What is the fourth trimester?

27 March 2014

The first 12 weeks after birth is a big adjustment for mother and child. Suddenly the mom has a helpless baby who must be cared for day and night, and the baby has to adapt to a new environment that’s nothing like the womb. This period, known as the fourth trimester, is a transitional period for moms and babies.

It can be traumatic, but if you approach it correctly the time flies. Experts give advice.


“Compared with other mammals human babies are born immature,” says Meg Faure, a Cape Town occupational therapist who works mainly with babies.

“Your baby is dependent on you in every way, not just for survival but also to learn basic skills,” she says. “All a newborn baby can do on its own is breathe and maintain its heartbeat. He must learn everything else.”

During the first three months after birth babies communicate by crying, says Dr Nandi Sibiya, a Johannesburg paediatrician. “Moms learn early on the difference between crying over a wet nappy, hunger, tiredness or discomfort,” she says.

“But take note of the baby who cries all the time,” she warns. “If you’ve done everything to comfort your baby and nothing is working, something is wrong.”

Help your baby

Newborns can easily feel overwhelmed by all the new sensory experiences of their first few days out of the womb, Faure says. You can make things easier for them by keeping these golden rules in mind:

  • Beware of overstimulation. “Your baby doesn’t yet have the capacity for high-level interaction,” she says. Feeding time, bath time and changing nappies are stimulating enough, and too much can make your baby cry.
  • Your baby must sleep a lot. Don’t try to keep your baby awake because you’re afraid they won’t sleep at night. When they wake, they should go to sleep again within an hour.
  • Avoid perfume and perfumed soap. Your baby is accustomed to the natural odour of your skin. Perfumes and other strange smells can overwhelm them.
  • Wrap your baby in a blanket or use a sling to carry them close to your body. This imitates the feeling of the womb.


It’s not unusual for new mothers to be anxious, especially if it’s their first child. Anxious feelings are normal for up to the first three months after

the birth, although moms should find their feet within three weeks, experts say. “About 80 % of new moms experience baby blues, says Almeré Curk of the Post Natal Depression Support Association of South Africa (PNDSA).

“Weepiness and anxiety are normal,” she says. Most moms get little sleep and struggle to adapt to their new figure and routine. Their hormones must also return to normal.

“If moms feel worse after the first three weeks, and don’t feel any better after three months, they could be suffering from post-natal depression.”

How to help yourself

Faure advises new moms to get as much rest as possible. “Try to have at least one nap during the day while your baby is sleeping.” Don’t give in to pressure to resume your social life soon and get on with your life. “You need time to adapt,” she says.

Dr Mariana Symington, an obstetrician in Paarl, says it’s important to have the support of friends and family during this time. She suggests the following:

  • Arrange with a relative or friend to come and sleep at your place for about three nights. She can care for the baby if you want to take a long bath or catch a little undisturbed sleep.
  • Keep the telephone number of your clinic nurse, doctor or paediatrician at hand in case you need urgent advice.
  • Touch your baby a lot because it’s good for the baby and for you. For example, allow your baby to sleep on your chest.
  • As soon as you’re comfortable, try to get out of the house a bit. Arrange to have tea with friends and take your baby with you.

If you still feel anxious three months after the birth seek professional help. Consult your doctor, clinic nurse, gynaecologist or midwife. You can also call the PNDSA’s national helpline on 082-882-0072.

- Shané Barnard

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