Postpartum

Why It’s Called the Fourth Trimester

Remember when you were thin, having sex, staying up late for parties, and watching Casablanca on the late show? Then you were pregnant, awkward, tired, swollen, and unable to see your feet -- longing for the time when your baby would be born. Now the baby is here, and this means you’ve taken the first step toward getting your body back. But it also means there is a whole new person in the world who is suddenly the center of the universe. Negotiating all these transitions is not easy for anyone. Even for a woman who has become accustomed to not being in control of her body, it can be difficult to realize that an eight-pound, twenty-inch baby is now in charge.

The first six weeks of having a new baby are some of the most challenging weeks in a woman’s life. It’s a relief to be done with pregnancy and delivery, but now there is a small stranger who demands continuous attention. The problem is, babies can’t tell you what they need. Are they tired, hungry, bored, lonely, or wet? In those first weeks, learning your baby’s crying language is a major developmental task for both you and the baby.

Delivering a baby is tremendous physical work -- think of it as major surgery (having a C-section literally is) -- and yet the American health system sends mother and baby home twenty-four hours after delivery. The combination of hormonal changes and the anxiety of not knowing what the infant needs will take its toll on any new mother’s moods. In addition to sleep deprivation and soreness, the demands of learning to breastfeed are significant. This transition, though long awaited, is shocking to mother and baby. That’s why the first three months of the baby’s life are often called the fourth trimester.

--from Understanding Your Moods When You're Expecting, Chapter 6

View the Edinburgh Postnatal Depression Scale (EPDS)