How to Look After Yourself During the 4th Trimester

The 4th Trimester is a term that many use to define the period of time that a newborn infant adapts to living outside of its mother’s womb. It is an important time for mothers to help their babies adapt to their new environment and should be a mother’s main focus. However, mothers should also be aware of their own health needs in view of the trauma that their bodies underwent during labor. The latest research confirms that a mother’s body can take up to 18 months to fully heal postpartum. What is done during the 4th Trimester can greatly affect a mother’s recovery? This article suggests simple things that you can that will greatly aid that process.

Get Support

It is very important that you do not over-exert yourself during this time. Ensure that you have a supportive team surrounding you. You will need as much help as possible to do things around the home such as cooking, cleaning, shopping, etc. As you focus on caring for your baby leave it in the hands of others to care for you as much as possible.

Lie down 

As you are recovering from giving birth it’s important that you lie down as much as possible. This will give your body an opportunity to heal and during this time your uterus will shrink back down. Being on your feet will exert great pressure on sensitive areas that are trying to heal. The weakness and stress may result in a prolapse and worsening of your diastasis recti. You can reduce this pressure by lying horizontally, or even better, as you lie down you can raise your tush by placing pillows underneath and practice diaphragmatic breathing.

Do Kegel Exercise

Kegels are an excellent way to strengthen your pelvic floor muscles. It is a simple exercise that involves contracting and relaxing your pelvic floor muscles. You may find it difficult to feel your pelvic floor muscles after childbirth due to swelling. One way that can help is to sit on a chair and lift your perineum (the area between your anus and vulva) off the chair. You can also try doing this lying down with your tush raised up on top of a pillow or inversion wedge. This way you will have the help of gravity to contract and lift those muscles.

Protect and Assist Your Abs

Diastasis Recti is a condition that has been getting more attention in recent years. It is a term used to describe the separation of the rectus abdominis and stretching of the linea alba. All women who carry to term will have diastasis recti. You can protect this area by avoiding movements similar to sit-ups and strengthening the deep abs, the transverse abdominis muscle which helps to pull the diastasis together and strengthens your core. When getting in or out of bed you can lift yourself off or lie on your back by using the log roll technique and avoid lifting your head when lying on your back. By rolling on your side, you can reduce the strain on your abdominal muscles, preventing the diastasis from opening further. Another way of assisting the muscle to close is by using taping. A therapist can assist you in placing the tape in the right places and can also teach you how to do so independently. A popular option is to use a corset or a girdle shaper. However, these can sometimes cause other problems. The increase in abdominal pressure and force on your pelvic floor can actually worsen a prolapse.

The 4th Trimester is an important time for both you and your baby. You now have a baby that is depending on you. So look after yourself and make the best recovery possible by following these simple steps mentioned in this article. Listen to your body and let it be your guide. If you feel that you have more pain than what is normal, need guidance with the proper exercises, or want a custom program then book an appointment with a doctor or pelvic floor specialist. At Maiden Lane Medical Physical Therapy we have many expert pelvic floor therapists that can help you with pre and postnatal. Give us a call to arrange an appointment.


Young woman with hands on belly because of constipation pain - Duffy & Bracken, NY


How long does it take to heal postpartum?

It can take up to 18 months to make a full recovery postpartum. Be sure to rest well during your first three months and perform Kegels to help assist pelvic floor recovery. Pelvic Physical Therapy can commence after your 6-week visit when you should get started on the rehabilitation of your postnatal body.

What is prolapse?

Prolapse is when either the bladder, uterus, and/or rectum protrudes into the vaginal wall. This not only occurs during pregnancy and childbirth but can also occur with chronic constipation. 

What are the symptoms of prolapse?

Symptoms often include a feeling of pressure or falling out of the pelvic floor, a bulge in the vagina, often felt while showering, sexual discomfort, and/or incontinence. You will feel symptoms getting worse in the afternoon or evening and feel better in the morning. The symptoms have varying degrees and can be so severe that the protrusion in the vaginal wall can extend outside the opening of the vagina. Be aware though that not all cases are as severe as this so don’t underestimate the trauma that you have experienced during childbirth.

How can I recover from prolapse?

It’s recommended that you avoid straining such as heavy lifting or high-impact activities and get as much rest as possible for the first 3 months after childbirth. Laying down flat or having your hips raised by pillows or an inversion wedge will relieve the pressure exerted on your vaginal wall. Kegels are a great way to strengthen your pelvic floor and vaginal wall, providing support for your prolapse. Try doing 80-100 a day, in 10 repetition sets, alternating between holding the contraction for 2 seconds and 10 seconds. You will probably have to build up to a 10-second hold and rest between sets, doing one set of 2 and 10 second holds 3 to 5 times a day. 

What are Kegel exercises?

This is a simple exercise that involves contracting and relaxing your pelvic floor muscles. You can locate these muscles between your anus and vulva. It is the same muscles that are used to hold in your urine. 

What can I do if I have incontinence? 

This commonly occurs when you cannot feel your pelvic floor muscles due to the swelling and trauma of childbirth. You can arrange an appointment to see one of our pelvic floor specialists at Maiden Lane Medical Physical Therapy. They will give you specific exercises that you can do to locate and strengthen your pelvic floor muscles.