The Fourth Trimester: Postpartum Mental Health and Treatment Options

The Fourth Trimester: Postpartum Mental Health and Treatment Options

The “fourth trimester” is a term used in reference to the three months immediately following baby’s birth. Like the time spent in the womb, this is a pivotal period for baby’s growth and development.

But those changes aren’t exclusive to your baby – the fourth trimester may impact you as a new mom, too, albeit in different ways. It's no secret that the postpartum period ushers in an intense life change. Especially for first-time mothers, the new transition can bring unexpected physical and mental challenges.

Taking care of yourself is crucial in these months.The transition to your “new normal” can be a bumpy one

Moms often talk about the "new normal" that develops in the months after their babies are born. And this new normal isn’t always an easy adjustment, thanks to personal and external pressure, physical changes, and a (sometimes unwelcome) spotlight from friends and family.

New moms often experience fatigue and sleep deprivation, a perceived loss of freedom, control, and self-esteem. They may experience a difference between the fantasy and reality of motherhood, all while needing to learn new skills and manage the new demanding role.

Unsurprisingly, your body is undergoing another transition (the post-pregnancy stages), at the same time you’re learning how to be fully responsible for a tiny, wonderful, wholly new life.

Mental health concerns, including depression and anxiety, are relatively common  

Every new mom’s experience is unique experience. However, if you’re feeling inexplicably anxious or depressed, it may help to keep these three common postpartum concerns in mind:

Baby Blues:

  • Affect approximately 60-80% of new moms in the postpartum stage
  • Last between 2 days and 2 weeks
  • Often peak 3-5 days after delivery

Postpartum Depression

  • Affects approximately 12% of new moms in the postpartum stage
  • Recovery time depends on a number of factors, ranging from personal history of depression to severity of symptoms and what type of support you have at home
  • Postpartum depression can begin days, or even months, after childbirth. The peak of risk for developing is three months after birth.


Postpartum Anxiety

  • Affects 10% of women during their first few months postpartum
  • Often starts in pregnancy and worsens after birth, but can start up to one year after birth
  • Recovery time ranges, depending on treatment, personal history, and severity of symptoms

Having a baby can also re-trigger or exacerbate other anxiety-related mental health conditions, too. Women sometimes experience newly-onset Obsessive Compulsive Disorder (OCD) after the birth of their child, or find that their previous OCD symptoms reemerge.

If you have a postpartum mental health concern, know that it’s likely highly treatable

New moms tend to overlook their needs as soon as their baby arrives, but supporting yourself in all stages of pregnancy is crucial to maintaining a healthy mental state.

Here are a few things you can do for yourself:

  • Be educated about postpartum mood disorders! For example, learn more about the symptoms of postpartum anxiety or the difference between postpartum depression and baby blues, so that if you or someone you love is affected, you can work towards treatment.
  • Attend a new mom’s group – even if you think you won’t enjoy it, this is a great way to connect with other moms, and learn useful tools to overcome your concerns, worries, and fears.
  • Start planning your fourth trimester early. Figure out who your support system is early on. This includes babysitters, and friends and family who can help with certain needs.
  • Consider starting, re-starting, or continuing therapy. Work with a clinician who specializes in cognitive behavioral therapy or interpersonal psychotherapy.

Postpartum therapy is helpful for mental health concerns – and beyond

If you’re experiencing symptoms of postpartum depression or anxiety, or another perinatal mental health condition, therapy can help! A panel of experts recently reported that cognitive behavioral therapy (CBT) and interpersonal therapy may be the most effective treatments for most women with postpartum depression.

It is also extremely helpful to explore your own beliefs about motherhood, and to look at what may be impacting your ability to bond. This can be achieved in individual therapy or in a group setting.

If you’re considering therapy for postpartum mental health concerns, Postpartum Support International is a great place to start. They provide many of the trainings for professionals specializing in perinatal mental health and have a plethora of information.

And if you’re ready to find a therapist for postpartum depression, anxiety, or the transition to motherhood, visit to browse a vetted network of perinatal specialists in NYC, Boston, and Rhode Island.

Finally, know that you are not alone in your struggles. Entering motherhood marks a significant life change for any woman, and the right support system can make a world of difference.



This is a guest post from Zencare, a website that helps people find their ideal talk therapists. Visit Zencare to browse their vetted network of top therapists, including perinatal therapists, using criteria like insurance, sliding scale, location, and specialties. You can also directly book a free assessment call from the Zencare site.


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