The Fourth Trimester and Beyond

The Fourth Trimester and Beyond

The Fourth Trimester and Beyond: Congratulations, you’ve had a baby! Perhaps you feel great and ready to go. But maybe you don’t feel so fine (despite everyone saying you are!) or you have questions about the best way to re-store, re-gain and re-train, and re-fine after giving birth.

That amazing feat of creating and delivering a child requires some huge changes of your body, and although you have had your 6 week check up and been told that you can “resume full activity”, it takes most moms longer than the magic 6 weeks to recover and re-strengthen.  The term “The Fourth Trimester” has become a hot topic, and we do think that it is a good start, but after working with new moms (and some older ones) over many years, we know that it can take longer than 4 trimesters to feel like you. The good news?  You can create change at any point….it’s never too early or too late to meet your goals of feeling good and doing the things that you enjoy!

The Fourth Trimester: Frequently Expressed Concerns from Moms:

  1. “Oh no!!! I think I have a diastasis!!” During pregnancy, your body is constantly changing to support the baby and to prepare for delivery.   ALL moms have a “DRA” (Diastasis Rectus Abdominus) if they go to full term.  We work with moms to regain support of the muscles and the tissue after delivery and into activities.  

  2. “I am having back or pelvic pain.” Many women have pain in the back/pelvis/hips during pregnancy… common but not normal and should be addressed.  About 1/3 of moms continue to have pain after delivery. It should not limit your life or ability to care for your baby (and self). We work with moms to make changes in your posture habits and to use the pelvic floor and other muscles more efficiently.

  3. “Umm….I’m leaking, even if I don’t laugh!!!” The pelvic floor goes through big (literally) changes to deliver a baby. “Just do Kegels” may not be enough; however, retraining the core and pelvic floor together will stop the leaking.  And this is a good time to talk about your bowels; your colon is pushed every which way by the baby, and it can take a while to get things back on track. Super important to have good bowel function. Eat healthy food and fiber, and don’t strain when you poo. 

  4. “I had a C-Section…now what?” Everything that we have mentioned above applies to you, and even more. Many C-section moms have more back pain as the muscles are not supporting well and it is more challenging to move. Exhale with exertion!!  Use a support panty.  Talk to us about scar and tummy work. Getting your scar gliding is a big part of retraining your muscles.

  5. “Will sex ever feel good again???” Yes, we talk about this in PT! For some women, no issues going back to an amazing love life, but in reality, nursing and other hormonal changes MAY create some vaginal dryness, your episiotomy or other scars may still be tender, and the vagina has stretched and is can take some time to regain muscle tone. We recommend simple lubricants to moisturize, and we work with you to retrain the pelvic floor, muscles, pelvic mobility, and breath to regain a happier sex life.

  6. “What’s the best exercise?” It depends. Sorry, but truth! Walking is a great early exercise, and after that, we base it on our mom, her interest and time, fitness pre and during pregnancy, and what is going on now! Be patient with yourself, and don’t compare what you are, or aren’t doing to your friend or sister. We all regain and retrain differently. 

  7. “Who do I turn to for answers?”  Embody Physiotherapy are experts in caring for moms at any age and stage. Your goals and needs are not the same as your friend or sister, and what worked for mom may not work for you.

Finally, if in doubt, ask. Be patient with your body as it relearns how to not be pregnant. And be proud of what you have accomplished!  

Article by Rebecca Meehan, PT Embody Physiotherapy & Wellness Request your “New Mom Tip Sheet” here: If you would like to speak with us about what your concerns are about the Fourth Trimester or any concerns you may be having during pregnancy and beyond, find help through Physical Therapy. Contact us at 412-259-5342 or here for a FREE 20 minute phone consultation: Email us at

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