Preparing for the fourth trimester: tips on what you can do now

Your fourth trimester — the first 12 weeks after you give birth — can be an intense time of change and adjustment, punctuated by many beautiful and sometimes challenging moments.¹ Here, we offer some tips for postpartum preparedness to help empower and support you as you adjust to being a parent (or a parent again!) and your baby adjusts to being a human.

What is the 4th trimester?

The fourth trimester is a time of transformation and adaptation for everyone involved. Although the phrase was first used in the 1970s, Dr. Harvey Karp brought it mainstream in his book, “The Happiest Baby on the Block,” published in 2002. These days, you can find many books about caring for yourself and your baby during the fourth trimester, as well as guidance on fifth trimester care and navigating a return to work. Additionally, the American College of Obstetricians and Gynecologists (ACOG) now offers recommendations on optimizing postpartum care,² and the phrase “fourth trimester” has become so popular that Merriam-Webster added it to its dictionary in 2021.³ Postpartum care preparation can begin as early as the first trimester.

How to prepare for the fourth trimester in the first trimester (weeks 1 to 14)

Think back to your last period — the day it began is considered the beginning of Week 1 or the start of pregnancy.⁴ Conception typically occurs about two weeks later. If you use Clearblue® Early Detection Pregnancy Test, you may be able to learn you’re pregnant six days sooner than your missed period.⁵ At this point, you’re likely letting the idea of a new baby settle in.

Give yourself some grace in the first trimester. Your body is going through many changes and you may be dealing with nausea, morning sickness and fatigue.⁶ Forcing yourself to take it easy will also be helpful practice for the postpartum period, a time when caring for yourself is important.

Additionally, now might be a good time to stock up on books about newborn care and breastfeeding, resources to dip into from time to time throughout your pregnancy to help you prepare for what’s to come. Also, if you will need some form of childcare, it may be smart to begin looking into that now.

Many childcare centers have waiting lists, and finding and interviewing nannies can be time-consuming. Doing this before your baby is born will save you a lot of anxiety.

How to prepare for the fourth trimester in the second trimester (weeks 14 to 28)

You may feel better — maybe even a lot better — in your second trimester. Think of the trimesters as a bell curve. The second trimester is your golden period, a time when you might have a lot more energy to prep and prepare.

Many people share their news of pregnancy in the second trimester. If you work and plan on returning post-pregnancy, it's good to begin making plans for your parental leave. This may include documenting what you do on a daily/weekly/monthly basis or training co-workers who will be filling in for you. Your goal is to not have to worry about work during the fourth trimester.

If you are having a baby shower, now is the time to register. Think about where the baby will sleep and prepare that space. Once your baby is born, the last thing you want to be doing is painting walls. Set up the crib, changing table and any other furniture you plan on using. Line the diaper pail, hang the mobile, wash the newborn clothes. The objective here is to have everything ready to go once the baby is born.

One of the tenets of Dr. Harvey’s book on the fourth trimester is that newborns crave a womb-like experience in the three months following birth. Now is the time to gather products that will help you create that familiarity for your newborn. These may include blankets to swaddle (you can also watch videos on how to swaddle and practice on dolls) and baby slings, wraps or carriers to keep your newborn as close to you as much as possible.

You’re likely being gifted and buying all sorts of things for the baby. Don’t forget what you’ll need, too! Purchase products that might make your postpartum recovery easier. These may include:

• Pads
• Peri bottle (you’ll likely be given one at the hospital, but some nicer versions exist)
• Postpartum support underwear
• Belly wrap (particularly nice if you have a cesarean section)
• Nipple cream
• Nursing bras/nightgown/shirts
• Nursing pads
• Breast pump (these can sometimes be rented from the hospital)

Now is the time to also research and line up professionals as needed in preparation for the fourth trimester. Knowing who to call if you have questions or need help post-pregnancy can save a lot of time and worry. These may include a:

• Pediatrician
• Healthcare professional who can offer postpartum maternal care
• Mental health professional who can help with feelings of anxiety, worry and/or depression
• Postpartum doula
• Lactation consultant
• Physical therapist who specializes in pelvic floor disorders and diastasis

How to prepare for the fourth trimester in the third trimester (weeks 28 to baby’s birth)

Your second trimester bursts of energy may wane as you enter the third trimester. Fatigue may set in again as well as backaches, shortness of breath and maybe even a little anxiety about what’s to come. Hopefully you can keep postpartum prep light during this trimester, something you’ll be especially thankful for if your baby arrives earlier than expected. If you haven’t done so already, you might want to:

• Take stock of what you have and purchase any outstanding must-have items so you’re not shopping days after the baby is born.
• Pack your hospital bag.
• Become familiar with breastfeeding resources so you can more easily find help and support if needed in the days following birth.
• Consider who you are comfortable with coming to the hospital, visiting your home etc., and make your wishes known. Postpartum care should focus on you and the baby, not entertaining visitors who, in their eagerness and excitement, may want to visit too quickly or overstay their welcome.
• If you have a partner, discuss expectations and openly communicate how you will share household duties. This will ease frustration when you are both sleep-deprived and suddenly have a sink full of bottles to wash.
• Stock up on nutritious food and snacks. Friends and family members may drop off food after the baby is born but you also may consider prepping and freezing some easy meals in advance.

Finally, consider making a plan for birth control. If you breastfeed, your first period post-pregnancy may be delayed. But you have no way of knowing when your period is going to return, and ovulation happens before your period. Talk to your healthcare professional about your plan for future pregnancies (if desired) and birth control options.

Finally, throughout your pregnancy and after, look to your village for support. Your village may consist of family, friends, colleagues, local parenting groups or communities online. Postpartum Support International provides resources for finding many different weekly online support groups here. By leaning into the generations of people who have supported one another in this exciting life phase, you may find comfort and help, no matter how prepared you are.

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