with the baby, but for us—the mamas! The American College of Obstetricians and Gynecologists (ACOG) released a Committee Opinion recognizing the importance of a continuum of care during the 4th Trimester, including a visit to her postpartum provider within the first 3 weeks of delivery. It details the importance of a postpartum care team, including physical therapists (YAY!), to support and assist mamas in the physical recovery post-birth. Postpartum is FOREVER, and if we can start to shift our mindset during the 4th Trimester to rehab our bodies the way we would post-injury, we can avoid a lot of the symptoms that most women take for granted as “just another part of motherhood”.

If you are expecting or postpartum and have any questions, we would love to speak with you!

Please email us: or call 843-410-8113.

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