The fourth trimester

Postpartum, week by week

The first 12 weeks after birth, sometimes called the fourth trimester. At a glance: what happens when, what's normal, and when to call.

The first 12 weeks

Roughly when things happen. A caesarean or a hard birth can take longer.

  1. Birth

    Day 3–4

    Milk comes in

    Breasts can feel tight and tender

  2. First weeks

    Bleeding eases

    Red, then lighter and brownish

    1
  3. 2

    By week 2

    Baby blues lift

    If not, talk to someone

  4. By week 3

    First check-in

    US guidance

    3

    From week 3

    Fertile again

    Even before your period

  5. 4
  6. 5
  7. 6

  8. Weeks 6–8

    Postnatal check

    UK

    7
  9. 8

    By week 8

    Tummy gap closes

    Ask about physio if not

  10. 9
  11. 10
  12. 11

  13. By week 12

    Full postpartum visit

    US guidance

    12

Your body

What's normal, and when to call your midwife or doctor.

Bleeding

Heavy at first, then lighter and brown over a few weeks. Pads, not tampons.

Call if Large clots

Stitches

Wash daily with plain warm water, then pat dry.

Call if Very sore or smells unpleasant

Caesarean

Keep the wound clean and dry, and keep moving gently.

Call if Signs of infection

Breasts

Tight and tender when milk comes in, around day 3 or 4.

Call if Hot, red patch with a fever

Bladder

A little leaking is common. Pelvic floor exercises help.

Call if Not improving by your check

Tummy

The muscle gap usually closes by 8 weeks. Skip sit-ups at first.

Call if Gap still obvious at 8 weeks

Your feelings

Three different things, on the same timeline.

Baby blues

Very common

Birth2 wks1 year

Usually gone within 2 weeks

Rest, support, tell someone

Postnatal depression

Common, in parents and partners

Birth2 wks1 year

Can start in pregnancy or any time in the first year

Talk to your doctor, midwife or health visitor. Treatment works.

Emergency

Postpartum psychosis

Rare, about 1 in 1,000

Birth2 wks1 year

Starts suddenly, usually in the first 2 weeks

An emergency: get same-day urgent help

Low mood lasting past 2 weeks is the moment to ask for help, even with only some signs. The EPDS, explained

Your check-ups

  1. 3 weeks

    First check-in

    US

  2. 6–8 weeks

    Postnatal check

    UK

  3. 12 weeks

    Full postpartum visit

    US, at the latest

Questions to bring to your check-up →

Get medical help straight away for

  • Soaking a pad or more in an hour, or clots bigger than an egg
  • Chest pain, trouble breathing, or a racing heart
  • Pain, swelling or redness in one calf or arm
  • A headache that won't go, vision changes, or a suddenly swollen face or hands
  • A temperature of 100.4°F (38°C) or more, or a sore, tender tummy
  • Thoughts of harming yourself or your baby, or seeing or hearing things that aren't there

These can happen up to a year after birth. Tell them you had a baby recently.

Your baby's first weeks

Breastfeeding a newbornNewborn feeding gearFirst pediatrician visits

Common questions

How long does postpartum bleeding last?

For a few weeks. It's heaviest and red at first, then gradually turns brownish and gets lighter until it stops. Use pads rather than tampons until your postnatal check, and tell your midwife if you pass large clots.

How long do the baby blues last?

Usually only a few days, and they're gone within 2 weeks of the birth. If low mood lasts longer, gets worse, or you're struggling to cope, talk to your doctor, midwife or health visitor; it may be postnatal depression, which is common and treatable.

When is the postpartum check-up?

In the US, guidance is a first contact with your provider within 3 weeks and a full postpartum visit no later than 12 weeks. In the UK, the postnatal check is at 6 to 8 weeks.

How soon can I get pregnant after giving birth?

From 3 weeks after the birth, even if you're breastfeeding and your periods haven't returned. Start contraception within 21 days if you don't want to get pregnant again yet.

When will my periods come back?

If you bottle feed or combine bottle and breast, as soon as 5 to 6 weeks after birth. If you fully breastfeed, including at night, they may not return until you start breastfeeding less.

What is the fourth trimester?

The first 12 weeks after birth. The name is a reminder that recovery, feeding and getting to know your baby are a stage of their own, deserving the same care as pregnancy.

NUGA comes with you into the fourth trimester

Log feeds, sleep and how you're feeling in a tap, take the gentle EPDS mood check-in when it's due, and keep your check-up questions ready.

Download on theApp StoreAvailable now

Sources

This page draws on public guidance from:

General information, not medical advice. Your midwife, doctor or health visitor knows your recovery. Last updated October 2026.