The Fourth Trimester
We often don't hear about or discuss the 4th Trimester. This is the 12 week period immediately following a mother's delivery. As you probably knew this postpartum recovery won't just be a few days. Recovery can take months. Some new research suggests it can take up to a year for the body to fully recover. During this time physical and emotion changes take place for the mother and baby as the duo adjusts to this new life. Katie and Amanda had very different pregnancies, deliveries, and recoveries. No matter what your birthing experience looked liked; complicated or "easy", cesarean birth or vaginal delivery, hours or days of labor your body will need time to recover because regardless it experienced trauma. Although we often think of our bodies recovery we don't think about how our mind will need time to adjust. Hormones will be ever changing during the 4th trimester. Lack of sleep mixed with these hormonal changes may make you more emotional and thinking less clear. Try to remember this will all pass in time.
Amanda's Vaginal Delivery Recovery
It's incredible that we spend so much time hyper focused on getting pregnant, pregnancy trimesters 1-3, then taking care of a newborn, and never once think about our own bodies recovery! We just birthed a human for crying out loud! Of course we are going to physically and mentally need to adjust to our new life, but no one seems to discuss this. Everyone's birthing experience is unique. After delivering Sonny I felt incredible! I was extremely fortunate to feel as good as a I did and attribute my "quick" recovery to having a positive vaginal birthing experience. For more information you can read all about my pregnancy and delivery on the BLOG. I can still remember how relieved I felt after having him. It was like a weight was lifted off my shoulder. Maybe it was my fear of labor and the relief of having a healthy baby that made be feel so positive. Quite often I found my pregnant self fixated on scheduling a C-section. The control and predictability was very appealing to me, but I knew the recovery would be more challenging. Many of my pregnancy side effects disappeared instantly too. Most of my food aversions GONE. My painful right foot plantar fasciitis GONE. Most of the aches and pains of carrying around extra weight magically GONE. A positive mindset and fixating on how my body felt better really helped me during my recovery. But even though I had a textbook 4th trimester recovery there are defiantly things I wish I knew more about and had prepared for.
The key to thriving and not just surviving the 4th trimester is to be prepared. For us that started with packing our hospital bags. Although you want to be prepared seize the opportunity to stock up on hospital items. There is NO SHAME in packing an additional (empty) bag to stuff full of postpartum care essentials and baby items. Take EVERYTHING... nipple ointment, nursing pads and shields, pump parts, diapers, baby wipes, formula, pads, mesh underwear, ice packs, witch hazel pads and spray for those pesky hemorrhoids, peri bottles because believe me you will use it every time you pee for weeks. Make sure to visit our BLOG post for more tips on what we packed and took! You can always stock up on those items if you are a concerned, control freak like myself but I had everything I needed from the hospital (and then some) so I was able to return the unopened items to Amazon and Target. Keep your receipts. The Frida Mom Postpartum Recovery Essentials Kits (Labor & Delivery and Postpartum) have many items you'll want around when recovering from a vaginal delivery. My saving grace was mesh underwear, witch hazel pads, peri bottle, ice packs, and MIRALAX. TMI: I probably took Miralax consistently for up to two months after Sonny's birth to help with constipation and hemorrhoids. I highly recommend having some on hand before your first postpartum poop along with that peri bottle when you pee. Trust me. You're bound to have some tearing, stitches and/or hemorrhoids from pushing. After birth your uterus will shrink and you can experience some abdominal soreness and pain. Mine felt like menstrual cramps and intensified when I breastfed/pumped. I also utilized sanitary pads for about 10 days after giving birth for bleeding. I may have had some spotting after that, but nothing concerning. Make sure you DO NOT use tampons since this can result in a bacterial infection.
Everyone's recovery is different and mine had some random and weird quirks. I'm sure yours will too. My aversion for vegetables vanished, but I gained some new ones. I'm almost two years postpartum and water is just starting to taste good again! You know when you are sick and water tastes funny? Well that's how it has tasted since I got pregnant. I've been using an excessive amount of lemon juice to drink it since I don't typically drink juice, sparkling water or pop. I'm also a pescatarian who is now randomly weirded out by seafood. My love for sushi and grilled octopus is no more. Oddly, most pregnant women get a chicken aversion and that never happened to me and I actually craved chicken wings. Don't worry I resisted the urge and stayed the pescatarian course!
It's no secret I did not love breastfeeding and my biggest postpartum challenge was pumping. I have an entire BLOG piece describing my experience. Since Sonny had a tongue tie I solely pumped, but to my surprise I had no clue how to use my pump! I called my girlfriend with three kids in a panic for help!!! Your body just spent 10 months growing and birthing a human. The decision to breastfeed is selfless. Whatever you decide is best for you, your baby, and your family remember to listen to your body! There is no shame or guilt in using formula.
Hair loss is something I anticipated in the 4th trimester. Around 3 months postpartum it began to fall out in clumps which I was prepared for. What I didn't expect was for the texture to change, to have periods where it completely stopped growing, and the worst was the horrible outgrowth. The struggle was real and not attractive. There was nothing I could do to tame that pesky outgrowth. It took 18+ months for my hair to get back to "normal". I would advise to keep taking vitamins to help with postpartum hair (and nails)!!! When you are pregnant you most likely won't lose any, but don't worry your hair will make up for it after baby is here.
I know my recovery would have been vastly different if my birthing experience had been different and/or if I had a C-section. The best advice I can give is GIVE YOUR SELF GRACE. Listen to and love your body. You had the ability to bring life into this world. That is remarkable! Forget social pressures about loosing the baby weight and bouncing back. Nicole Conteduca, a registered dietician, wrote an amazing piece for the blog in regards to loving your postpartum body. If you need a friendly reminder to love yourself make sure to check it out on the BLOG. I'll be the first to admit that I was disheartened to see my postpartum belly. I left the hospital very much still looking pregnant. Mentally I had to shake it off and be grateful I packed a pair of maternity leggings that fit! So don't store your maternity gear right away. You'll want to wear that comfy and stretchy maternity gear in the 4th trimester. Most of my 4th trimester recovery was physical and not mental. I was extremely fortunate to not experience postpartum blues or depression becasue it is very common. Try to enjoy the moments, but remember that it's okay not to love every second. Breastfeeding is hard. Sleepless nights are a nightmare. Adjusting and figuring out this tiny new human takes time. Social media is fake. The "influencers" and celebrities painting a pretty picture all the time are lying. Take each day as it comes and find yourself some good mom friends to lean on.
Katie's Cesarean Delivery Recovery
Delivery for me did not go as expected. Don't get me wrong, women can have a positive experience when it comes to cesarean deliveries. I remember visiting my best friend after she gave birth to her second child and it was like night and day from her first cesarean. She was in a euphoric state unlike myself who was in a groggy, swollen haze trying to wrap my head around the past 34 hours of labor. You can read all about my COVID delivery on the BLOG!
For weeks after delivery I felt my organs adjusting back into place and had tons of gas bubbles. I didn't want to take the pain medicine I was prescribed since I needed a clear head while caring for the baby. Amanda felt a weight off her shoulders and relief and physically I felt the complete opposite. I felt extremely anxious. I myself did not feel 100% recovered and now I am trying to navigate life with a baby. I chose not to breastfeed after a difficult few days however your decision doesn’t mean your milk stops coming from coming in. When it did my boobs instantly went from A cups to Ds. I had extreme pain and tenderness for a week until my milk went away. Wearing a tight sports bra everyday and hot showers helped the discomfort and eventually they went down.
I didn't eat as much as I should have been eating and seemed to substitute meals for cups of coffee. I lost my appetite early on which could have been a reaction to being overwhelmed and anxious. My food aversions did not subside and two years later I still detest chicken! Physically my c-section scar seemed to take forever to heal. I remember my first checkup post partum the doctor said wow you healed beautifully and I looked at her going what!? You can still see the scar, that's when she reminded me that scar represents strength...she gave me the you're a badass speech. To this day, I look at it differently. It has faded significantly over time but it’s still there, changing from a darkish purple to white.
Once we got home I quickly came to find that everything I had imagined or thought I would be prepared for I was not. You can have all the newborn furniture, equipment, accessories but it truly comes down to how your baby reacts. When you make the decision not to breastfeed, you think lets try some formula. Remi reacted poorly (gas bubbles and poor digestion) to the first 4 before we settled on one that worked for us. She didn't take to the first 3 brands of bottles we got but settled on the 4th one we tried. I am suddenly seeing a pattern, she was born on 4/4 so maybe the universe was playing a cruel joke on me. We had all the swings and all the loungers, none of them seemed to keep her asleep or from crying. You truly cannot plan for anything and should be ready to adjust and ride the waves.
It's not unusual to have a lot of bleeding in postpartum and I was not the exception. Make sure you stock up on pads since you are not able to use tampons. Ice Maxi Pads can help relief pain even if you did not deliver vaginally. The mesh underwear was the absolute best, they are large and oversized so they rise to above your belly button which wouldn't come into contact with my healing scar. It can take several weeks for the bleeding to go away. I remember asking numerous friends how much was ok, at times I felt like I was going bleed out, yes I am somewhat of a hypochondriac.
You wont be brining sexy back anytime soon. Most likely your doctor will clear you at your six week follow-up appointment whether you deliver vaginally or by cesarean. A return of intimacy can be comforting to a new mom. Connecting with your partner is an important part of this healing journey and your relationship. I've spoken with moms who differ in opinion. Sometimes postpartum intimacy comes with hesitation and worries of body image, discomfort and unexpected pregnancy (yes you can become pregnant early in your recovery). Women can experience a low libido after delivery and even have extreme dryness. If you are someone who doesn't feel comfortable after you get the "all clear" try starting out with a dinner date or cuddling. Your body just went through some radical things, give yourself time to heal. Amanda and I both gave birth in early spring, we were lucky to enter the warm summer months and became addicted to going on stroller walks. We found the exercise, movement and increased blood flow helped in our recovery and mindset.
Pelvic Floor Recovery & Scar Therapy
We both know people that have personally benefitted from pelvic floor recovery and scar therapy. To be honest neither of us knew we had these options...the things you learn from drinking wine with fellow moms!! Pelvic floor physical therapy is recommended during postpartum and encourages pregnancy wellness. This is a tailored therapy that targets the pelvic floor muscles, ligaments and connective tissues. There are a long list of benefits including incontinence of bladder, organ balance, clear pelvic congestion, and aid in tissue repair. Therapy has also been known to benefit sexual function postpartum. Scar tissue therapy has a few different approaches, some being less invasive than others. Postpartum scar tissue massage can reduce discoloration, flatten scar and reduce numbness.
Again, there is so little emphasis in on a mother's recovery in the 4th trimester because everything is focused on baby. Is baby eating enough? Counting daily pee and poop diapers becomes all consuming. Tracking babies schedule and having the best baby gear is a top priority. If we would have been knowledgeable about these options when we were pregnant we think we would have seized this opportunity to improve our recoveries. The few people we know who sought out these treatments swear by them.
Greatest piece of advice, throw out all expectations! Your body and mind don't have a timeline. Try not to "plan for everything" cause that baby is going to write their own rules and you need to figure out how to fit in the puzzle pieces and make it work. Allow yourself grace and rest to help adjust to your new life. Even though your body and mind is bound to go through changes if something does not seem right seek professional and medical help. Make yourself and your physical and mental health a priority. Our goal is to share our experience in the hopes that is makes yours a little bit better!
XO - Katie & Amanda