The weeks and months following birth can feel chaotic for women. Like babies, mothers also need to adjust to their new life in the fourth trimester. Many of these adjustments are physical, as the body recovers from birth and prepares to feed the newborn. In some countries, women are confined to their bed or home for over one month, while family members tend to their emotional and physical needs. This time allows for a full recovery, which prevents post-birth complications.
Here in the Western world, we don’t make as many allowances for the time needed to recover. Many new parents are living at a distance from their families, and there is a lack of support. There is also the expectation that women will be “back to normal” within a week of the birth. New mothers can feel pressure to clean the house, get back to an exercise routine, or attend events and activities. None of this is helpful in the fourth trimester, and can set women up for physical or emotional problems.
Some of the symptoms women can experience include:
- Bleeding (or “lochia”)
- Sore bottom after vaginal birth (especially with tearing)
- Abdominal soreness (as internal organs and muscles shift back into place)
- Engorgement (when breasts become swollen and tender)
- Hemorrhoids
- Loose ligaments (the hormone relaxin continues to be released, making joints loose)
- Baby blues
- Fatigue
- Hair loss (this tends to occur later, around 3-4 months postpartum)
Women can help to ease their transition in the fourth trimester by preparing for these symptoms, and proactively gathering supplies and resources to have on hand.
Rest
New mothers are often told to “sleep when the baby sleeps.” This is great advice….if the baby actually sleeps! But many times, given baby’s own adjustment in fourth trimester, sleep can be difficult. Throw in nighttime feedings, and new mothers can get exhausted. This is why staying in bed as long as possible (for at least 7 days post-birth, and periodically for longer) can help promote rest and relaxation, even if sleep is hard to come by. Partners can help by changing diapers, or rocking the baby to sleep if they’re fussy.
Bed sharing (following safe guidelines) is an excellent way for both mom and baby to get more sleep, but this is not always feasible or desirable. Having the baby “room in” is recommended by Public Health, and means that the mother does not have far to go when she needs to tend to baby.
Activities should be kept to a minimum for at least 3-4 weeks after birth, and it’s normal for mothers to feel unable to get out of the house (except for medical appointments) for close to 6 or 7 weeks postpartum. Proper rest is the best way to promote healing, lessen bleeding and prevent exhaustion.
Support
Parents need extra support in the weeks following birth. Partners often only get 1-2 weeks off after the baby is born, and new mothers are left alone when they go back to work. If inviting family members to stay is not realistic, parents can consider hiring outside support – postpartum doulas can help families adjust by providing light housekeeping, breastfeeding support, and newborn care tips. Parents can also consider hiring a house cleaner, dog walker, or daycare provider for older siblings. If having people come into the home is not desirable, parents may wish to consider asking friends and family to help prepare freezer meals and snacks. It takes a village to raise a baby, and parents shouldn’t have to do it alone!
Another way to prepare for support is to make a list of care providers’ email addresses and phone numbers before the birth. That way, it’s easy to make a quick phone call to someone in the event that help is needed. Mothers can contact lactation consultants before the birth, so that they have someone on-call for breastfeeding support. Other important numbers will include doctors, midwives or doulas.
Supplies
There are a number of supplies to have on hand after birth. Mothers will need large pads or adult diapers to manage their postpartum bleeding. A Peri bottle (or just a water bottle with a squirt lid) can help with stinging or burning during urination if the woman has received stitches. Some women prepare “frozen pads” (menstrual pads squirted with water and put in the freezer) to help with swelling. For engorgement, women can use a warm wash cloth to massage their breasts or can apply ice packs for 10 minutes at a time. Green cabbage leaves placed inside the bra can also reduce swelling of the breasts, although should not be used for long periods of time. Constipation after birth is common, and can lead to hemorrhoids. Women should be advised to take stool softeners (not laxatives,) drink plenty of water and eat as much fibre as possible. Advil and Tylenol can help deal with any aches and pains she may be experiencing.
In terms of eating and drinking, advise your clients to eat and drink as they would have during pregnancy. They will be very thirsty and hungry if they are breastfeeding, as hundreds of calories are burned each day making milk! Most women report that their senses are heightened after birth, and warm, comforting meals can taste even better than normal. Families should have pre-made meals and snacks on hand, or can consider getting a meal delivery service for a couple of weeks.
Take it slow
These first few weeks of a mother’s life are filled with joy, panic, and exhaustion. It’s important that women listen to their bodies and know when to slow down. Some women are ready to venture out after a couple of weeks, whether it’s a trip to the supermarket or a walk around the block. However, it’s also very normal to feel overwhelmed being out. Women should be advised that intense physical activity is not recommended in the first 6 weeks after a vaginal delivery. That said, gentle exercises (ones that don’t strain the core or pelvic floor) can be beneficial for a mother’s wellbeing. SHE needs to take the lead, and know when it’s time to slow down.
Did you know that we offer a “Fourth Trimester” workshop where we will share with you what you REALLY need to know in the Fourth Trimester? Led by a midwife and experienced mom to three children under the age of three you will leave this workshop feeling prepared for anything that may come up!
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