The fourth trimester, which begins virtually the minute your baby arrives, brings a massive amount of physical and emotional change. “For a first-time mom, there’s often an intense moment of realization when she considers the magnitude of the responsibility of caring for another life,” says Dr. Gopalan. “Her body goes through significant changes too, so she needs to tend not only to her newborn, but to her own personal care and recovery from the birth.” Tremendous hormonal and physical changes occur during the fourth trimester — your body is trying to get back to its pre-pregnancy state and healing from the delivery. Almost all moms have some degree of pain after giving birth. Mothers who deliver vaginally may have to deal with perineal issues, which can include an episiotomy, vaginal tearing, and/or hemorrhoids. Mothers who give birth by C-section will need to monitor the incision and follow lifting/moving limitations. Other physical issues associated with the fourth trimester include breast changes — nipple pain from adjusting to breastfeeding, and breast engorgement (if not nursing) — as well as postpartum blood loss, which can cause low blood pressure and exhaustion. Almost all new mothers report fatigue due to sleep deprivation and shortened sleep cycles as the result of night-time feedings. “All of these changes and stressors can make new moms susceptible to behavioral health issues,” says Dr. Gopalan. “These issues can range from the baby blues to postpartum mood and anxiety disorders, such as PPD and postpartum PTSD.”