The Emotional Stages of the 4th Trimester

After giving birth, estrogen and progesterone levels plummet. These fluctuations can have both a physical and emotional effect on new moms. Similarly, the thyroid hormones, triiodothyronine (T3), and thyroxine (T4), which control your metabolism, can also effect your energy levels and well-being after giving birth.

These biological factors coupled with sleep-deprivation, drastic changes to your body, and questions about your new role as a mother, can wreak havoc on your emotions. This often makes the 4th trimester one of the most difficult stages of early motherhood.

Feelings of sadness, anger, or fear are common emotions after giving birth. Similarly, mood swings ranging from anger to happiness are not uncommon. Fluctuating hormones are to blame for these feelings and emotions and they often come and go in waves. You may feel exhausted and tearful one moment and then in the next moment, your heart is bursting with joy as you watch your new baby sleep. These mood swings are normal and to be expected.

As moms, we often tend to do too much for everyone else. The 4th trimester is a time to focus solely on healing. Taking care of yourself, your newborn, older children, and getting adequate rest should be the priority.

Ask for help
Early on during pregnancy, compile phone numbers and contact information for those who you know you can count on to lend a hand. “It’s easier to make the decision to get help when you have that list of where to turn to for help ready before a baby arrives,” obstetrician and gynecologist Katherine Pasque told University of Michigan Health. Whether it's breastfeeding assistance from your doula or a list of babysitters, keep a list handy so you're not scrambling during a moment of anxiety.

Take time for yourself
Have a friend or family member watch the baby for an hour or so while you get some much-needed rest. Go for a drive, grab a coffee at the drive-thru, and turn the radio up loud. Try a walk around the neighborhood while listening to your favorite podcast. A change of scenery and fresh air can do wonders. While you are home with baby, connecting with other moms online is also a good option.

Be realistic about what you can do
For some moms, regular reminders while in the thick of the 4th trimester can prove helpful. "I had to remind myself that babies don’t keep," mom of two, Cortney S. said. "The housework will wait and sleep is important. I had to continually tell myself that it was ok to ask for help and be gentle with myself in terms of what I was able to accomplish during this time."

Baby blues vs. postpartum depression
The baby blues typically affect 80% of new moms and occur between within the first month after delivery. Postpartum depression can last for a year after childbirth. Baby blues will often go away once the mom finds her routine with the new baby while moms experiencing postpartum depression have more severe and harmful mood swings that can interfere with their ability to take care of themselves or the baby.

Thankfully, attitudes about the postpartum period are changing. A report by The American College of Obstetrics and Gynecology (ACOG) is now recommending that medical practitioners provide additional maternal follow-up after birth as well as insurance coverage for continuous postpartum care for women.

Research from the Center for Disease Control and Prevention (CDC) indicates that 1 in 8 women experience symptoms of postpartum depression. New moms who experience mood swings or anxiety that lasts for an extended period of time should seek treatment. If you're having thoughts of doing harm to yourself or your baby, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for free and confidential crisis counseling, 24 hours a day. TTY: 1-800-799-4889. Online chat is also available 24/7.