Yes, Fourth Trimester Care is a Necessity

When the Empress Maria Theresa gave birth to Maria Antoinette, she was cleaned up and back to her royal duties within hours. While some may think that such dedication is admirable, Dr. Garritano and Christina know it’s really horrifying for the health of the person who has just given birth.

The fourth trimester requires just as much care for the newly delivered person as the previous three trimesters during pregnancy. Astonishingly, for some people, the only care they receive is one follow-up visit to clear them for physical exercise and sexual activity.

Here in America, we may be starting to understand the real value of fourth trimester care – and the expense in both health and cost that neglecting it can cause. Her Wellness is here is explain.

What is the fourth trimester?

The fourth trimester is the first three months following the birth of a newborn, and in many ways the birth of a new family, as each addition to a family changes the dynamic that is already in place. This term was first coined in 2002 by Dr. Harvey Karp, founder of Happiest Baby on the Block books.

What happens in the fourth trimester to the person who has given birth?

In the fourth trimester, the person who has given birth does not magically transform overnight into who they were before the pregnancy. There is a physical and mental impact to giving birth that people need time to heal from, and often even when healed, not everything reverts to “normal”.

Hormonal Changes

Hormonal changes after pregnancy are drastic. During pregnancy, estrogen and progesterone levels increase to all-time highs. However, these levels careen back to pre-pregnancy levels after the first 24 hours after giving birth. This hormonal change can cause postpartum depression and anxiety, hair loss, acne and often nausea. Most people will experience all of this - to some degree - after giving birth.

During this time, it’s important to reach out to your partner and to your physicians to let them know what you are feeling. Brainstorm together to be sure you are taken care of, either by your partner or an outside caregiver. Schedule regular check-ins with your partner, ensuring you get as much sleep as possible. Alert Her Wellness so we can get involved to help relieve depression and anxiety with medication and therapy recommendations.

Physical Changes

Physical recovery takes time. Healing from any tearing, caesarean incisions, episiotomy sutures, sore arms from IVs, and all over aches and pains from pushing a baby out of a human body may take weeks.

On the inside of the person’s body, there is even more healing and recovering to be done. Organs are adjusting, changing size and shifting back into place – more or less - now that they are no longer accommodating the expanded uterus. The coccyx or tailbone may be bruised or broken.

Some physical changes may never revert to pre-pregnancy condition. Hips that have stretched and widened may keep their more generous shape. Breast tissue may be less firm. Stretch marks may leave trails on the skin even when they shrink.

Having a baby is the most impactful natural event that will ever happen to your body and you may need physical therapy, nerve manipulation or visceral massage to fully recover. Talk to Her Wellness about pain or discomfort after you’ve delivered. We’ll talk through what can be expected and when intervention is needed, always listening receptively and communicating openly.

What’s the public opinion on supporting the fourth trimester?

In many countries, the first 12 weeks of a baby’s life is also recognized as a time for the parent to heal and be cared for and includes mandatory maternity and paternity leave, lactation consultation and all-around support for new families, an entire village to care for both baby and parent.

While that is not universally true in the United States, there is encouraging news. The American College of Obstetricians and Gynecology (ACOG) has recognized and created a task force to redefine proper postpartum care in America. In the committee report, the task force calls for:

Pregnancy Care is Four Trimesters, Not Three

The fourth trimester is rough and everyone needs help. Talk to your partner and make sure there is support after your delivery, whether from your partner if possible or from an outside caregiver.

When family or friends ask if they can help, say “yes, we would be so grateful if you’d bring dinner on Tuesday” or “yes, please come over at 6 pm to sit with Baby for an hour so I can sleep.”

We must make fourth trimester care a priority. While the healthcare system will not make changes overnight to address the gaps in healthcare coverage, there are ways we can work together to set new parents up for success. Call when you have questions about your recovery, any pain or any other issue. Ask us about classes, online videos and webinars that discuss topics such as delivery, post-delivery care, and lactation. At Her Wellness, we are here to advocate for your health and recovery.

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