I Thought There Were Only Three Trimesters: Bleeding, Hair Loss, Emotions, and Other Fourth Trimester Surprises

A fourth trimester? Wait a minute. I thought pregnancy was only three trimesters. Taylor, I can’t be pregnant for another three months! What are you talking about?

Sorry to freak you out. Don’t worry, you aren’t going to be pregnant for another three months. Goodness, I was struggling to even get around by the end of the third trimester for both of my pregnancies. The puffy feet, sciatica, frequent bathroom trips, lack of clothing options, and sleepless nights had me wanting to get on a loudspeaker and tell both of my boys, “Time’s up! Move out!”

Whew, pregnancy is hardcore.

No, the fourth trimester refers to the first three months after birth. It’s a time filled with a lot of emotional and physical changes for the mother, major developments for baby, and the two of you adjusting to baby living outside of the womb. There were a lot of things that caught me off guard during the fourth trimester, even though it seemed like I had done all of the suggested things to prepare myself.

I thought as a fellow mother and pregnancy warrior I’d share some things about the fourth trimester that might also catch you off guard. I use pregnancy warrior because, again, pregnancy is hardcore. You grow a whole human and then expel them from your body! That is intense my friend.

Fourth Trimester Happenings

1. There will be blood.

I was not prepared for how much and how long I bled for. How much a new mom bleeds can vary widely, but I think it’s good to know that you could be bleeding for six weeks after delivery. Now it’s important to note that the amount of bleeding typically decreases over that time, and you need to speak with your doctor if you notice any of the following symptoms that the March of Dimes has identified as warning signs for postpartum hemorrhages, infections, postpartum depression, or other medical complications.

• Blood clots the size of an egg or bigger
• Heavy blow flood where you are soaking through a pad each hour
• Bad smelling vaginal discharge or blood
• Dizziness
• Breathlessness
• Fainting
• Chest Pain or Racing Heart
• High Blood Pressure
• Nausea or Vomiting
• Fever or Chills
• Swelling
• Headache
• Vision Changes
• Sadness or hopelessness lasting longer than 10 days after delivery

2. Your hair may fall out.

There seemed to be some extra hair coming out when I combed or washed my hair during this time period, but I didn’t realize quite how much I was losing until I looked at pictures of myself. That was a hard change for me. I have long hair that feels like a part of who I am, so a lot of it falling out felt like an emotional loss. The American Academy of Dermatology Association refers to postpartum change as excessive hair shedding caused by drops in estrogen levels after birth. The hair isn’t gone forever, but it will just take some time to grow back. The amount of hair that new mothers shed is different for everyone, and some women may not experience any. Due to the amount of my hair that fell out, there were some pretty large chunks of baby hairs that grew back together.

There wasn’t much to do in the way of styling them, so I finally had to just laugh about and view them as a battle scar of my hard work to grow and birth a human.

3. You’re in for an emotional rollercoaster.

I shed many tears in those first few months. I was aware of the running joke that pregnant women can cry at the drop of a hat for unknown reasons. By "aware," I mean I cried at everything.

There was one time during my first pregnancy that I was baking a cake for my dad’s birthday, and spontaneously started crying. There was no spilled milk. Just stubborn filling I was trying to make from scratch that made my eyes well up. I composed myself and pushed on, determined to make that pudding to hold the cake together.

My partner came home to me having just finished my third attempt at the pudding. The second round tasted fine, but was runny and therefore unsuccessful. I kept some of that reject-batch for my partner to eat. I told him he could have the pudding in the blue bowl, but not the red bowl which was the successful third pudding. I turned around just in time to see him getting the red bowl out of the refrigerator. I yelled at him and ragefully yanked the bowl out of his hands. I then had the thought that I was freaking out over pudding and started laughing. Then almost as soon as I started laughing, I started sobbing. My poor partner stood wide eyed witnessing this rollercoaster of emotions all over that dang pudding.

I had some similar mood swings during my fourth trimester as well, although I didn’t bake that cake again.

There are a lot of factors that go into the increase in emotions during the first three months after delivery.

• Dramatic hormone changes
• Lack of sleep
• Difficulty with recovery
• Lifestyle changes due to caring for an infant
• Baby struggling to adjust to life outside the womb

If you feel as though your emotions are consuming you, you can’t stop crying, you have difficulty functioning, or the initial sadness after birth lasts more than two weeks, reach out to your doctor or a counselor for support.

4. You will be exhausted.

Imagine the most tired you have ever felt in your life. Now imagine that exhaustion lasting for months.

Ain’t no tired like new-mama tired.

Even births that go according to plan, for the most part, are traumatic on the body. So it’s kind of like you go through a major car wreck or have major surgery and then get sent home with a tiny, needy, and helpless baby to care for 24 hours a day/7 days a week.

Waking up during the night every couple of hours and having to be on all the time to care for your little one adds up. One important thing is to get help from your partner, friends, or family to prioritize your sleep. (read more here in our previous blog post No, It’s Not Just You. Breastfeeding is Exhausting)

5. Recovery is a lot.

Labor and delivery take a toll on your body. Your body has worked for months to grow and nourish a baby inside of you, and then you have to actually birth that baby either by pushing them out of your vagina or having major surgery. Neither of which is a walk in the park. Recovery will probably take longer than you expect it to. Think months, not days. I underestimated the amount of time it would take for my body to begin to feel normal again. I didn’t realize that I would have a hard time simply sitting down for a while or that I would need to use a squirt bottle when using the restroom because I had stitches. It also may take a bit longer to heal if you had complications or especially difficult labor.

6. You don’t have as much control over your time.

When I became a new mom, I didn’t realize how much of my time would be spent caring for my son. I knew it would be time-consuming, but I didn’t understand just how

time-consuming it would be. So much time is spent feeding, burping, diaper changing, soothing, and bathing your baby. Then there are the in-between times when they do not want to be put down, so it feels like they are an actual extension of you. Babies also aren’t on a set schedule in those early months, so it can be difficult to plan out your days. Daily tasks often take longer, because you’re either tired, holding a baby, or are interrupted when your little one needs something. I also didn’t fully grasp that I would have to work hard to schedule alone time for myself. This is hard during those first three months, especially if you are breastfeeding.

7. The attention shifts to your baby

When you are pregnant, the majority of the attention from your medical professionals, family, and friends is on you. After the baby arrives, the baby usually becomes the center of attention. This isn’t entirely bad. We want others to intentionally care for our baby.

However, mothers need care and support during the fourth trimester just as they do during pregnancy. Wrap-around support from partners, family members, friends, and medical professionals help promote positive outcomes for both mother and baby.

Throughout pregnancy, you continue to see your obstetrician or midwife more frequently as you get closer to your due date. By the end of pregnancy, you will see them weekly. Once you deliver, you may not have another appointment for yourself until six weeks postpartum.

I had complications during labor with both of my sons, so I had to attend appointments with my midwife and doctor weekly after I delivered. While it was a financial burden, I was relieved to see them regularly. I felt safer knowing someone was checking on my emotional and physical well-being. It’s okay to ask to see your doctor sooner than six weeks after delivery.

I’m not saying you need to go to the doctor every week after you deliver, but it is okay to ask to be seen sooner than six weeks if you have concerns and are struggling with recovery.

Preparing for the Fourth Trimester

Pregnant women are typically encouraged to write out birth plans regarding all things labor and delivery. It's more uncommon but equally important for women to create a postpartum plan.

This plan will help you think through your preferences, goals, and support you will need during your fourth trimester. It's a good idea to discuss the topics below with your partner when creating your plan.

• Infant care
• Breastfeeding
• Food
• Childcare for older siblings
• Household tasks
• Emotional support
• Sleep schedules
• Medical care

The Baby Chick created a thorough postpartum plan you can use to get you started.

Ellie and Becca staff want moms to feel comfortable and supported during the fourth trimester. That’s why we create beautiful dresses specifically for breastfeeding moms. We want you to have clothes that help you feel confident in how you look and your ability to nurse your child anywhere. You make a lot of sacrifices as a mom, especially when you breastfeed, but one thing we don’t think you need to sacrifice is wearing beautiful clothes.