Wellness·6 min read

Your Fourth Trimester, Skimm’d

Your Fourth Trimester, Skimm’d
Mosa Tanksley
November 4, 2021

The Story 

We often talk about pregnancy in terms of three trimesters. But after your baby is out in the world, surpriseeee: You have to deal with even more physical and mental changes. There’s a term for that phase of parenthood.

Oh, I know this one: “fourth trimester.”

Yep. That’s what people call the first 12 weeks postpartum. Because it’s important to acknowledge that birthing people are dealing with a whole lot internally and externally. All while taking care of a tiny human.

What am I getting myself into?

Parenthood. It’s a lot. But the first step to dealing with it all is to acknowledge what you’re going through. For starters, here’s a word to know: “matrescence.” 

Excuse me?

It’s an term used to describe *gestures wildly* ‘all of this.’ It means ‘the process of becoming a mother.’ It’s kind of like adolescence, because there are so many new things happening mentally and physically all at once. Which leads some people to think there’s something wrong with them. But unlike puberty, you might experience these feelings every time you have a baby. And it can continue well past three trimesters. 

What should I expect (besides my baby)?

  • Emotionally...You’ll be hormonal, to say the least. After the baby gets out in the world, a number of your hormones will drop. And with them, your body will lower its natural defenses against depression. Which means you could get easily irritated and experience the ‘baby blues.’ About 10%-20% of moms experience postpartum depression, with new mothers of color particularly impacted. And a woman is more likely to have her first hospitalization for bipolar disorder in her first month postpartum than at any other time in her life. That’s a lot to take in — read on for resources below. Also know that there are some happy hormones, too. Specifically, the ‘love hormone’ oxytocin could get a bump when you breastfeed or even just look at your baby. Which might explain all those pics on your camera roll. And parents who adopt can also get all these feels, even without natural postnatal hormones. 

  • Physically…Take a moment to remember that your body did this amazing thing. Go you. Now you need to rest (or at least try) in between the whole parenting thing, because your postpartum body needs to recover. Literally. Your organs moved during pregnancy to make room for that plus one, and your hips may have widened during labor. Plus, you might experience any of these side effects: uterus and back pain, sore wrists and shoulders, night sweats, swollen feet, constipation, and sore breasts from feeding (more on breastfeeding here and how to get a handle on nipple pain here). And don’t be surprised if you have hair loss, acne, prominent veins, a belly pooch, stretch marks, and zero sex drive. Sorry. Other things you might be dealing with: peeing your pants a little, having a tear down there, or tending to stitches. Could get why all of these uncontrollable changes might lead to a love-hate relationship with your body (but here are tips to embrace it). Know that breastfeeding helps your uterus shrink down to its pre-pregnancy size, and if exercise was part of your pre-birth routine and you’re feeling OK to start moving again, you can reintroduce some workouts early on in your fourth trimester. Start small with short walks and then low-intensity workouts focused on strengthening your abdominal and back muscles. And keep in mind: Some people naturally lose some pregnancy pounds about 6ish weeks after delivery, but it can take months to physically recover from childbirth and lose weight. As you’re monitoring your baby’s every move, it’s important to look out for yourself, too. If you feel ‘off,’ consider seeing a PT who can specifically help rehab your pelvic floor, aka the spot you target with kegels. It’s the group of muscles that hold up your uterus (among other things), and is connected to all the parts that just did a lot of work. The American College of Obstetricians and Gynecologists recommends checking in with your doc within the first three weeks postpartum, and then again before the end of your fourth trimester for a full exam.

Sounds like I’m going to need some time off of work.

Yes, that would help. But the US is the only wealthy country in the world that doesn’t require paid parental leave. We’ll let that sink in... President Biden’s $3.5 trillion social spending package initially included paid leave, but the package has since been debated and trimmed down by nearly half. Meaning paid family leave could be off the table. Speaker Nancy Pelosi says House Democrats are keeping four weeks of leave (down from 12) in their version of the bill. But it’s unclear if that’ll pass in the Senate. As it stands now, only 23% of American workers have some type of paid family leave. Check with HR on whether you can take time off, paid or not. And take a look at your local laws: Some states require paid family leave or disability insurance that applies to birthing people.Psst...Check out Skimm Money's guide about how to financially prepare for maternity leave.

What if I need help?

Your first official check-up is typically six weeks after delivery (the baby might have three or four by then). But that might be later than you need. Know that you can contact your OB whenever you have questions or concerns. And you can look into hiring a doula, who’s trained in helping new parents adjust. Apps like virtual health care provider Maven, baby tracker Huckleberry, white noise maker Sleeptot, and all things parenting Ovia Health, could also help. And joining a parenting group (that isn’t judgy) can be a good way to compare notes with people going through similar things. But there are also clinicians who specialize in reproductive psychology (like Dr. Aurélie Athan, who we consulted for this guide) and are trained to help you manage mental symptoms related to matrescence as soon as they come up — or as a preventative measure. Here’s a database for finding a therapist for prenatal, pregnant, and postnatal people. If you find yourself experiencing postpartum depression symptoms that “substantially limit” at least one life activity, consider applying for Social Security. Pro tip: If you have insurance, talk to your provider about mental health coverage, because there’s a good chance your plan includes appointments with mental health professionals. And don’t forget to reach out to friends and family for help during this transitional time. You know what they say: It takes a village.


We doubt anyone would argue that becoming a parent is simultaneously beautiful, transformative, and overwhelming. But preparing for all of the mental and physical changes to come — and having the words to describe them — can help you advocate for yourself during your fourth trimester. Remember: Help is out there.theSkimm consulted with clinical reproductive psychologist Dr. Aurélie Athan for this guide.

This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition. 

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