The Fourth Trimester

By NCT Doula Beverley Hinton

Human babies are born much earlier in gestation than any other mammal baby. Due to the large head size of humans, and smaller pelvises, designed to walk upright, our babies need to be born when they are smaller. This means they are born developmentally immature compared to other mammals. So, when a human baby is born they really need a few more months gestation. To fulfill this need for extra gestation, the first three months after a baby is born can be looked at as a ‘fourth trimester’ of pregnancy.

Often when a baby is born new parents are encouraged to try to begin to get into a routine, to get baby feeding at ‘good’ intervals, to help it learn to sleep well, and to encourage it to become independent, being put down in its bed and relaxing alone. Unfortunately, this approach frequently causes distress for both mother and baby. Deciding to give your baby a ‘fourth trimester’ of gestation outside the womb can make an easier and happier transition for baby to life outside the womb, and for the woman to becoming a mother. It has also been shown that keeping your baby close and responding to their cries in the early weeks can positively effect brain development (1).

Creating a ‘fourth trimester’ for your baby simply involves being responsive to your babies needs and comforting them with your presence. UNICEF suggest: –

  • Cuddling/comforting them when they cry
  • Frequent skin-to-skin contact
  • Offering the breast for comfort as well as nutrition
  • Keeping the baby close; touching, massaging and rocking the baby
  • Talking to the baby (2)

Some practical ways to help with these suggestions include: –

  • Use a baby sling to carry your baby. You can put the baby in the sling if you want to go out or use it in the house if the baby is restless, or to help baby to sleep so that you can have two hands free to get on with something!
  • Plan to have time at home with people who you feel comfortable with after the birth. You can then stay in bed and have skin to skin with your baby and focus on feeding frequently. They can bring you the things you need and make sure the house stays in order while you rest and spend time with your new baby.
  • Hire a postnatal doula. She will come to you at home and help you to care for the baby, other children and the house. She can help look after you so that you can prioritise your and your baby’s needs.
  • Have a bedside cot so that you can sleep close to your baby and easily feed her when you are in bed or need to rest.
  • Listen to your natural instinct telling you to hold your baby if he is crying and learn about early feeding needs so that you feel confident to pick him up and comfort him at the breast.


Responding to your baby in a loving way in the first months of life will not spoil your baby. It has actually been shown that babies who are responded to quickly grow up to be happier and more independent children. (3)

Having a ‘fourth trimester’ is hard, so make sure you have help. Let someone else hold the baby if you need a break.

  • Evidence Based Care for the Breastfeeding Mother, 2nd edition, Maria Pollard, 2018.
  • UNICEF Baby Friendly Initiative