4th Trimester Pregnancy Specialist

Women's Healthcare Group -  - Obstetrics

Women's Healthcare Group

Obstetrics & Gynecology located in York, PA

This is the time following your delivery, and it is a time of many changes. It is a very exciting time, but can also have many challenges. You are now dealing with an infant who may not sleep and you may have health concerns. There are changes in your body which take some time to get back to normal. All of this can lead to changes in your relationships. Since many new moms do not have families nearby, they have limited options for help. Several options do exist, and we can help you to navigate them as well as review your concerns.

4th Trimester Pregnancy

  • Emotional concernsSleep deprivation is a key trigger for some of the emotional changes new mom's experience. If your family and friends can help you to get even a short nap, that can go a long way towards feeling better. Women's Healthcare Group also has a counselor who can help you with a phone call or office visit if you prefer. If you are struggling with deeper concerns for depression or anxiety, we can help you to navigate the process of finding a mental health provider. Never feel worried that telling us your emotional concerns will jeopardize your family. You will have had depression screens done at your first visit, the 32-week visit, in the hospital, and another at your six week after delivery check. Even if these have been normal, please notify us if you feel you are still struggling.  

If your baby has been or is in the NICU, you have more emotional stress. Please let us know how we can help.  

  • Vagina I changes:   You may have experienced a tear or needed sutures, and that can make everything feel sore and irritated. Breastfeeding can also cause the vaginal skin to feel irritated, and this can continue until you wean your baby. If you have this symptom, sometimes lubricants help. If you have sutures, please let us know if something starts to feel worse instead of slowly better. The sutures can take up to a month to dissolve, and are designed to dissolve and fall out on their own.

If you have a 3rd or 4th degree tear (involving the muscle that controls stool continence or the skin inside the rectum) you should stay on stool softeners for at least 2 to 3 weeks after delivery, and we would like to check the area about 2 to 3 weeks after you go home, as well as at the 6 week visit.

  • Pelvic Floor ChangesIf you just had a vaginal delivery, all the tissues in this area get stretched a lot, including the deeper fibrous tissues and muscles. Most times these tissues slowly get back to close to normal. There are some things you can do to help this process:

Kegel exercises; the muscles you use to stop your urine stream are interconnected with many muscles in the region of the vaginal opening. These exercises help this area to have better tone, and to help lessen risk for incontinence later. You can find instructions on line, but essentially it involves the tightening of the muscles you would use to stop your urine stream, hold as long as you can, 10 times in a row, 3 sets a day. It may

take a few weeks until you have enough normal sensation and muscle return to do these.

Avoid extreme lifting (20 lbs.)  if possible for 6 weeks; this helps these same muscles and tissue get back to more normal tone and strength. 

Vaginal rest for 6 weeks

After your postpartum visit at 6 weeks, if you are still having weakness in these muscles, you may benefit from a pelvic floor physical therapy referral.


    • Weight issues:  every Mom wants to be back to her normal weight at 6 weeks, but this is the exception.  Most times this process takes close to a year to happen. You should always try to eat healthy.  

Minimize juice and soda, try to get at least 6 to 8 glasses of water a day. If you are

nursing, this helps your milk supply too.

Have 4 to 5 servings of fresh fruits and/or vegetables a day.

Eat a relatively low fat diet; this means more lean meats  and avoid or lessen fried foods. Healthy fats include olive oil and canola oil.  Both are healthier than vegetable oil.

These principles will help you to have healthier choices in your food selections, and exercise       is  key as well.

  • ExerciseStart with walking 4 to 5 times a week, 30 to 45 minutes if you can make it happen.  Leisurely strolls give you fresh air, but are not enough to be helpful exercise. The pace should feel like a little bit of a work out, so essentially a brisk paced walk.  If you have always done strenuous exercise, you can get back to this about 6 weeks after delivery.  

We recommend you have a plan for after the delivery. Do you have options to plan ahead and have people lined up to help? If not, check what community services may be available. Allow yourself permission to have a break here and there. Maybe a nap, a massage, a shower with no one yelling, "Mom, where are you?"

Things to have at home when you get home with your newborn:

  • Things like Sitz baths and creams for vaginal pain are typically given to you at the hospital before you leave.
  • Pads; you will typically have bleeding for 2 to 4 weeks, sometimes a little bit longer.
  • Nursing pads; if you plan to nurse, you will most likely experience leaking from your breast when your milk comes in, and at times in between feeding your baby.
  • Nursing bra if you plan to nurse; you can purchase this ahead of time, but since your breasts may change significantly in size after you start nursing, consider not buying too