What is this about a fourth trimester?
You did it, mama! Your precious baby is here! So, now what? Welcome to the fourth trimester. There’s a common theory that babies need about three months to adjust to being out in the world. Well, mamas need recovery time too. Whether you had a vaginal birth or a C-section, your body just went through a very intense experience. It needs to rest and heal while you figure out caring for this tiny human and the new shape of your family. There are resources, like postpartum doulas, who can help during this important time. Experienced with baby care, doulas can show you the ropes or refresh your memory, while supporting your physical healing and emotional balance. Postpartum doulas can also help with breastfeeding, meals, light housework, caring for older kids, and more.
Vaginal Birth Healing
Yes, there’s blood. After birth, your uterus sheds its lining, so it’s normal to see heavy bleeding and blood clots for several days, and lighter bleeding for up to 6-8 weeks. Too much blood is serious though. If you’re soaking more than one pad per hour, if your bleeding gets worse, or lasts longer than 8 weeks, call your doctor or midwife.
After pushing out a baby, your vagina and perineum will probably feel all kinds of sore and swollen. If you had a vaginal tear or an episiotomy, you may also have stitches. Warm baths, ice packs, and witch hazel can soothe the area, as well as gently cleaning with a squirt bottle. Ibuprofen or Acetaminophen can help with pain and are considered safe for breastfeeding. Watch out for any signs of infection like severe pain, increased swelling or redness, or a fever.
You may have cramping as your uterus shrinks down again, and, ahem, ‘going’ might not come easily. TMI, we know, but this is a real thing to navigate! Eat your fruit/veggies and take stool softeners if necessary to get things moving.
Feeling more like yourself again? Wait until your 6-week health check up before using tampons, having sex, or exercising. Bouncing back quickly is also not the reality for many women. So, ignore those Instagram snap back photos of other moms and take your time.
C-sections are a major surgery, so healing will likely take a bit longer. Your doctor should explain how to care for your incision, keeping it clean, and avoiding pressure or strain. Stay on top of your pain with regular medication, and try ice packs for extra relief from pain or itching. Watch for infection warning signs like pain getting worse, your incision becoming red, swollen or pussy, or a fever.
You’ll have vaginal bleeding too for 4-6 weeks as your uterus does its shedding thing. Driving will be off limits for a while and also bathtubs. When you shower, run soapy water over your incision and gently pat it dry. If you’re breastfeeding, your doula or lactation consultant can help you find a comfortable nursing position.
Is everyone telling you to rest while you’re caring for a newborn? We know, it’s tough, but do your best. Stay off your feet until you feel ready for walking, and don’t lift anything heavier than your baby. After 4-6 weeks, you should be moving more easily, but listen to your body, and if it hurts, slow down.
Got Too Much Milk?
When your breast milk comes in, there might be a lot! Many mamas start out producing more milk than baby needs, which can lead to engorgement. Full, hard breasts, with tightly stretched skin – oy! Meet your breast pump. Pumping should soften your breasts, but try not to empty them completely, which triggers more production. If you’re breastfeeding, engorged breasts may be too hard for baby to latch, so pumping briefly beforehand can help. Also try a shower or warm towel before nursing and gentle massage from the chest toward the nipple while baby feeds to move milk through the ducts. The milk factory works through supply and demand, so things should even out as long as baby is nursing well.
If you’re formula feeding, your breast milk will usually dry up within 7-10 days. Ice packs can help reduce pain and swelling, as well as pumping small amounts. Wear a supportive bra, but don’t “bind” your breasts tightly, which can cause problems.
Watch out for plugged ducts (hard, painful spots on the breast), as well as hot, red patches, fever, or flu symptoms, which can be signs of mastitis. If engorgement lasts longer than a day or two, or your baby is having nursing issues, talk to your doula or lactation consultant.
Feeling weepy, moody, or mad? Say hello to postpartum hormones. After birth, your body is going through major hormonal shifts, which can bring mood swings and anxiety, hair loss, acne, and night sweats. Just fun times with the baby blues. You’re also adjusting to first-time motherhood or a growing family, caring for a newborn 24/7, and not getting much sleep – feeling overwhelmed is so normal. Be patient with the emotional rollercoaster. Things usually get better within two weeks as your hormones calm down. Also, your life has changed, and it’s okay to love your baby and still feel scared, disappointed, or sad at times.
There’s a big BUT though. If it’s been more than two weeks and you’re still feeling sad, hopeless, angry, or disconnected from your baby, if you’re crying a lot, or having sleep issues, extreme anxiety, or intrusive thoughts, don’t ignore any of this. Postpartum depression and other mood disorders after birth affect millions of women. There are treatments that work, so talk to your family, your doula, and your health care provider, and get help as soon as possible.
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