Many people haven’t heard of the ‘fourth trimester,’ let alone when it applies in a surrogacy arrangement. The fourth trimester refers to the first three months after a baby is born, when baby is going through a period of massive growth and change and getting used to the outside world. It also refers to the period of the parents growing into their new roles. And in surrogacy, it refers to the surrogate’s period of transition to no longer being pregnant, her new role in the intended parents’ and baby’s lives and adjusting to life beyond surrogacy. It is important to respect the fourth trimester as a period of great change for everyone, a time which demands respect and gentleness with ourselves and each other, and a time of transition from ‘surrogacy arrangement’ to friends.

Surrogacy counsellor Katrina Hale and I talked extensively about the fourth trimester in this Podcast episode and it is a must-listen for intended parents and surrogates alike. Katrina has also developed a guide to the fourth trimester for intended parents, which you can download.

Surrogates and intended parents can prepare for a smooth and happy fourth trimester, and it will be different for everyone. As a pregnant surrogate, I spent some time in the lead up to the birth making plans to help me transition from pregnant surrogate back to Sarah the lawyer, mum, partner, non-pregnant woman. Here’s my tips for a smooth and happy fourth trimester:

  1. Plan, Plan, Plan
    Plan nice things for yourself to do. Plan all the nice things! I had a long list of nice things I wanted to do in those first few months, but none of them were difficult or locked in. That way, I could decide on a whim to do them if I felt up to it, or leave it for another day. Have nice things planned that are good for the mind, good for the soul and good for the body. Some nice things you might like:

    • Pedicure
    • Massage
    • A trip to an art gallery or museum
    • A brunch date with a friend
    • A picnic with your kids
    • Read a new book
    • A movie date with your partner
  2. Take it Easy and Be Kind to Yourself
    Your body, hormones and mind might play tricks on you during the first few weeks. Many surrogates say that they forget that they’ve given birth, or forget that the baby in the intended parents’ arms is the baby they birthed. Your hormones might make you cry at the drop of a hat and you might not know why! And your body might be the only reminder that you just had a baby. I was shocked that my body looked like it had been recently pregnant because my mind was telling me to get on with my life. The biggest lesson here is that no two surrogates are the same, but we can probably relate to each others’ experiences of the fourth trimester. Be kind to yourself – there is no rule book about how you will feel. Remind yourself that your body needs time to recover and you shouldn’t feel the need to get it back to its pre-pregnancy state too quickly.
  3. Visits with Surro-baby
    Visits with your intended parents and the baby are a lovely way to see them as a family and bask in the glow of the surrogacy and what you did to help them become a family. If you are not able to see each other in person, Facetime catch ups and photos are almost as good. Many surrogates don’t feel the need to see updates from their intended parents, but staying in close contact can be a lovely way to stay connected after the epic event of the birth and everything you’ve done together.
  4. Debrief the Birth
    This is more important than most people realise, and can be a crucial part of transitioning from surrogacy to the new normal. Even if the labour and birth went to plan, debriefing can help everyone process the enormous event of birth and your feelings about it. If the birth didn’t got as you’d planned or hoped, it can help you process it so that it doesn’t keep you awake at night. The surrogate might like to debrief the birth privately with a counsellor or midwife, but doing it together as a team can be really useful as well.
  5. Fourth Trimester Counselling
    Counselling in the fourth trimester is a requirement for the Parentage Order application in several States. Many teams treat it like a tick-a-box process, but it can be helpful not only for debriefing the birth but adjusting and transitioning to the new normal post-surrogacy. I benefited from having a counsellor to help my clarify my feelings about my new role as the ‘ex-surrogate’ and given language to all my thoughts and feelings about the baby and the intended parents. Counselling, before during and after surrogacy, is not about crisis management or fixing something that is broken – it is a vital part of maintaining individual and team well-being and relationships.
  6. Post Birth Care
    One thing that many teams don’t plan for is what needs to happen if the surrogate and her family need assistance post-birth. This might be because she had a caesarean and cannot drive for six weeks. It might be because she has other post-birth recover or complications and requires ongoing medical appointments. She’s unlikely to be able to clean her house or return to work in the early weeks. Meanwhile, the intended parents are understandably besotted and and absorbed in their newborn. How is the team going to support each other and move through these early weeks, to make sure the surrogate is getting the care and assistance she needs? Some things that might be needed include:

    • A cleaner for the surrogate family;
    • Someone to assist with driving the surrogate family, or taxi vouchers;
    • Ready-made frozen meals for the surrogate family.
  7. A New Project
    Having a new project to keep you busy is one way to transfer the energies from the surrogacy to something else. It might be a craft project, or a new educational endeavour, or planning a family holiday. I’m all for surrogates having a new project in the pipeline after the surrogacy birth, but be sure that it doesn’t take too much physical or emotional energy, or require too much brain power. You may find that you don’t have the emotional or intellectual energy for anything too complex in the first few months.

We did some work at the Sisterhood Day, working on our own fourth trimester goals and Finding Happiness Beyond Surrogacy.

What have you found helpful in the fourth trimester? What worked and what didn’t? Was the fourth trimester what you expected?

You might like to listen to Episode 33 of the Podcast with Marnie, where we talked about her fourth trimester experience. Other episodes include Madeline, and Jessica, both talking about their fourth trimester experiences.

You can find more information in the free Surrogacy Handbook, reading articles in the Blog, by listening to more episodes of the Surrogacy Podcast. You can also book in for a consult with me below, and check out the legal services I provide.

Hi! I’m Sarah Jefford (she/her). I’m a family creation lawyer, practising in surrogacy and donor conception arrangements. I’m an IVF mum, an egg donor and a traditional surrogate, and I delivered a baby for two dads in 2018

I advocate for positive, best practice surrogacy arrangements within Australia, and provide support and education to help intended parents make informed decisions when pursuing overseas surrogacy.

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