The Fourth Trimester – Why Postnatal Care Matters as Much as Pregnancy Care
By Dr Greg Jenkins | Sydney-based specialist in Fertility, Obstetrics and Gynaecology
For many families, the focus of care and attention during pregnancy naturally ends at birth. Yet, the first three months after delivery, often called the fourth trimester, bring enormous physical, emotional and lifestyle changes for both mother and baby. This period deserves just as much planning, support and medical care as the pregnancy itself.
As an obstetrician, I’ve seen firsthand how the right postnatal care can make all the difference to a mother’s recovery and a family’s well-being. Here’s what every parent should know about the fourth trimester and why it matters.
Understanding the Fourth Trimester
The fourth trimester refers to the first 12 weeks after childbirth. During this time, both mother and baby are adjusting:
The baby is transitioning from life inside the womb to the outside world, learning to feed, sleep and regulate their body temperature.
The mother is recovering physically from birth, experiencing significant hormonal changes and adjusting emotionally to the demands of parenthood.
This period can be overwhelming. Fatigue, physical healing, feeding challenges and emotional highs and lows often arrive all at once. Yet, with the right support and information, families can navigate it confidently.
Physical Recovery for Mothers
Every birth is different, but most mothers experience some degree of physical healing in the first few weeks after delivery. Common aspects include:
Perineal healing: For women who have had vaginal deliveries, stitches from tears or episiotomies need time to heal. Pain, swelling and discomfort are normal but should improve steadily.
Caesarean recovery: For those who’ve had a caesarean, incision care, pain management, and gradual return to activity are key.
Bleeding and uterine involution: Vaginal bleeding (lochia) can last for up to six weeks. The uterus also contracts back to its pre-pregnancy size during this time.
Breast changes: Engorgement, milk coming in, or challenges with breastfeeding can occur early and need guidance if problems arise.
Postnatal check-ups with your doctor help ensure that healing is progressing well and allow time to discuss any concerns about pain, bleeding, or recovery.
Emotional Health and the “Baby Blues”
Emotional wellbeing is just as important as physical recovery. Many mothers experience the “baby blues” around day 3–5 after birth, caused by hormonal shifts, lack of sleep and the emotional weight of caring for a newborn. This usually settles within two weeks, but for some women, symptoms persist or intensify. This may indicate postnatal depression or anxiety. Signs to look out for include:
Persistent sadness or hopelessness
Anxiety or panic attacks
Difficulty bonding with the baby
Withdrawal from loved ones
Early support from a GP, obstetrician or mental health professional can make a real difference. No parent should feel they have to manage these feelings alone. Very sadly, it is important that we are aware that suicide within 12 months of giving birth is the commonest cause of death in association with pregnancy in Australia. There are extensive mental health support services available and readily accessible via your GP, obstetrician or midwife. If you or someone you care about is feeling persistently low in mood, please seek help early.
Feeding Support: Breast, Bottle or Both
Feeding a newborn can be one of the steepest learning curves for new parents. While breastfeeding offers many benefits, it can also be challenging, particularly in the early weeks. Common issues include latching difficulties, nipple pain and concerns about supply.
Lactation consultants, midwives and obstetricians can help troubleshoot these challenges and provide support if families choose to combine breastfeeding with expressed milk or formula.
The best feeding approach is the one that nourishes your baby and supports the wellbeing of the mother. There is no one “right” way, only what works for your family.
Why Postnatal Care Visits Matter
In Australia, most mothers see their obstetrician or GP about 6 weeks after birth. I encourage families to view this visit as more than just a “tick box” appointment. Postnatal care should include:
Physical recovery assessment: Checking healing of stitches, caesarean incisions and any pelvic floor concerns.
Contraception planning: Discussing options if and when you wish to prevent another pregnancy.
Feeding and baby care support: Addressing questions about breastfeeding, bottle feeding and newborn routines.
Emotional wellbeing screening: Asking about mood, anxiety and adjustment to parenthood.
Return to exercise: Advising on safe timelines for walking, strength work and higher-intensity activity.
Some families benefit from earlier or additional visits, especially if there are complications or emotional health concerns.
Caring for the Baby: Health Checks and Beyond
Babies also have their own set of postnatal care needs. Early visits usually focus on:
Feeding and weight gain
Jaundice checks (if needed)
Vaccination planning
Developmental screening
Paediatricians, GPs or child health nurses provide ongoing support as the baby grows.
Sleep, Rest and Practical Support
Sleep deprivation affects nearly every new parent. While waking for feeds is unavoidable, small changes can help:
Safe sleep setups reduce anxiety about positioning and SIDS risks.
Sharing night duties when possible gives mothers longer rest blocks.
Accepting help from family or friends for meals, cleaning or baby care allows parents to recover and bond.
Postnatal doulas or visiting midwives can also provide in-home support, especially for families without nearby relatives.
When to Seek Medical Help
It’s important to know what’s normal, and what isn’t, after birth. Contact your doctor urgently if you experience:
Heavy bleeding (soaking a pad in under an hour)
Fever or signs of infection
Severe abdominal or pelvic pain
Signs of postnatal depression or anxiety
Concerns about the baby’s feeding, weight, or jaundice
Early assessment and treatment can prevent small issues from becoming bigger problems.
The Role of Partners and Families
The fourth trimester is not only a transition for mothers, it affects partners and families too. Supporting the mother’s recovery, sharing care tasks and watching for signs of emotional distress in both parents helps create a stronger start for the whole family.
Partners should also attend postnatal visits where possible. It ensures everyone understands the care plan and can ask questions together.
Why I Emphasise Postnatal Care
In my practice, I’ve seen mothers thrive when postnatal care is treated as an essential part of the pregnancy journey, not an afterthought.
When families feel informed, supported and connected to care providers, they recover better, physically and emotionally. Babies benefit from calmer, more confident parents and complications are spotted earlier.
Final Thoughts
The fourth trimester deserves just as much attention as pregnancy itself. Physical healing, emotional wellbeing, feeding support and practical help all play a role in creating a strong start for mother, baby and family.
If you are preparing for birth, I encourage you to plan your postnatal care just as carefully as your pregnancy. Schedule your appointments, know where to go for help and surround yourself with support for those first 12 weeks and beyond.
Meet Dr. Greg Jenkins: Your Partner in Fertility and Obstetrics
Dr Greg Jenkins is a specialist obstetrician, fertility specialist and gynaecologist, and the Head of Obstetrics and Gynaecology at Westmead Public Hospital. He provides personalised care for women and couples across fertility treatment, pregnancy and birth — with the unique advantage of continuity of care from conception through to delivery.
Dr Jenkins consults privately at Norwest Private Hospital in Bella Vista and works in partnership with Minerva Fertility at Bond Day Hospital. He offers delivery at Norwest Private, Westmead Private and Westmead Public Hospital, giving families flexibility in choosing the setting that best suits their needs.
