Surviving the fourth trimester for the new mom is essentially a “trial by fire” situation. You’re sleep-deprived, you’ve been through a huge change that affects you emotionally and physically, you’re dealing with a tiny little human who demands your attention all the time – it’s rough. In this post, we’re covering the difficulties of the fourth trimester and how to take care of yourself after giving birth. This is a difficult time, but it doesn’t mean you can’t thrive in it.
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What is the Fourth Trimester?
First, what exactly is the so-called “fourth trimester”? Coined by Dr. Harvey Karp, the guy behind “The Happiest Baby On The Block,” the idea of the fourth trimester is that human infants are born essentially prematurely, compared to most mammals. They spend their first three months of life mostly asleep, with periods of awareness and activity, similar to how they behaved in the womb. They want to be in constant contact with their mother because that’s what they’re used to.
In the first few months, babies are easily soothed by mimicking the conditions of the womb – swaddling (they’re used to tight spaces), rocking (they’re used to you walking), loud noises (your body is a noisy place, between your blood scooting around, your digestive system, your voice…). Dr. Karp says that due to the size of a standard infant, we essentially have to “evict” them early, before the optimal time, because we couldn’t get a baby through our pelvis otherwise. You can read a little more about the fourth trimester on his site.
Basically, what it all comes down to is – the first three months of an infant’s life are really tough. They lack the ability to regulate their sleep schedule. They want to constantly be in contact with someone. And now they’re dealing with new sensations like “hunger” and “cold” and “space” that are hard to get used to – after all, they’ve never encountered those in their previous existence.
It’s tough on the baby, but it’s also tough on Mama. You’re dealing with an inconsistent sleep schedule, a body that’s been through huge physical changes, a new role, changes in your relationship – it’s not a wonder pregnancy is considered a major stress-inducing life event.
How to Take Care of Yourself After Giving Birth
I really want to divide this into two realms: the physical aspect, and the mental one. Both are equally valid and important to your recovery.
Physical Care After Birth
When I had my oldest, I had a rough transition. Labor was only twenty hours, but I had preeclampsia, and it took a toll on my body. I didn’t nourish myself adequately, she didn’t sleep, and I was too proud to accept help. I was convinced I had to do it all myself.
I was an idiot.
Nourishing yourself after birth is the best thing you can do for both yourself and your baby. Learn from my lessons.
Listening to your doctor or midwife is incredibly important. If you had a C-section, you need to know how to care for your incision – if you gave birth vaginally, you need to know if you had a tear, and if so, how bad was it, and is any special care needed. If you had any other complications, find out if you need to keep an eye out for further issues. Use a sitz bath. Use a peri bottle. Pat, don’t wipe. Make sure you’re taking stool softeners for the first week or so.
Remember, even when things feel healed, they’re still weak, so don’t strain yourself. You also have an internal wound that’s roughly the size of a dinner plate – let it have time to heal.
You can look at my postpartum must-haves post for the items I found to be essential after my births, but make sure you’ve stocked up on things you need beforehand so you don’t need to go to the store for at least the first few days.
Make sure you’re taking your prenatal vitamins – yes, even though you’re no longer pregnant! If you’re breastfeeding, your body will steal whatever nutrients it needs from you to make sure it’s in your milk. It’s not a bad idea to take a calcium/magnesium/zinc supplement while you’re breastfeeding, especially if you don’t tend to consume a lot of dairy.
Keep your water intake up! If you’re breastfeeding, this is essential, but even if you aren’t, your body will function so much better while hydrated. I recommend using a water bottle with time markings on the side to track how much you’re drinking, and if you hate plain water, flavor it with something like Crystal Light, or infuse it with some fruit.
If you’re breastfeeding, nipple care is important. Use a nipple balm (I’ve used the Bamboobies one twice now, Lansinoh also makes a good one) after nursing. When you shower, massage your breasts while the hot water is running on them – it helps prevent clogs. Make sure you’re feeding from both sides, and alternating the breast you’re starting on. Many women will wear a bracelet they can swap between wrists to indicate which one was last. If you start running a fever and have any breast tenderness, get in to see a doctor ASAP – those are signs of mastitis, an infection of the tissue. And if you’re having problems with cracked or bleeding nipples, have your infant evaluated by a pediatric dentist for a tongue or lip tie. A lactation consultant may be able to help as well.
Sleep when you can. That’s hard, when you have a small baby that doesn’t want to sleep without being held, like most do, but seriously – sleep whenever you can. Hand the baby off to someone. Trust me, there are so many people who would happily hold a baby while you take a nap. I like to remind people that motherhood is not martyrdom and that starts at the beginning.
Postpartum Mental Health Concerns
It’s normal to be all over the map emotionally after you give birth. After my first daughter was born, I developed the sudden ability to cry at…well, anything. More than just commercials set to Sarah McLachlan songs and videos of soldiers returning home to their unknowing kids and dogs. I cried because I didn’t know why I was crying.
After my second daughter, I was so irritated. Why did my family members suddenly not know how to breathe correctly? I recognize I was irrationally irritated, so I kept myself in the bedroom to spare my family my wrath.
Baby blues occur in most new mothers. I saw numbers citing 70-80% but since most of my searching wanted to turn up results for postpartum depression, I had problems finding accurate statistics. They consist of depression-like symptoms – feeling sad without knowing why, having sudden mood swings, irritability (cough cough). Think PMS on steroids. It’s totally normal and usually resolves within a couple weeks.
You’re probably aware of postpartum depression. It can affect up to 15% of women. You should also be aware of postpartum anxiety – I talked about my experience with it after my first daughter’s birth. If you find yourself feeling unhappy after the two-week mark, “in a funk” and unable to shake it, dealing with intrusive thoughts that keep happening, or feeling negative feelings towards your child, please talk to a therapist. If you feel any desire to harm yourself or your baby, tell someone immediately and get help. That can be anything from an immediate call to a therapist to checking yourself in to a local mental health facility for immediate evaluation.
If you are prone to depression or anxiety, or have been diagnosed with those in the past, have a plan in place before you need it. For my second daughter, after having PPA with my first, I knew that if my symptoms hit a certain point, I was going to be scheduling a doctor’s appointment and looking at my treatment options. I also made more of a point to journal and learned some cognitive behavioral therapy techniques, along with generally being more mindful, because I wanted to prepare myself mentally as much as possible – and I’m of the opinion it helped quite a bit.
Make Things Convenient For Yourself
Consider signing up for something like Amazon Prime – even if you don’t want the yearly membership, having it for a couple months and then canceling can really be helpful (two-day shipping and having essentials like diapers delivered to your door is amazing!).
I also suggest signing up for the Target RedCard debit card. It connects to your bank account, gets you free shipping (generally pretty quickly too), and you get an automatic 5% savings and additional savings (their Up and Up diapers are often 10% off!). Plus, they offer drive up pickup services with no minimum spending required, which is awesome when you realize you’re down to your last pack of wipes but don’t want to haul a newborn into a store.
Accept help. Does someone want to come help you out around the house? Great, here’s the broom. Do they want to give you food? Yummy, we usually eat at 6:30. This is not the time to be prideful. Let others help you. Remember, some people have “acts of service” as a love language. Let them show their love for you.
Keep easy snacks on hand. A few ideas:
- Make muffins and freeze them – a minute in the microwave and they’re back to being warm and ready to eat
- Make some hardboiled eggs and peel them in advance – store them in salted water and they’ll last several days
- Have string cheese, pepperoni, and salami slices – roll them together
- Put peanut butter into celery stick
- Put baby carrots and hummus or ranch dip into a container
- Pair up crackers and cheese (you can even buy pre-sliced “cracker cheese”)
- Buy pre-made popcorn and put it into individual baggies
- Have some instant oatmeal on hand – add hot water and it’s quick and easy
You want something you can easily grab and eat, and protein-based snacks are going to help you out more than carb-heavy snacks. Pre-packaged individual servings will help you more than something that needs to be made in advance. Spend a little extra to get things that are ready to go – the extra convenience is worth it.
How to Help Your Newborn
Your baby is transitioning to a new existence. The warm, tight confines of your body have been replaced by the cold, open world. They are little and tiny and their instincts are screaming that they will be eaten by a lion if they are left alone (never mind that they have no idea what a lion is).
As frustrating as it can be to you, remember that your baby is not trying to be difficult. Crying is a sign that something is distressing them. When a baby is crying, it may be they simply want to be held. If picking them up doesn’t help, consider if they are hungry (how long since the last feed?), tired (have they slept in the last couple of hours?), or uncomfortable (too hot, too cold, a hair wrapped around a finger or toe, gassy or colicky).
Babywearing is a really useful tool with a newborn. I used this wrap with my first and a similar one with my second. A cheaper wrap is perfectly adequate – I’ve not had an issue with any of the wraps I’ve had, all from different brands and on the cheaper end of the scale.
Swaddling is also useful, although if you have a baby who likes to sleep with their hands by their face (both my daughters!) you may want a hands up swaddle – I liked this one for my second daughter because the sleeves could be folded over and her hands could be accessible (she liked to occasionally suck on her fist for comfort).
While neither of my daughters suffered much colic, my oldest definitely had some bouts of gassiness that had her quite distressed. Lying the baby down and pumping their legs up and down (it’s known as “bicycle legs” because it resembles the motions of riding a bicycle) is helpful to get it moving. Some people swear by gripe water, but I think its efficacy has more to do with the baby being surprised by something in their mouth (I’m not a believer in homeopathic medicine, which is what gripe water is based on). The Frida Windi has many positive reviews, but I’ve not used it myself (however, if it’s as useful as their snot sucker, it’s probably worth having!). Honestly, other than trying to make sure your baby isn’t inhaling too much air during a feeding and burping them well afterwards, it’s all trial and error to see what works best. Consult your pediatrician if it’s happening frequently though.
Keep The End In Sight
The first three months are just flat out difficult. It’s a huge adjustment, getting used to a new baby. It gets easier after that, so keep looking to that goal.
When my first was born, someone had told me in regards to breastfeeding, give it six weeks. A month in, I was ready to throw in the towel. It hurt, I wasn’t getting any sleep, I had neglected myself and was being depleted of the nutrients I needed, I definitely wasn’t drinking enough water – and while I loved the small human I had produced with all my heart, I was a wreck. But because I had that six week goal, I kept pushing through. When we made it to that point, we were nursing like pros, I was taking vitamins and drinking more water, and I felt like a new person.
My second daughter was a much easier transition, because I knew what to expect. I made sure I was drinking more water, didn’t stop taking my vitamins, and even though I had a wild toddler running around, it was a better experience. I’m actually writing this just a couple days before she is seven weeks old, and even though she’s basically been cluster feeding since birth (seriously, how does one small baby eat that much?!) it’s been so much better.
When they’re around three months old, it’s amazing – they suddenly go from a sleepy, wrinkly newborn to a plump, happy infant. One day, you look at your baby and it will hit you something has changed – and you’ll realize you’ve survived the fourth trimester.