[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2019\/07\/fourth-trimester-of-pregnancy\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2019\/07\/fourth-trimester-of-pregnancy\/","headline":"What Is the Fourth Trimester of Pregnancy?","name":"What Is the Fourth Trimester of Pregnancy?","description":"A normal full-term pregnancy is divided into three trimesters. But did you know that there is a fourth trimester and it is as important as the first three?","datePublished":"2019-07-25","dateModified":"2024-12-05","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/services\/women-regions","name":"UPMC Magee-Womens","url":"https:\/\/www.upmc.com\/services\/women-regions","sameAs":"https:\/\/share-dev.upmc.com\/upmc-magee-womens-hospital\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/07\/love-and-emotion-picture-id1147976678.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/07\/love-and-emotion-picture-id1147976678.jpg","height":327,"width":754},"url":"https:\/\/share-dev.upmc.com\/2019\/07\/fourth-trimester-of-pregnancy\/","about":["Living and Wellness","Mental Health","Pregnancy and Childbirth"],"wordCount":947,"keywords":["post-traumatic stress disorder","postpartum depression"],"articleBody":"A typical full-term pregnancy is divided into three trimesters that help define the changes that happen during the pregnancy.But the fourth trimester \u2014 the six to 12 weeks after the baby is born \u2014 can be a particularly vulnerable time for new mothers and their mental health.Keep reading to learn more about what you can expect during the fourth trimester.What Happens After the First Three Trimesters of Pregnancy?The fourth trimester \u2014the first weeks and months after delivery \u2014 is just as important for new mothers and should be viewed as a continuation of prenatal care.\u201cThe fourth trimester is a time of great adjustment for new mothers, so it can be incredibly stressful,\u201d says Priya Gopalan, MD, chief of psychiatry at UPMC Magee-Womens Hospital. \u201cThat is the period when the risk of postpartum mood and anxiety disorders is highest, which coincides with moms going back to work and caring for a newborn and older children. In all the excitement about the birth and focus on the new baby, the new mom often puts her own needs aside to care for her infant, which can have a negative impact on her mental health.\u201dAccording to the American Psychological Association, roughly 14%of new mothers develop postpartum depression (PPD). Postpartum Support International reports that approximately 13% develop postpartum post-traumatic stress disorder (PTSD).Why Is the Fourth Trimester Important?The fourth trimester, which begins virtually the minute your baby arrives, brings a massive amount of physical and emotional change. \u201cFor a first-time mom, there\u2019s often an intense moment of realization when she considers the magnitude of the responsibility of caring for another life,\u201d says Dr. Gopalan. \u201cHer body goes through significant changes too, so she needs to tend not only to her newborn, but to her own personal care and recovery from the birth.\u201dTremendous hormonal and physical changes occur during the fourth trimester \u2014 your body is trying to get back to its pre-pregnancy state and healing from the delivery. Almost all moms have some degree of pain after giving birth. Mothers who deliver vaginally may have to deal with perineal issues, which can include an episiotomy, vaginal tearing, and\/or hemorrhoids. Mothers who give birth by C-section will need to monitor the incision and follow lifting\/moving limitations.Other physical issues associated with the fourth trimester include breast changes \u2014 nipple pain from adjusting to breastfeeding, and breast engorgement (if not nursing) \u2014 as well as postpartum blood loss, which can cause low blood pressure and exhaustion. Almost all new mothers report fatigue due to sleep deprivation and shortened sleep cycles as the result of nighttime feedings.\u201cAll of these changes and stressors can make new moms susceptible to behavioral health issues,\u201d says Dr. Gopalan. \u201cThese issues can range from the baby blues to postpartum mood and anxiety disorders, such as PPD and postpartum PTSD.\u201dWhat Are Postpartum Depression (PPD) and PTSD?Postpartum depression is characterized by persistent and often disabling symptoms of depression or anxiety in the first weeks or months after childbirth.Postpartum post-traumatic stress disorder (PTSD) is caused by a real or perceived trauma during delivery or after the baby is born. It has the same symptoms as PPD plus others, including:AvoidanceFlashbacksFunctional impairmentHyperstimulationObstetricians and pediatricians have begun routinely screening for signs of PPD at the baby\u2019s first wellness visit and the mother\u2019s postpartum checkup, usually about four to six weeks after delivery.That\u2019s just one reason why it\u2019s so important for new moms not to skip their postpartum appointment. Another reason: Skipping that appointment could lead to serious physical complications, such as an infection or incomplete healing.What Is Screening for PPD?At UPMC Magee-Womens Hospital, doctors use the Edinburgh Postnatal Depression Scale, a standardized screening tool that asks patients to rate their feelings of sadness or anxiety within the last seven days. Based on the responses, doctors can recommend the appropriate resources.Magee Behavioral Health Services offers therapist appointments at the hospital during pregnancy and after delivery, especially for women who have a history of depression. Outpatient therapy is available at our locations in Wexford and Bethel Park for women who are identified as having PPD symptoms.For those women whose depression would qualify them for intensive outpatient treatment, UPMC Magee offers the New and Expectant Mothers Specialized Treatment (NEST) program in conjunction with UPMC Western Psychiatric Hospital.NEST is available at the UPMC Magee provider offices in Wexford three days a week for three hours per day. Services include individual and group therapy with a psychologist or therapist. NEST, which is available for women who are pregnant and up to one year postpartum, accommodates both mother and infant by:Helping with medicine management.Offering specialized group and individual psychotherapy.Promoting healthy adjustment to pregnancy and motherhood.Providing a supportive environment that promotes mother\/infant bonding.Stabilizing depression, anxiety, and other symptoms.What Are the Signs and Symptoms of PPD?All new moms and their family members should be aware of the common signs of PPD, which include persistent feelings of:Anxiety.Hopelessness.Not being engaged with the baby.Not taking care of herself, dressing, showering, etc.Sadness.Something that seems \u201coff.\u201dIf you notice signs of PPD or postpartum PTSD in yourself or a new mom you\u2019re close to, don\u2019t ignore or brush them off, says Dr. Gopalan. \u201cThese are very treatable conditions. The sooner your doctors knows about your symptoms, the sooner they can help get you on your way to feeling better.\u201dFor more information about Magee Behavioral Health Services, visit UPMC Magee-Womens Hospital\u00a0or call 1-866-MyMagee (696-2433).Editor's Note: This article was originally published on July 25, 2019, and was last reviewed on December 5, 2024."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2019","item":"https:\/\/share-dev.upmc.com\/2019\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"07","item":"https:\/\/share-dev.upmc.com\/2019\/\/07\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"What Is the Fourth Trimester of Pregnancy?","item":"https:\/\/share-dev.upmc.com\/2019\/07\/fourth-trimester-of-pregnancy\/#breadcrumbitem"}]}]