What To Expect After Having A Baby

We always hear about the three trimesters of pregnancy. But many women know little about a critical time period immediately after their baby is born: The Fourth Trimester.

As a Midwife, I know that the medical care of women before, during, and immediately after pregnancy has long focused on the goal of achieving a healthy pregnancy and a healthy baby. But often, the fourth trimester — that time between birth and 12 weeks postpartum — is forgotten.

This post aims to educate you on what to expect in the fourth trimester in order to give you and your baby the best possible start in the next chapter of your lives.

1. Breast Milk-  

Colostrum starts being produced from about 16-22 weeks of pregnancy. Colostrum is the early, concentrated milk that is full of nutrients and antibodies and is specifically catered to your baby. It provides all that your baby needs for health growth and development. When baby is born they have a very small stomach and the amounts of colostrum that you develop will be small (but will be enough for your baby). As you continue to breastfeed your baby the colostrum will develop into breastmilk which is thinner and whiter. This happens about day 3 and is often referred to as ‘milk coming in’. This is also full of nutrients and is perfect for your baby’s needs.

Signs that your milk is increasing may include:

• Change in colour of from golden (colostrum) to white (breast milk).
• Milk leaking freely from breasts. You may wake up to your pyjamas drenched with breastmilk after a nights sleep.
• Breast fullness, characterised by; engorgement, swelling, tenderness, heaviness or tingling (pins and needles sensation). To alleviate engorged breast gently express some milk until you feel comfortable again.

The average colostrum  intake by healthy babies increases from 2-10 mL per feeding in the first 24 hours to 30-60 mL (1-2 oz) per feed by the end of day 3. Generally you should aim to feed your baby “responsively”. This means looking out for feeding cues and feeding as and when you see cues from baby OR if you feel your breast are full you can also offer a feed. The NHS recommend that you feed baby 8-12 times per 24 hours.

Breastfeeding can be quite stressful in the early stages but there is plenty of support available for any mum who wishes to breastfeed from:

• Midwives
• Health Visitors
• Local breastfeeding support groups.
• Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily)

2. Blood loss-

Whether you’ve had a vaginal delivery or a caesarean you will experience vaginal bleeding post-delivery, often referred to as lochia. Your lochia goes through 3 stages (Rubra, Serosa, Alba).

Your blood will be bright red, and you may see some clots for the first few days after you give birth. The clots shouldn’t be bigger than a 50 pence piece. You’ll have to wear maternity pads at first, disposable knickers are always useful too. You should be able to go back to a regular pads after the first week. 

It’s also normal to sometimes feel a gush of blood when you stand, just like when you have a period. This is because of the way your vagina is shaped. The blood collects in a cup-like area while you’re sitting or lying down. When you stand, it comes out.

After about 10 days, you should see less blood. You may have light bleeding or spotting for up to 4-6 weeks after delivery. You can only use sanitary pads during this time. Tampons could lead to an infection and are not recommended.

3. Contractions-

Just when you thought the contractions were over…

After delivery the uterus has to contract back to its pre-pregnancy size so women experience cramping/ pain/ discomfort. Women may experience these contractions for about 2-3 days after baby is born. Women who have had more than 1 baby will generally experience more contractions because the uterus has more work to do when contracting back to that pre-pregnancy size.

If you decide to breastfeed you may notice that every time baby suckles you contract. This is because breastfeeding releases a hormone called Oxytocin. Oxytocin is what causes contractions. This is nothing to worry about and completely normal. If you are finding the cramping painful please ask the Midwife for paracetamol or you can take 1gm (x2 500mg tablets) of Paracetamol.

4. Midwife Visits-

You will be seen by the community Midwife after your baby is born. Generally the visit schedule is:

• The first day after discharge from hospital.
• Day 5.
• Day 10.

This is the bare minimum visits that you should expect. Depending on what the Midwife finds on any of these visits will influence your visit schedule. For example if you need assistance with breastfeeding the Midwife may come back to help you on day 3. After day 10 if yourself and baby are thriving the Midwife may discharge you from Midwifery care and refer you to the Health visitor. If you don’t feel confident enough to be discharged please let your Midwife know. I will be able to assist with postnatal advice up to 28 days post delivery. You can book a consultation here

5. Tiredness-

Having a baby is a very exciting time in any families’ life. A women’s body goes through so much being pregnant, then labour, then the body has to go back to normal whilst you look after a newborn. All these changes mean that naturally you will be left feeling very tired.

I recommend that you:

• Get your Iron levels checked. A Low iron count can lead to tiredness.
• Sleep when baby sleeps.
• Eat a balanced diet.
• Accept help from family and friends.

Tips on how to successfully navigate the fourth trimester

1. ‘Bounce Back’- Myth!

In today’s society there is a huge misnomer that as soon as we have a baby, everything returns to normal, including our weight, tummy, sex life etc. When it doesn’t we then put ourselves down as if we have somehow failed at motherhood. This is not true! You have not failed. Give yourself time to adjust to your new life.

2. You are not alone.

Motherhood can feel very isolating, but you are not alone.

Have you ever heard of the saying “It takes a village to raise a child”. This is when you will need the support of many family and friends. Reach out ask for help! If you need professional help book a consultation with us. Our expert Midwife is more than happy to signpost you to the correct services.

3. Self care is a must!

Have you experienced mum guilt? Society has painted a picture of the perfect mum constantly attached to her newborn. This is unrealistic. We need some time out too.

So please, do not feel guilty about taking care of yourself. Regularly. Self-care should be a regular routine. We have the perfect treat for new mums. How about a warm bath with luxury calming bath salt. This is a great stress reliever and works wonders on ensuring mums are relaxed. Don’t believe us? Check out the amazing reviews. You are so important—to your baby and to the world.

I hope this has helped prepare you for the fourth trimester. Just remember: You’ve got this mama!