The Importance of the Fourth Trimester
For a long time, we have viewed the postpartum period as the first six weeks after a baby is born. But really we should be talking about the importance of the fourth trimester. At six weeks you are discharged from your midwife or OB’s care. You are also told you can be intimate again, and that you are “back to normal”. Six weeks is a good milestone and many new families start to feel like they are getting the hang of things around that time. But that doesn’t mean that the healing and adjusting are done yet. That’s why these days we talk about the fourth trimester instead.
The fourth trimester is exactly what it sounds like – the first three months after having a baby. Humans give birth much earlier in terms of development than other mammals and so those extra three months are vital for both you and baby.
Physical Recovery
Just because you have been discharged from medical care does not mean that you are fully healed. There are many factors that contribute to healing, some of which will take months to get back to “normal”. Some things you can help along, but many things take time.
Nutritionally we always recommend staying on your prenatal vitamin as long as you are making milk. These help your body to regain some of the nutritional stores used during pregnancy and lactation. This includes calcium, iron, B vitamins, folic acid, and more. All of these are important for your own health. You should also focus on foods that are rich in nutrients such iron rich foods and a wide variety of fruits and vegetables. As tempting as it is to reach for the coffee pot, a well-balanced snack that includes protein and fibre will probably give you more energy than another cup.
Intimacy is also back on the table once you have been cleared medically, but that doesn’t mean you have to jump straight into bed. Consider your birth and whether you feel physically or emotionally ready for sex. If you had stitches you may still feel some tightness and if you had a caesarean you might still be uncomfortable. You may also be feeling touched out or stressed and just not in the mood. All of that is normal. We love seeing clients work with pelvic floor physiotherapists to help ensure that a return to intimacy is a positive experience.
Emotional Recovery
Birth doesn’t always go as planned and parenthood is often harder than people expect. Hormones run wild and can effect even the most even-keeled individual. It is normal to experience emotional upheaval and upset in the weeks and months following birth. The first three months are often the hardest because your hormones are still changing significantly. Emotionally you may feel burnt out, touched out, like you just need to cry, or like maybe you weren’t cut out to be a parent. All of those things are completely normal. Usually sometime in the third month, your hormones will start to level out as your milk supply stabilizes and that can help with some of the difficult feelings. But if you are struggling at the six week mark, we do recommend speaking with your doctor about postpartum mental health concerns and consider seeking professional support.
Your Baby
Your baby is born much earlier in their development that would be ideal, the price we pay for walking upright! That means that in the first three months of life, they should really still be in the womb. It is great to treat this time as though they are – baby wearing, skin-to-skin, dim lights, and calming sounds. This is a time for family bonding. Let your baby hear your voice and your heart beat, let them smell your skin and feel your warmth.
The 5-5-5 Rule
The 5-5-5 rule isn’t a hard and fast rule at all, but it a great suggestion for how to approach your first few weeks. It stands for FIVE days in bed, FIVE days on your bed, and FIVE days near your bed. What does that mean practically?
For the first five days you are home you should be in bed as much as possible. Obvious get up for hygiene purposes, but ideally there is someone who can bring you your food, refill your water bottle, and change baby’s diaper.
The next five days you can be a little more active but still mostly on your bed or resting. This can be a good time for close friends or family to visit, but only if you don’t feel like you need to entertain them!
And for the last five days, stick close to where you and baby are sleeping. You can get up and move around, lift and change baby yourself, or prepare yourself a snack. The goal is still to rest and recover, but to start introducing gentle movement back into your day.
The 5-5-5 rule is one way for new parents to set boundaries and expectations around the early postpartum period. It also sets parents up for a healthy recovery and stable fourth trimester.
The most important thing to remember is that it takes time to feel like yourself again. More time than most new parents are given. The importance of the fourth trimester gets downplayed because too often we expect new parents to jump right back into all the same activities and responsibilities, just with a baby. But bodies don’t work like that. And neither do babies.