What It Means
The fourth trimester is the period right after a baby is born, named as if it were one more stage of pregnancy. For postpartum care, the American College of Obstetricians and Gynecologists (ACOG) uses the term and asks that this care be an ongoing process shaped to each mother's needs instead of a single visit. Its recommended care runs through the first 12 weeks after birth.
Try It: Where You Are on ACOG's Postpartum Timeline
Type how many weeks it has been since the birth. The marks come from ACOG Committee Opinion No. 736.
ACOG asks for contact with your obstetric provider within the first 3 weeks. If nobody has called or seen you yet, call them.
Book the comprehensive postpartum visit now if it isn't on the calendar. ACOG says it should happen by 12 weeks.
Past 12 weeks. If you never had the full visit, it's still worth booking; ongoing care continues as needed.
How Parents Say It
- "We're still deep in the fourth trimester."
- "She just wants to be held all day."
- "My six-week check felt like an afterthought."
The Breakdown
ACOG's postpartum timeline
| When | What ACOG recommends |
|---|---|
| First 3 weeks | Contact with your obstetric provider to check how you're recovering |
| Weeks 3 to 12 | Follow-up care shaped to what you need |
| By 12 weeks | A comprehensive postpartum visit that ends this stretch of care |
| Postpartum visits | Screening for depression and anxiety with a validated questionnaire (2023 guideline) |
Your baby's visits count too. The American Academy of Pediatrics (AAP) recommends that pediatricians screen mothers for depression at the baby's 1, 2, 4 and 6 month visits, so those appointments are a second chance to say how you're doing.
A short version to try this week
- Write down the date of your 3-week contact and your 12-week visit.
- List questions as they come up, about healing, feeding, sleep or mood.
- Ask who to call between visits, and save that number.
When to call sooner. Call your provider if low mood, worry or tearfulness lasts 2 weeks or more, or if anything about your recovery worries you. Thoughts of harming yourself or your baby need help right away: call 911 or 988.
Where It Comes From
The phrase borrows the three trimesters of pregnancy and adds a fourth for the months after birth. ACOG revised its postpartum care guidance in 2018 in part to give the fourth trimester more weight, calling for care that continues across those weeks instead of one visit.
Good to Know
ACOG Committee Opinion No. 736, "Optimizing Postpartum Care," is the guidance behind the 3-week and 12-week marks. If you have questions or feel low at any hour, the National Maternal Mental Health Hotline from HRSA takes calls and texts at 1-833-TLC-MAMA (1-833-852-6262), free and confidential, 24/7.
FAQ
How long is the fourth trimester?
It covers the weeks after birth, and ACOG's recommended postpartum care runs to about 12 weeks. That's when ACOG says the comprehensive postpartum visit should happen at the latest.
When is the first postpartum checkup?
ACOG recommends contact with your obstetric provider within the first 3 weeks, then ongoing care as needed and a full visit no later than 12 weeks after birth.
Will anyone ask about my mood after the birth?
Yes. ACOG's 2023 guideline asks providers to screen for depression and anxiety at postpartum visits, and the AAP asks pediatricians to screen mothers at the baby's 1, 2, 4 and 6 month visits.
Do It in Buhata
Calendar and Reminders
Add the 3-week contact and the 12-week postpartum visit to the Calendar in Buhata and set a Reminder a week before each, so the appointments get booked in time.
Open BuhataRelated Terms and Categories
- Newborn
A baby in the first 28 days of life, the stage doctors also call the neonatal period.
- Postpartum depression
Depression that begins in the weeks or months after a baby is born, up to a year, lasting 2 weeks or longer and stronger than the baby blues.
- Matrescence
The process of becoming a mother, seen as a developmental stage like adolescence, a term anthropologist Dana Raphael introduced in 1973.
- Safe sleep
The AAP's rules for lowering the risk of SIDS and suffocation: baby on the back, alone, on a firm flat surface in their own sleep space, every sleep.
Sources
ACOG, Committee Opinion No. 736, "Optimizing Postpartum Care" (2018); ACOG, "Postpartum Toolkit"; ACOG, Clinical Practice Guideline No. 4, "Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum" (2023); American Academy of Pediatrics, "Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice," Pediatrics (2019); HRSA Maternal and Child Health Bureau, "National Maternal Mental Health Hotline"
- www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
- www.acog.org/-/Media/Project/Acog/Acogorg/Clinical/Files/Committee-Opinion/Articles/2018/05/Optimizing-Postpartum-Care.Pdf
- www.acog.org/-/media/project/acog/acogorg/files/pdfs/publications/2018-postpartum-toolkit.pdf
- www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/06/screening-and-diagnosis-of-mental-health-conditions-during-pregnancy-and-postpartum
- publications.aap.org/pediatrics/article/143/1/e20183260/37306/Incorporating-Recognition-and-Management-of
- mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline
Last updated .