The Fourth Trimester: Do You Have A Post-partum Plan?

For most of us, when we fall pregnant with our first baby, our thoughts turn to the baby and birth. Very seldom do any of us consider what the aftermath of birth will look like: How will it be having a baby? How will our day to day life look? What will change? Who will look after the things that we’ve been taking care of? 

Modern western women are often expected to ‘bounce back’ and even go back to full-time work within a few days or weeks of giving birth. Proponents of the fourth trimester argue that it benefits no-one to send new mothers back to work so soon. They argue that caring for new mothers enables mothers to care better for their babies, which results in better care all around.

What is the ‘fourth trimester’?

Pregnancy is divided equally into three trimesters, and the so-called fourth trimester is the three-month period after birth. During these weeks, new mothers are often quite vulnerable, recovering from birth and adjusting to their new role as a mother while getting to know their baby.

In many cultures, there is a period of around 30 days where women tend to stay at home. In Japan, it’s known as “sango no hidachi”; in Korea, it’s “sanhujori”; in Latin America, it’s “la cuarentena”; in India, it’s “jaappa” and in Pakistan, it’s “sawa mahina”. There’s a term for it — and an allowance for it — in so many languages and cultures, and yet modern Western women, by contrast, get just a few days, weeks, or at most a few months, with their babies.

How does a fourth trimester help?

When we focus on the welfare of the baby to the exclusion of the mother, no-one benefits. Mothers, especially new mothers, are frequently overwhelmed and underprepared for the realities of motherhood. 

By creating a fourth trimester, we are attempting to create a space where mothers and babies are cared for in a way that helps the whole family adjust to their new member and provides new mothers with adequate support.

A new wave of professional has even come into being called postpartum doulas. A pregnancy and birth doula cares for the wellbeing and advocates for the mother, while postpartum doulas do so during the period after birth instead of during birth. 

What should a fourth trimester cover?

Lots of things become overwhelming while recovering from birth and caring for a newborn. Simple things like cooking, feeding yourself and your family, doing the dishes and the laundry, and even finding time to sleep. 

In those cultures who practice a post-birth ‘lying-in’ period, new moms are expected to stay mostly in bed, resting and recovering from birth, learning how to feed and care for their baby, and getting to know their new baby. Of course, you’re not on bed rest — unless prescribed by your doctor — but most new moms relish the chance to just rest and get to know their baby. 

How to plan for your own fourth trimester? 

In past generations, this kind of period was expected and the village would take care of things like meals, cleaning, childcare and so on while a new mom was ‘lying-in’ with her new baby. These days — especially in this time of social distancing — it may be helpful to plan for this yourself. 

You could, for example, set up a rotational meal roster using something like Meal Train. With enough people participating, no one person is responsible for more than a couple of meals throughout the period and the easy setup and reminders make it a no brainer. No matter who you are and how many children you have, a meal is always welcome in the postpartum period!

If you have friends or family that are further away, you could request a cleaning service to take care of your home or a nanny to take care of older children. Of course, partners can also take on this mantle, but a nanny or a cleaning service can allow both parents time to bond with their new baby. 

Does a fourth trimester help with mental health?

In the US alone, 1 in 7 women is likely to experience postpartum depression in the year after giving birth. There are, of course, many factors that contribute to this, but overwhelm and a lack of support are definitely a factor. 

Additionally, if you have set aside a period of three months — a fourth trimester — you are aware that it can take time to feel ‘normal’ again after having a baby. You are more likely to be aware of fluctuations in your mental health and wellbeing and, if you have support, more likely to seek help from a mental health professional earlier. Isolation and trying to do it all is far, far more likely to result in postpartum depression.

Can it help with physical health?

No matter how you come to have your child, it takes time to adjust afterwards. Even adoptive parents will need time to adjust to the lack of sleep and extra anxiety that often comes with having a small baby. 

In a fourth trimester, you are given space and time to rest and recuperate, whether that is from a vaginal birth, a Cesarean section, or the lack of sleep that comes from being woken multiple times each night.

Planning for postpartum can also mean lining up a lactation consultant if you plan to breastfeed, or a physiotherapist to assess your pelvic floor and abdominal muscles after carrying a baby. It can simply mean having the time and space to feed yourself regularly, rather than pouring all your energy into your new baby. There are many aspects to physical health and they often just require time, space and energy.

How to make it happen

In order to make a fourth trimester or postpartum plan happen, especially in these days of social distancing, you have to be willing to communicate. As soon as you know that you are going to have a baby, start recruiting help. Talk to your partner, your parents, and your reliable friends. Engage professionals where appropriate and financially manageable. 

With everyone, lay out your expectations, what you would like to happen and ask them where they can help. Most people want to help when they hear a friend or family member is having a baby, but they just don’t know how to provide it.. Give them the opportunity to help you in ways that work for you.

Sources:

1. Major Care Doulas: https://www.instagram.com/Majorcaredoulas/

2. Scope of Postpartum Doulas: https://icea.org/wp-content/uploads/2015/12/Role-Scope-of-Postpartum-Doula-3.pdf

3. Meal Train: https://www.mealtrain.com/

4. Postpartum Depression Statistics: https://www.postpartumdepression.org/resources/statistics/