Surviving the 'Fourth Trimester'

Dr. Brittany Falcone

During pregnancy, your body goes through an immense physical transformation over a relatively quick nine-month period. But, there is a secondary component of pregnancy that most women don’t even consider: the fourth trimester. The fourth trimester marks the time after delivery where your body works to return to normal. This return to previous form and function is the most rapid transformation our bodies will ever endure. After delivery, the weight of the baby on your body is suddenly removed. Subsequently, your body now lacks stability from hormones that worked to soften the spine and surrounding soft tissues in preparation for the birthing process. Further, there is the added physical stress of breastfeeding/pumping, carrying, and caring for a newborn. Clearly, the fourth trimester can be a physically (and emotionally) challenging time for a woman’s body.

What was most surprising to me during my postpartum period was the lack of support given to new moms. My first visit with a health professional was six weeks later – I had gone through a lot during that time! As new mothers, we have just been born, too, and we aren’t getting the proper postpartum care our bodies deserve. How many times does your child go to the doctor in the first month of life? Thinking back, my daughter went to her pediatrician eight times in the first year and almost half of those were in the first month. Along with obstetricians and primary care doctors, there are a wide range of health professionals available to support women during the fourth trimester.

In consideration of the dramatic bodily changes a woman undergoes, I suggest that all women receive some postpartum physical support. I recommend visiting a Doctor of Chiropractic that specializes in working with new and expecting moms like myself. Through gentle treatments, we encourage pelvic balance and allow your body to heal in good alignment. Chiropractors are also great at treating any back pain, headaches, or neck tension resulting from your pregnancy and/or motherly duties. To find a chiropractor certificated to care for children and pregnant women in your area, you can visit the International Chiropractic Pediatric Association (ICPA) website at: In addition to chiropractic care, lactation consultants, massage therapists, acupuncturists, and pelvic floor physical therapists are great at addressing the myriad of physical challenges new mothers experience as they transition into motherhood.

I have the honor of taking care of many moms in my practice. I interviewed several of my clients about the fourth trimester and here are some of the things they had to say :

1. Don’t be afraid to ask for help.

As women, many of us think we can do it all, all the time. While I agree women are freaking amazing, the truth is that sometimes we can’t do it all. If you need someone to pick up milk for you or throw a load of laundry in the dryer then don’t be afraid to ask. Your friends and family don’t mind helping. What is the worst thing that happens? They say “no.” Or better yet, they say “yes” and you get to take that one thing off your to do list. If you feel shy about asking those you know for support, consider hiring a postpartum doula.

2. Saying “Yes!”

If someone asks if you need something, don’t be afraid to say “yes.” It doesn’t make you any less amazing. I asked my 72-year-old grandmother to clean my bathroom during my maternity leave and guess what? She did it without hesitation.

3. Saying “No!”

Conversely, if your friends and family ask if they can come over and visit and it just isn’t a good day for whatever reason then don’t be afraid to say “no.”

4. Find a community of supportive women

Join a mom’s group, find a breastfeeding support group, or go to the library for a baby and me class. There are many cheap/free options out there for new mothers in Massachusetts. Many of these communities are very active online, so make sure to search for ways to connect virtually. When you’re ready, get out there and connect with other adults who are going through the same thing.

5. Give yourself some slack

It is okay if you are not back to your pre-pregnancy body at the end of your maternity leave. Physically, I assure you that it is totally possible to get back to who you once were. You can and will get there, but for right now just give yourself some slack.

6. Everything is temporary

The early days and weeks with a newborn can be really challenging – adjusting to motherhood wasn’t the walk in the park I thought it would be. During a rough few days remember this: everything is short-term. Just when you think you can’t take another sleepless night it will change and things will get better, I promise.

7. Be flexible

Becoming a parent has nothing to do with balance and everything to do with flexibility – flexibility with your schedule, with your body, with your work, and in your life. Everything won’t always go as planned, so remember to be less rigid and embrace the chaos.

8. Hydrate

Most new moms do not drink enough water. Soreness? Have a glass of water. Not producing enough milk? Have a glass of water. Have a headache? You guessed it, have a glass of water! Take your body weight and divide it in half – you should be drinking at least that many ounces of water per day (more if you’re pumping/breastfeeding). Water can’t solve all our fourth trimester woes but being dehydrated certainly doesn’t help.

9. Get some fresh air

It really is tempting to stay inside all day and watch Netflix. The cold weather in New England may limit us at times, however I encourage you to take advantage of warmer days and get outside. Babies love going for walks! Sunshine can be the best dose of medicine for a new mom.

Taking care of ourselves during the fourth trimester feels almost impossible, but it really is the most important time to make yourself a priority. A strategy for self-care is not a one-size-fits-all solution but should include efforts in all areas of health – physical, chemical, and emotional – to gain the most benefit.

The American College of Obstetrics states that “postpartum care should become an ongoing process rather than a single encounter with services and support tailored to each woman’s individual needs.” What does this mean for you? Be creative to find what works to optimize your health during the postpartum period. No matter what you choose, make your wellness a priority! I hope this advice empowers you and minimizes some of the stressors you’ll most likely encounter during this special time in your life.

Dr. Brittany Falcone is a Worcester-based chiropractor who specializes in pediatric and pregnancy related chiropractic care. She is Webster Technique certified and board certified by the Academy Council of Chiropractic Pediatrics (CACCP). She is a mother, a wife, and an entrepreneur. She is an active member of her local community. Contact her directly at or visit her office website to learn more at