Pregnancy: The Fourth Trimester

Physical changes after birth


In the days after the birth the mother’s body will be recovering and adapting. A monthly period will not start again for around 5-6 weeks. The mother can get pregnant again after around 3 weeks, even if there has been no period.


The breasts will be tender and produce a yellowish liquid (called colostrum) at first, and milk after 3-4 days. The belly will be bigger than before pregnancy, partly due to muscle adaptation. With a balanced diet and exercise this will gradually return to normal.


Another common physical change is the separation between the stomach muscles. These should come back together after around 8 weeks. Stomach and pelvic floor exercises can strengthen pelvic and abdominal muscles-post birth. These are all things that can be discussed with a midwife or doctor. 


Hormonal changes after birth


Oestrogen and Progesterone are the most important hormones in pregnancy that support the changes in both mother and baby. After the birth, Prolactin stimulates milk production throughout breastfeeding. It can also affect behaviour, metabolism, and the immune system. Prolactin can be responsible for mood-swings after the birth. These are normal and should eventually settle.


Oxytocin is also key to labour and breastfeeding. This hormone is associated with social behaviour. It promotes bonding between mother and baby, but also other feelings like defensiveness. It is normal for pregnancy and birth to affect the levels of hormones produced. Everyone experiences these hormone changes differently. Some may develop postpartum depression. It is always good to talk about how you are feeling, and sharing experiences with other mothers can be useful. 


New-born Care


A new-born will need feeding roughly every 2-3 hours. Baby-led feeding allows the baby to decide when they are full and find their own pattern. Babies should be bathed when they are awake and content, in warm water, with a towel, cotton wool and clean nappies/clothes to hand. Changing the nappy regularly will stop any build up of bacteria. It preventing nappy-rash.


New-born babies are not tuned in to night and day and so will sleep for 2-3 hours during both

night and day. They will also need regular feeds. As they grow, they need fewer night feeds and

sleep for longer. Sleeping when the baby sleeps, sharing tasks with a partner, friends or relatives, and getting plenty of exercise can increase sleep and reduce feelings of tiredness in the first few months.


Babies under 6 months should be put to sleep on their back, in a cot in the same room as the

parent(s). Bonding is important for both mother and baby. This can be promoted in a number of ways including baby-massage, eye-contact, skin-to-skin contact, and reading, singing or dancing with the baby.




The change of having a new-born to take care of can cause stress or add to existing stresses

such as work or family life. Stress may be reduced by unwinding with an enjoyable activity, or

spending time with a partner, family, and friends. Any health concerns can be addressed with a midwife or doctor. It may also be beneficial to share experiences with other new parents.



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