Fourth Trimester – Recommendations

The postpartum fourth trimester is a transition period when the body and mind adapt to a new phase of life: recovery from childbirth, adapting to breastfeeding and sleep deprivation, and the new role as a mother. 

This is a time when the body needs rest, support, and conscious recovery.

General Recovery Recommendations

General recovery recommendations after childbirth are as follows:

Ice Pack for Swelling and Pain Relief:

Within the first 48 hours, use a cold pack in the perineal area as often as possible, while sitting or resting.

Do not place the cold pack directly on the skin – use a thin cloth in between.

Bidet Shower or Water Bottle for Urination:

If urination is painful or stinging, use a water bottle or bidet shower to rinse the intimate area.

This relieves stinging and helps cleanse lochia (postpartum bleeding), which lasts 6–8 weeks.

Instead of wiping with paper, pat the area dry.

Using the Toilet in an Ergonomic Position:

Place your feet on a low stool to achieve an optimal angle for the rectum and reduce pressure on the pelvic floor.

Moving Slowly and Consciously:

When getting up from a lying position, first turn onto your side and use your hand to push yourself up to a sitting position.

If sitting is painful (e.g., due to tears or stitches), get out of bed by moving into an all-fours position.

Avoid Heavy Lifting:

For the first three months, avoid lifting anything heavier than your baby. Before lifting your baby, consciously engage your abdominal and pelvic floor muscles.

If you must lift heavy objects, use an abdominal support belt, exhale, and keep your muscles engaged.

If you feel pressure in your pelvis or perineum, lie down and place a pillow under your buttocks to reduce the pressure.

Important! Breathing is the foundation of recovery – do not hold your breath during any activity or exertion.

Daily Life and Rest

• Rest consciously. Sleeping with your baby is essential for recovery. Do not use all of your baby’s sleep time for cleaning and household chores – this increases mental and physical exhaustion.

• Drink enough water (2–3 liters per day), especially if you are breastfeeding. This supports tissue healing, metabolism, and breast milk production.

• Nutrition and Digestion. Eat fiber-rich foods; if necessary, take calcium and magnesium to support muscle and nervous system function and prevent constipation.

• Use the toilet every 2–3 hours, even if you don’t feel the urge. Avoid straining and practice relaxing breaths. If necessary, use a bidet shower or let water run from the tap.

• Avoid strenuous household chores (e.g., vacuuming, lifting a heavy laundry basket or stroller). Ask for help.

Movement – From the Very First Days

The body needs movement for effective healing. If your doctor or midwife has given permission, start moving immediately – even with slow walks in the ward or at home.

Even if walking, getting up from a chair, or turning onto your side is initially painful, regular, moderate movement helps prevent muscle stiffness, swelling, and circulatory problems.

First Restorative Exercises

Start with pelvic floor exercises as early as 24–48 hours after a natural and uncomplicated birth.

If 3rd or 4th-degree tears occurred, consult a pelvic floor physiotherapist before starting.

A prior postpartum check-up with a midwife is not a prerequisite for an appointment.

You can come to Naistefysio for an appointment as early as 3 weeks after childbirth. 

Pelvic Floor Muscle Exercise:

• Starting position: Lie on your back, knees bent, feet flat on the floor.

• Exercise: As you exhale, contract your pelvic floor muscles (as if holding in urine and gas); as you inhale, relax.

• Duration: Start with 3–5 minutes per day. Then, perform 5 quick contractions and relaxations, 10 repetitions. Each week, add 1 until you reach 10×10 repetitions.

What is normal and what is not?

During the 4th trimester, the following complaints may occur:

• Protruding/Bulging Abdomen

• Urinary, Gas, or Fecal Incontinence

• Pelvic Heaviness

• Back or Hip Pain

❗ If symptoms persist for longer than 3 months, consult a women’s health physiotherapist.

Studies show that without rehabilitation, these problems may not recover spontaneously.

What to Avoid in the First Three Months?

• Intense Workouts.

• Start with lighter exercises/workouts and progress gradually. It is important to listen to your body!