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What postpartum symptoms occur during the fourth trimester?
Your body has just accomplished an amazing thing: you made another human! Now it’s time to give your body the healing care it deserves. The transition from pregnancy to postpartum comes with its own list of symptoms – and every new parent’s experience is different – so try to be patient as your body recovers during the fourth trimester. And remember there are many resources to support you during this time!
Here are a few things to consider with fourth-trimester pregnancy symptoms:
- Physical recovery: Even if you had an “easy” pregnancy and a “perfect” birth experience (or maybe you had neither of those things), your body has been stressed and stretched to the max. You’ll experience soreness throughout your body, a gassy postpartum is possible as organs shift to their original place, postpartum bleeding can occur, and milk production can make breasts tender.
- Hair loss or skin changes: It is not uncommon to experience postpartum hair loss, dry skin and breakouts a few months after pregnancy. Your estrogen levels are resetting and causing your hair to shed and your skin to react. The good news is it’s temporary and your hair and skin should return to normal by your baby’s first birthday.
- Weight change: It took nine months to grow your baby, so it’s going to take some time to get your body back to “normal.” Most gain 25-35 pounds during pregnancy and shed about 13 pounds after giving birth. Now is the time to give yourself a break and focus on creating a healthy, happy body rather than focus on “getting your body back.”
- Heightened emotions: You’ve heard of the “baby blues,” feelings of sadness, irritability, and anxiety that kick in a few days after birth. About 8 in 10 women feel down after giving birth.
For most new moms, these feelings subside in about two weeks. But for about one in five people, postpartum depression can settle in. Keep in mind that “baby blues” can affect our partners and support team as well and we encourage the entire family to seek care if needed.
Why are postpartum emotions so strong?
Mood swings, sadness, irritability, and anxiety are totally normal after pregnancy. Your body has been working hard to grow a baby for the past nine months. Now that your baby has moved out, your hormones are giving your body a whole new set of directions to reset. Add to that all the stress, exhaustion and joy that comes with an expanding family.
However, if you’re feeling really anxious, deeply sad, or depressed or having thoughts of harming yourself or your baby, you could have postpartum depression (PPD) or postpartum anxiety (PPA). These mental health issues are not your fault, and they are treatable. You should contact your health care team if you need help.
Fortunately, your hormones and emotions should level off in a week or two. This worksheet can help you make a plan to prioritize your mental health.
Postpartum hormones
Research says your hormones estrogen and progesterone go from the highest levels they’ll ever be during pregnancy to the lowest they’ll ever be after giving birth. Then, your hormone oxytocin, which is called the “bonding hormone,” surges in, turning on your parenting instincts. All these hormonal fluctuations stir up mood swings, anxiety, sadness, irritability and sometimes depression. Fourth-trimester emotions are no joke, so trust what you’re feeling is totally normal and will get better.
Sleep deprivation and fatigue
Sleep deprivation and fatigue is typically the number one struggle for new parents. After your baby arrived, you quickly discovered it’s going to take some time for your baby to settle into a sleep routine. And even if/when they do, you’re still going to be up with them every few hours for feedings.
You need a sleep strategy. For example:
- Sleep when your baby is sleeping.
- Take turns sleeping and feeding with your partner or support person.
- Delegate chores and errands. Friends and family members are often eager to help when a new baby arrives. Let them!
Quality sleep is really important for your recovering fourth-trimester body and your mental health. Talk to your healthcare team if you need help getting the sleep you need.
Sense of self and identity
Being a parent is thrilling and you’ve been anticipating your baby’s arrival for nine months (and maybe longer). Now that they are here, it’s setting in that life as you knew it is over and this new chapter is really different. Maybe you’re even feeling a lost sense of identity and struggling with how to process becoming a parent. We’ll say it again: that’s normal.
You don’t need to feel like you’re going through this alone either. New parent groups – either for couples or individuals – can be helpful to meet other parents and share your feelings with people who understand because they’re going through the same things. This is a great way to find support and build a new sense of identity.
Anxiety and stress
We mentioned the hormone oxytocin and how levels of it tend to surge after delivering a baby. Oxytocin “turns on” your parenting behaviors, which includes your sense of danger and protecting your child.
When your oxytocin goes up, so can your feelings of anxiety. Now add to that, your progesterone – which tends to lower anxiety – drops after giving birth. This combination can make anxiety and stress feel out of control.
Here’s one more: thyroid hormones. For 5-10% of women, their thyroid is inflamed after giving birth. Symptoms of that include insomnia, anxiety and rapid heart rate.
The bottom line is if you’re feeling anxious or stressed, your hormones are very likely to blame. Plus, you’re exhausted, and you might also be struggling with taking care of your baby. Talk to your provider about how you’re feeling during the fourth trimester of pregnancy and don’t be afraid to ask for help.