The Start of the Fourth Trimester (in the Hospital)

February 6

newborn baby on mom right after birth- fourth trimester

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The fourth trimester. Its basically the time right after the baby is born, until about 3 months of age. By definition, it is not supposed to exist. TRI-mester is only supposed to have 3, right?

Well, it made it’s own name for itself and pushed it’s way into being (not unlike a baby). That’s how significant the fourth trimester is.

But what exactly do you need to know about this newfound trimester while you are still in the hospital with your newborn?

Don’t worry, new Mama. I got you.

If you haven’t already, check out my post on What No One Tells You About Labor and Delivery to find out everything you need to know about giving birth.

Fourth Trimester: Immediately After Labor and Delivery

You just finished giving birth. One of the hardest things any human can do on this earth.

Ya, you. YOU did it.

But now what?

Now it is time to get to know this stranger you call your baby. And it is time for your baby to learn how to be comforted by you and your significant other in this loud, cold, and bright new world.

First impressions can make a huge difference. This is the time to try and make the best first impression to your baby as possible.

But please don’t stress too much if things don’t go according to plan. Your baby will still recognize you and find comfort with you even if the hospital stay does not go as smoothly as you want it to.

Fourth Trimester at a Baby Friendly Hospital

image of a hospital building

As for myself, I feel more comfortable having the baby at a place where I will have access to all possible resources. If things go south (it must be my emergency room nurse mentality).

Some moms are able to have a home birth so that this (start of the fourth trimester) time for bonding can happen where they are the most comfortable.

But a home birth is not an option or not even possible for most moms.

So most hospitals are ‘baby friendly’ now. Yay!

Before, you would look through the window to get a glimpse of your baby that was hoarded together with all the other babies in the nursery.

Well, this is not the case anymore. Babies stay with the mom in her room almost the entire time. It is an attempt to help nurture the mother-baby bond and promote breastfeeding. Studies show that it really works.

Establishing a strong bond with your newborn in the fourth trimester while still in the hospital can be done.

Preparing Yourself for NICU (Just in Case)

Letters spelling out NICU with a stethoscope

The neonatal intensive care unit. This is NOT what most moms want to think about when they are pregnant. I don’t blame you. I know I did not want to think about it (and I am an emergency room nurse- I should have known better).

The NICU is simultaneously a horrible and wonderful place. They save your precious babies and yet the sadness can be so overwhelming- absolutely unbearable at times.

If you are pregnant, do yourself a favor and just wrap your head around the possibility of having to be a resident of the NICU; if only to avoid the shock of being hit by a ton of bricks. This will help you to better be able to bond with your baby, even in the NICU.

If I had prepped myself (at least just a little bit), then I would have been able to make better decisions when the time came.

My labor

With my first baby, I was actively pushing for 3 hours on Pitocin (probably should have taken me to a c-section).

I had a malfunctioning epidural. I could feel and move EVERYTHING. Needless to say, I was NOT in my right mind when my baby finally came out.

I thought I had nothing to worry about because my pregnancy went so well and he was meeting all prenatal milestones perfectly.

Even during active labor he was being continuously internally monitored with no significant decelerations (low heart-rate) the entire time. So no one was worried.

My Delivery

According to my birth plan, immediately after he came out of me, they pulled him out and placed him on my belly. I felt his warmth and sliminess, but as I looked down I couldn’t get the thought out of my head that he looked a little purple.

I waited, and waited what seemed like 5 minutes (I think it was more like 30 seconds) but no cry. Now the only thought in my head was, “After ALL this, he has to cry, right? No, he’s gonna cry.”

They were rubbing him, suctioning his nose and mouth, and then I could feel the panic, not from myself (I was in a state of shock), but from everyone else in the room. They cut the umbilical cord and rushed him to the warming table where they overhead paged CODE BLUE- Labor and Delivery, CODE BLUE- Labor and Delivery.

Finally, after deep suctioning, we heard a whimper. It was an eternity. They checked him out and brought him back to me placing him on my chest.

Why my baby went to NICU

baby in NICU under bili-light during fourth trimester

With my first, we took only about 10 minutes of our Golden Hour. I go over the Golden Hour in its own section a little further down.

We were so scared that something was going to happen to him that when they offered NICU, we took it.

Having a CODE BLUE called on your newborn, makes the thought of possibly hearing that phrase again, unbearable.

I was the most exhausted I have EVER been in life after 24 hours of labor, 3 hours of active pushing with the Pitocin cranked up to the max, and the trauma of a not so perfect birth experience. I was a brand new mom. And I was SO SCARED.

None of my emergency room training prepared me for this. None of the training as a nurse kicked in.

The only thing that made me feel better was having someone else monitor him. I needed that while I gained some strength back and got some sleep.

If I kept him with me, I was sure I would fall asleep and not realize that he stopped breathing and they would have to call a code again. I just couldn’t do it.

So off to the NICU my poor little baby went. I am so thankful for the NICU, but I can’t help but feel a pang of regret for not being able to think after delivery.

What I could have done better

Thinking back now with my ER nurse brain intact again, I could have taken him with me to the postpartum room.

I would have asked the nurses for a pulse oximeter. They put this device on the baby’s foot to measure oxygen and heart rate and kept it on him. And I would have comforted and breastfed him while he healed from his long, traumatic birth.

That is why I ask you to think through the possibility of NICU. You can make informed decisions before-hand, and be as prepared as possible. So you can be a better mom in that moment if it comes.

Immediate Skin to Skin

skin to skin with baby immediately after delivery in the fourth trimester

When my babies were born, they came out of me and right onto my belly. Immediately. Delayed cord clamping, vernix, and all.

The benefits of immediate skin to skin contact range from regulating baby’s body temperature and heart rate to increasing mom’s milk volume. It helps keep mom and baby calm and relaxed.

It’s a strange yet intense feeling; having that baby come out of you and placed on top of your now somewhat deflated belly. I will never forget it, and I really do have a terrible memory.

I highly recommend it for anyone planning on having a vaginal delivery. With a c-section, they bring the baby to your chest, neck and face area. Not immediately, but definitely as quickly as they can.

The Golden Hour

mom, dad, and newborn's hands during the fourth trimester

Side note: I really wish I would have kept him with me after the Golden Hour. . . Maybe I would established a better bond and been less nervous when it was time to take him home.

This is the time where you and your significant other will have about 1 hour of alone time with your baby. It can be one of the most beautiful times you have together. It’s just you, your significant other, and this new life you brought into the world together.

The staff will leave you alone (usually still in the delivery room). This “Golden Hour” is pretty standard in most baby friendly hospitals. Well, they aim for an hour, the best they can.

Your baby will recognize your voice, your heartbeat, and your smell. So keep your baby real close, right on your chest.

Your baby will even recognize your significant other’s voice! Your baby will start to settle and begin to feel at ease, especially if they are able to breastfeed.

It is absolutely beautiful.

This is also a great time for the Daddy to do skin to skin with the baby as well.

I wasn’t sure how my husband would take to this (he is very manly).

But as soon as I reminded him to try it, that shirt was off in 2 seconds flat and that only diaper clad baby was smack up against his chest. And both were loving it.

It’s the best time to get to know your new baby before the rest of life (and the world) sets in.

The Fourth Trimester: Breastfeeding and Bonding for Mommy

new mom bonding with baby during the fourth trimester

So this little precious love is hungry. SUPER hungry. Even though only a tiny bit of breast milk comes out (colostrum), the sucking reflex is very comforting for them.

There are lots of ultrasound images of babies sucking on their thumbs or even the umbilical cord in the womb.

Plus their strong suck reflex helps to stimulate breast milk production.

Only you can comfort the baby in the way that you do with breastfeeding.

Breastfeeding is WONDERFUL, but breastfeeding is also very, very HARD!

If you decide it is not for you, there is no judgement here. But if you want to do this thing, and you are hitting more roadblocks than expected, don’t give up.

Use all your resources. One great thing about experiencing the beginning of the fourth trimester in the hospital, is that you have access to experienced (most of the time) postpartum nurses, and a lactation consultant.

Use that lactation consultant to the max. You can’t take her home with you.

And check out my post on What No One Tells You About Breastfeeding to find out everything else you need to know on the subject.

Bonding for Daddy

New dad holding new baby in fourth trimester

Bonding during the fourth trimester is a wonderful time for Daddy. He can establish a unique and close relationship with the baby.

If he liked skin to skin in the golden hour, encourage him to continue for as much as he can in the hospital (and after). Newborns can’t see very well yet, but their hearing and sense of smell are excellent.

The more skin to skin he does with the baby, the more the baby will bond with him. His smell, his breathing patterns, and his voice.

Oh, and don’t forget another plus. If they do this often, you might actually get some well deserved sleep.

Summery of the fourth trimester while in the hospital

newborn baby sleeping comfortably

Immediately after giving birth to your precious, precious little love, BAM, you have officially hit the fourth trimester. Most of you will experience this in a hospital setting.

The beginning of the fourth trimester is a very special time. It can be difficult to bring comfort to the baby when you yourself don’t feel very comfortable stuck in the hospital right after birthing what feels like a watermelon.

But with the suggestions I’ve laid out for you here, you will be more prepared to focus your energy on bonding during this time.

If you are finding it difficult to bond with your new baby, try to get some sleep.

Losing just one night of sleep can impair your reasoning for up to four days!

If it’s been much longer than a few days and you’ve taken a long nap, then take this postpartum depression screening I made and talk to your doctor.

You can read all about postpartum depression in my post here as well.

Hopefully this post on the beginning of the fourth trimester has helped you gain a better picture of what to expect, ideal or not. If I am informed, then I feel prepared. I always do much better when I am prepared.

Have you read all about giving birth yet in my post on What No One Tells You About Labor and Delivery?

Leave me a comment below or email me what fears or expectations you have. Or, how you experienced the beginning of your fourth trimester after labor and delivery. I would love to hear all about it!

All the love,

-Jen

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