Navigating Parenthood: Five Essential Conversations for the Fourth Trimester

The term "fourth trimester" refers to the first three months after a baby's birth. It is a period of significant adjustment and development for both the baby and caregivers.

At the best of times, it can be hard to be vulnerable with our partners and to send clear messages about our needs. So let's just normalize that it can be even more difficult to communicate when we are sleep deprived, our hormones are fluctuating and we are caring for a tiny creature whose main form of communication is crying.

That is why I find it so important for clients to begin conversations about the fourth trimester before they find themselves deep into it. I am not concerned so much with the content of the conversations, but in developing the felt sense that they can turn to their partner and share a hope, fear or need and trust that their partner will be there for them. We will need to draw on that felt sense of being there for one another when the baby comes.

With that in mind, here are some key aspects to keep in mind about the fourth trimester and five critical conversations to take on inside and outside of a therapy session.

Key Aspects of the Fourth Trimester: 

• Physical Recovery – The mother or gestating parent’s body is recovering from childbirth. 

• Emotional Attachment – The baby and caregivers are experiencing emotional changes as they bond and adapt to their new roles. 

• Baby’s Development – The baby is rapidly growing and learning, developing senses, motor skills and cognitive abilities. 

• Feeding – The caregivers establish a nursing or feeding routine to support the baby’s growth. 

• Sleeping – The baby's sleep patterns are still developing, with frequent feedings and short sleep intervals. 

Conversation 1: Your Vision of Parenthood

• What is your ideal vision of parenthood and partnership?

• What are your hopes, fears or expectations of the fourth trimester?

• Can you share these feelings with your partner? How is it to share and hear from them?

• Can we celebrate the areas of alignment and address any areas of concern?

• Tip – Create a shared document (I called mine a “Baby Pact”) and take notes on your answers to these questions and the following questions. Check-in with yourself and your partner regularly to see if you are aligned or need to adjust. 

Conversation 2: Your Approach to Support

• How do you feel about asking for help and/or accepting help from your partner or other people in your life?

• What sort of help feels good and what sort feels less good?

• Who can you count on for support during your fourth trimester and in what ways?

• What boundaries feel good or less good to you, particularly in terms of friends or family members, your home and your time?

• Tip – Practice asking for and accepting help and reflect on the feelings that come up. Share these feelings with your partner.

• Try this – Set up a text or email chain with an inner circle of parent friends who you feel comfortable turning to with questions, complaints and celebrations. 

Conversation 3: Feeding

• What are your hopes, fears or expectations around feeding your child?

• If nursing is part of your expectation, does your medical provider provide lactation consultation and/or breast pumps? How do you feel about using those resources?

• How important is it for both parents to be able to feed and burp the baby? How would you ideally share the responsibility?

• How do you want to approach cleaning and sterilizing bottles and pumps, washing burp cloths, purchasing formula (i.e. the labor that supports feeding)?

• How do you plan to feed yourselves while you figure out feeding a baby?

• Get this gear – Nursing bras or nursing tank tops, nipple lotion, small anti-colic bottles with slow flow nipples, bottle brushes

• Tip – Delegate a friend to set up a food train for you and stock your freezer with single-serve meals to ensure you have easy access to healthy food.

Conversation 4: Sleep

• What are your hopes, fears or expectations around the baby and sleep?

• How do you feel about sleeping arrangements such as co-sleeping and co-rooming?

• What are your current sleep patterns or needs? Are you a good napper, a night owl, a morning person? How might your sleep patterns or needs match-up with the baby's sleep and care needs and your partner’s patterns and needs?

• How do you want to approach nights? How comfortable are you with pivoting if the plan needs to change?

• How can you find time to rest while you figure out your baby's sleep patterns?

• Get this gear - White noise machine, infant sleep sacks or sleep suits, baby monitor

• Tip – Tap a friend or family member to watch your child for 90-120 minutes a couple of days a week so you can take a nap!

Conversation 5: Parental Efficacy

• How confident are you in your parental abilities? In what areas do you feel more confident or less confident?

• Can you share these with your partner? How is it to share and hear from them?

• How could your partner help you build your parental efficacy?

• How do you prefer to learn about parenting? Do you prefer to learn by doing, learn by watching a video? Do you research, crowdsource, etc.? How does that compare to your partner’s approach to learning?

• Who do you trust for parenting information (friends, family, medical providers, ChatGPT, Reddit, etc.)? What are the trusted areas of overlap between you and your partner and how can you access those resources?

During the fourth trimester, it is normal for the birth parent to experience short-lived periods of sadness and mood swings. But if you notice feelings of sadness, hopelessness, anger or overwhelm persist and the feelings interfere with your ability to bond with your baby or accept support, you may be showing signs of postpartum depression (PDD).

Let me be very clear that PDD is not a sign of failure and it is treatable with counseling, medication and social support – all the more reason to build your capacity for emotionally honest conversations with your partner or other caregivers before or during your pregnancy.

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