The journey into motherhood is often filled with wonder, excitement, and joy. Yet, alongside those beautiful moments, it’s also completely normal to experience feelings of uncertainty, change, or even sadness and anxiety. While there are countless classes and books to help you prepare for your baby’s arrival, the guidance on how to care for yourself during the postpartum period isn’t always as easy to find. As you learn to nurture this new life, it’s just as important to remember your own healing and emotional well-being. Let’s take a moment to talk about postpartum care and how to gently navigate the “fourth trimester.”
What is The Fourth Trimester?
We so often hear about the three trimesters of pregnancy, which refer to the growth of the child, but what is the fourth trimester? It’s a term used to describe the time from birth to 12 weeks postpartum. The fourth trimester is a critical period for both the mother and the baby as it pertains to healing and attachment. Oftentimes, many mothers are not seen by their doctor until six to eight weeks postpartum and so care of significant mental health issues may have gone unnoticed and untreated leading to worse outcomes. Many mental health and medical professions are beginning to acknowledge the importance of early or even proactive measures as it comes to mothers preparing for the fourth trimester and seeking help for common postpartum mental health issues including Postpartum Depression (PPD), Postpartum Anxiety (PPA), or in rare cases postpartum psychosis.
Baby Blues Versus Postpartum Depression
It’s completely natural for emotions to feel like a rollercoaster after giving birth. Many mothers experience mood changes, tearfulness, or fatigue in the first few days or weeks after delivery. This is often referred to as the “baby blues.” However, when those feelings linger or become more intense, it may be something deeper, such as PPD. Understanding the difference can help you know when to reach out for extra support.
Baby Blues
The baby blues are very common and usually appear within the first few days after giving birth. They tend to fade on their own within two weeks.
Common signs may include:
- Mood swings or sudden crying spells
- Feeling easily overwhelmed or anxious
- Irritability or impatience
- Trouble sleeping (even when you’re tired)
- Difficulty concentrating
- Feeling emotional or sensitive
Postpartum Depression
Postpartum depression is more intense and lasts longer than the baby blues. It can develop any time in the first year after giving birth and often requires professional support and treatment. Studies show that between 10 and 20 percent of all mothers experience PPD.
Common signs may include:
- Persistent sadness, emptiness, or hopelessness
- Loss of interest or pleasure in things you used to enjoy
- Significant changes in appetite or sleep
- Intense guilt, shame, or feelings of worthlessness
- Difficulty bonding with your baby
- Withdrawal from loved ones
- Thoughts of harming yourself or feeling that your baby would be better off without you
Other Common Postpartum Mental Health Struggles
While postpartum depression is the most widely recognized postpartum condition, it’s not the only one new mothers can experience. The period after birth can bring a mix of emotional and psychological changes that may feel confusing, overwhelming, or even scary at times. Learning about these experiences can help reduce shame and remind you that you’re not alone in what you’re feeling. Some of these struggles include:
Postpartum Anxiety
It’s completely normal to worry about your baby, but postpartum anxiety goes beyond the usual new-parent concerns. It might feel like your mind never stops racing or that you can’t relax no matter how much you try.
Common signs may include:
- Constant or excessive worry
- Restlessness or feeling on edge
- Racing thoughts, often about your baby’s safety
- Physical symptoms like a rapid heartbeat, nausea, or shortness of breath
- Trouble sleeping even when your baby is resting
Postpartum Obsessive-Compulsive Disorder (OCD) and Intrusive Thoughts:
Some mothers experience upsetting, repetitive thoughts or images that seem to appear out of nowhere. These intrusive thoughts can feel very distressing. Having them does not mean you want to act on them. They’re a symptom of anxiety, not intent.
Common signs may include:
- Unwanted, intrusive thoughts about harm coming to the baby
- Repetitive behaviors or mental rituals to try to reduce anxiety (such as checking, cleaning, or counting)
- Feelings of guilt or shame about having these thoughts
Postpartum Rage
Postpartum rage is not talked about often, but it’s more common than many realize. It can show up as sudden bursts of anger or irritability that feel out of proportion to the situation. This can leave you feeling out of control or guilty afterward. Common signs may include:
- Intense or frequent anger
- Feeling constantly on edge or easily irritated
- Guilt, confusion, or regret after an outburst
- Difficulty calming down once upset
Postpartum Psychosis
While rare, postpartum psychosis is serious and requires immediate medical attention. It often develops within the first few weeks after giving birth.
Warning signs may include:
- Extreme confusion or disorientation
- Seeing or hearing things that aren’t there
- Intense mood swings
- Agitation or restlessness
- Thoughts of harming yourself or your baby
Finding Support and Building Your Self-Care Plan
If you are struggling emotionally after giving birth, please know that you don’t have to go through it alone. Reaching out for help is an important act of care for both yourself and your baby. Building a support plan can make a real difference in your recovery and emotional well-being.
Here are a few ways to start:
- Talk to a trusted professional. Reach out to your OB-GYN, midwife, or a licensed mental health therapist who understands perinatal and postpartum care.They can help you explore treatment options and connect you with local or online resources.
- Join a support group. Sharing space with other mothers who understand what you are going through can be incredibly comforting. I will be offering a free 6-week Fourth Trimester Support Group beginning in January. This group is a safe and welcoming space to talk about the emotional ups and downs of postpartum life, learn coping skills, and feel supported through your journey. You can check out the details here.
- Lean on your support system. Whether it’s a partner, family member, or friend, do not hesitate to ask for help with daily tasks, rest, or emotional support. You deserve care too.
- Prioritize rest and nourishment. Healing takes time. Give yourself permission to slow down, eat nourishing foods, and rest whenever you can.
There is no single right way to feel after giving birth. Every mother’s journey is unique, and healing looks different for everyone. What matters most is giving yourself grace, asking for help when you need it, and remembering that support and recovery are always within reach. Feel free to contact us here if you believe you would benefit from talking with a therapist.
Additional Resources:
Helpful Books for Postpartum Wellness:
- The Fourth Trimester by Kimberly Ann Johnson
- Good Moms Have Scary Thoughts by Karen Kleiman
- The Postpartum Depression Workbook by Abigail Burd
- The Motherhood Diaries by Reva Rubin
Podcasts to Support and Encourage You:
- The Momwell Podcast by Erica Djossa
- The Birth Hour by Bryn Huntpalmer
- Motherhood Meets Medicine by Lynzy Coughlin
- The Postpartum Collective Podcast
-By Alize Morrow