Post-Labour: Recovery in the Fourth Trimester

Post-labour your body will need time and support to recover. We refer to the three months following your labour and delivery as the fourth trimester. This is a very emotional time for both you and your baby as you grow into your new relationship and environment. It’s also a critical time for your body to recover from the strain of growing your baby and giving birth.

As you enter the fourth trimester, your hormones are changing quickly and dramatically, your organs are returning to their natural positions, and your perineum is healing. Be mindful of the changes that are taking place in your body as you recover, and don’t hesitate to reach out for support when you need it.

The Hormonal Shift

While pregnant, your progesterone levels are extremely elevated. This is designed to relax your ligaments and to help your body better accommodate your growing baby. Elevated progesterone levels also counteract the effects of the hormone prolactin that your body is producing to support your milk supply.

Aversely, increased prolactin lowers your dopamine levels, which are responsible for feelings of happiness and euphoria. With reduced progesterone, you become vulnerable to feeling especially anxious and/or low as a result. This is more commonly referred to as the baby blues.

The baby blues usually last around six months. You may find your mood changes abruptly, you are crying more often, and you are having difficulty sleeping. Usually this is a normal response to the incredible hormonal shift that has taken place in your body. Sometimes it isn’t.

About 10 percent of women that experience the baby blues experience postpartum depression, which is often mistaken for the baby blues at first. You should reach out to your doctor if you find yourself struggling to bond with your baby, withdrawing from your family and friends, having extreme changes in appetite, feeling overwhelming fatigue, or experiencing thoughts of worthlessness, shame, guilt, or harm.

Working with your support system to maintain a positive mind-set will make it easier to take care of the physical aspects of your recovery, like tending to your perineum and rebuilding your pelvic floor.

Recovery of the Perineum

The perineum is the area between your vagina and your anus. Your perineum becomes swollen during labour and often tears with the stress of vaginal delivery. Many new moms are not prepared for the discomfort in this area over the first several weeks postpartum.

You can take some of the stress off your perineum by sitting on a pillow or padded ring and talk to your doctor about pain relief options that are safe for your baby.

Ease the swelling and soreness in your perineum by sitting on or gently pressing an ice pack against this area for a few minutes several times a day. You should also use a perineal irrigation bottle (or a clean squirting bottle) to rinse the area with warm water after urinating. Many other tips and tricks exist—contact us to find out some of them if you are finding it difficult to urinate pain free. 

Having strong pelvic floor muscles improves blood circulation and helps the perineum heal more quickly after delivery.

Supporting Your Pelvic Floor Postpartum

Your pelvic floor is similar to a hammock of muscles and ligaments. It attaches to your pubic bone, sit bones, and tailbone. Not only do your pelvic floor muscles support the weight of the growing fetus throughout your pregnancy but they also control your bladder and bowel muscles and stabilize your spine.

Delivering your baby is traumatic to your pelvic floor because the muscles have been so rigorously stretched and strained, but remember, it was made to do this and can recover. These muscles need to be supported post-labour in order to recover fully. Proper rehabilitation will help prevent loss of bladder control, low back pain, pain with sexual intercourse, and pelvic organ prolapse.

A pelvic floor physiotherapist can help ease your recovery and guide you comfortably back to your routine activities and exercise. We will also look for signs of diastasis (the separation of abdominal muscles) and give you core exercises that will help restore this area. 

In most cases, new moms are physically recovered to resume usual activities in around six weeks. We recommend a structured plan with your local pelvic floor therapist—or online consultation with one of ours—to help you through the first weeks of exercise. The goal is to be educated on the dos and the don’ts of post delivery. We can show you some more comfortable pelvic tilt and abdominal bracing exercises to do in the interim instead.

Pelvic floor exercises are not a one-size-fits-all. In fact, these exercises are most effective when tailored and monitored on an individual basis. We are here to uniquely assess your pelvic floor function and design a program that will best fit your needs and lifestyle.

Work with Our Team of Caring Professionals!

We are eager to make your body’s journey through pregnancy a more comfortable one. Not only can our pelvic floor physiotherapists help with your postnatal needs but we can also work with you throughout your pregnancy too. Having a strong pelvic floor makes the pregnancy experience smoother, more enjoyable, and enhances your overall quality of life. 

No matter where you’re at in motherhood, we want to be there for you along the way. Book an online consultation with our pelvic floor physiotherapist online at or call us anytime with your questions at (833) U-R-HEARD.