Preparing for the Fourth Trimester

“When we remember that the postpartum period seems longer than we think it should be, perhaps we can give ourselves a break. We can adjust our expectations, and instead of insisting on our familiar, faster pace, we can soften into a slower rhythm, so we can truly relish what this time has to offer.” ~Kimberly Ann Johnson

Fortunately, there are a growing number of resources available for mothers and new families around preparing for the 4th trimester and centering a mother’s healing journey during those first months postpartum. I’ve written two other articles on postpartum healing and why it’s such a crucial time to rest and get support. I’ll include those in the resources section of this post and I encourage you to read those if you’re uncertain as to why this is important in the first place.

The knowledge and wisdom I’ve gathered in this area comes from my Chinese Medicine studies, personal experience, experience in serving mothers and the work of Kimberly Ann Johnson and her book “The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality.” I contributed to the book and was also able to read it before my first baby was born. It’s essential reading for mothers, new families and all those who care about them!

Here I’ll include the 5 universal postpartum needs, which comes directly from Kimberly’s book and I’ll talk about how to get those needs met during the postpartum time.

5 Universal Postpartum Needs

Every new mom basically needs what a new baby needs. These needs are fundamental and can seem so simple, yet they are hard to obtain day to day in modern society, especially with a newborn. These needs are universal in that you can find them in various traditional postpartum practices and healing traditions. They are:

  1. Extended rest period — This is a period of time ranging from 20-60 days when the mother is spending most of her time in bed with her baby resting and allowing her body to heal from pregnancy and birthing.
  2. Warm, nourishing and nutrient dense food — This is what allows a mother’s body to heal any birth injuries, produce ample breast milk and restore her own mineral stores. This also protects from future illnesses by reinforcing the mother’s constitution, rebuilding tissues and building strength.
  3. Loving touch — Various cultures have different postpartum body care practices ranging from belly binding and mother warming to oil massage, vaginal steaming or a closing of the bones ceremony. All focus on warmth, containment, nourishment and healing.
  4. Companionship from wise women — Since childbirth and postpartum are rites of passage, skilled witnessing and reflection facilitate any emotional or psycho-spiritual healing or integration that needs to take place. Wise women will fortify a new mother’s sense of self and ability to care for her newborn, while also giving her space to express her deepest insights or fears.
  5. Contact with nature Nothing takes you into your animal self more than birth and early mothering, at least that I have personally experienced. Nature is the great equalizer and reminder that the slow, languid and sometimes mundane ways of postpartum can also be revealing, beautiful and rich with wisdom.

So the question becomes, how do you set yourself up for meeting these needs in those first days and weeks postpartum?
I’ll be honest with you, it’s not easy! However, it is possible! It is so worth it and every step you can take is valuable, so even if you feel like you can only do a few things to prepare, the benefits will be long-lasting. Every bit counts, truly. I encourage you to be brave in asking for and receiving support throughout the process.

Postpartum Preparation for the Universal Needs

Rest

To be able to rest in those first weeks postpartum, you need to consider who will be taking care of your normal daily activities (cooking, cleaning, other chores, caring for other children etc). If you have a partner who is able to have time off work, he or she could fill in for some of this. However, they are also going through a transformation and may want to spend as much time as possible bonding with you and the new baby. So, this is where other family members can come into the home to help with specific tasks or you can hire a postpartum doula (even coming once a week is better than not at all!). A postpartum doula is a great resource for navigating the early weeks postpartum and can usually help with a variety of things, including: meal preparation, laundry and light cleaning, baby care questions or concerns, emotional support and processing and even breastfeeding support!

To make any of this possible, I recommend writing a list of what you typically take care of in your home day to day. Write it all out, even the small stuff like watering plants, taking out the trash, etc. This will help you see that yes indeed someone else needs to takeover these items for at least a few weeks time. If you have family who wants to help and who you feel comfortable having in your home for short periods of time, then you can ask or assign them tasks for when they visit. Another option is having one family member, perhaps your mom or an aunt or even a friend, stay with you or come daily with the understanding that they are caring for you by taking care of the items on your list so you can tend to your baby and your body can heal!

Getting additional support is essential to ensure you can actually rest after your baby is born. I realize some women and families are not comfortable with having visitors at all. I respect that, especially if setting boundaries with family members is challenging and you know your request for short visits won’t be respected. This is where a postpartum doula can be so valuable! I still encourage you to consider how it could feel to know someone is there to take care of you and your home, even if it’s just a few hours a couple times a week. It can truly make a difference!

Food

All of the postpartum needs are important; however, rest and nourishment are really first and foremost if you ask me. There are several creative ways to ensure you have nourishing, nutrient dense food available for the early weeks postpartum.

I won’t go into details in this article on what foods are typically recommended for postpartum healing but across cultures generally you will want to focus on easy to digest, warm, nourishing food like soups, stews and slow cooked meals with animal protein and fat. Of course there are great vegetarian options out there as well, especially in the Ayurvedic tradition; however, collagen and fat found in animal products are very beneficial for healing. Minimizing inflammatory foods is also recommended, including gluten grains, dairy (raw or butter may be an exception), sugar, soy, alcohol and caffeine. You can find a great postpartum cookbook with more detailed recommendations here.

Here are my suggestions for ensuring you have healing food around during the 4th trimester:

  • Setup a meal train. Someone can do this for you at your baby shower or mother blessing. Be specific in your requests. For example, include a few example meals that you like and specify a drop off time of day. Let people know this doesn’t necessarily mean they will be able to visit or see the baby.
  • Consider getting a meal delivery service. There are some great women owned businesses popping up that cater specifically to mothers. Talk to local birth workers or doulas to find resources in your area.
  • Prep and freeze food while pregnant! I had trouble with this one during my first pregnancy but now that I’m more settled into cooking for a family, we often batch cook anyways. We have been able to freeze various soups, stews, sauces and broths a little at a time. This has been fairly stress free and easy to do. You can also set aside a weekend during your third trimester and invite a few friends over to cook and freeze food. I like freezing in quart mason jars, which fit nicely in a standard sized freezer.
  • Create a standard grocery list that someone could use to check your fridge and pantry and go for you to pick up the necessities!

Touch and Body Care

There are so many ways to meet the last three universal postpartum needs and it will vary greatly depending on your own cultural heritage, what’s accessible in your area and ultimately what’s a priority for you as a unique individual. Again, I’ll reiterate here that a postpartum doula is a fantastic resource for helping you create a postpartum plan for yourself, while also offering emotional support and potentially body work as well.

Beyond rest and good food, there are various ways to support the physical body for healing in those initial weeks. Here are some possibilities:

  • Work with an acupuncturist who is skilled in postpartum care and have them do a home visit for you or teach you how to do “mother warming.” Mother warming is a Traditional Chinese Medicine practice that involves burning moxibustion (an herbal blend consisting of mainly mugwort) close to the skin for warming and circulation. This is traditionally done on days 4-7 postpartum to support the uterus to return to it’s normal size and complete the bleeding process.
  • Use a belly binder to support your abdomen and pelvic floor recovery and function. You can start belly binding within 24 hours of a vaginal birth if desired. I recommend working with someone who is skilled in traditional Bengkung belly binding or use the AB system from Bellies, Inc. In some cultures, it is worn daily for up to 6 weeks; however, I found that wearing it for 3-4 hours a day was often enough and I didn’t feel the need for it for 6 weeks. I was surprised by how quickly my waistline, rib cage and low belly changed with regular use!
  • Vulva and vaginal care in the form of herbal sitz baths and vaginal steaming! I wrote a whole blog post dedicated to this topic which you can read here.
  • Other great body based therapies that are gentle and nourishing for a postpartum body include: Ayurvedic oil massage, craniosacral therapy, Mayan abdominal massage or holistic pelvic care. Again, please reach out to local doulas and midwives for resources in your area.
  • Medicinal teas, herbs and supplements can be useful as well. Work with a holistic practitioner in your area for individualized care or reach out to me for a virtual session.

Companionship and Emotional Support

In regards to having the right emotional support and witnessing, I encourage you to consider who exactly you will want to visit you during this vulnerable time and who you can truly rely on for deep listening and support as it’s needed. Having close female friends or relatives that love and support you can be very healing and grounding.

You will probably find that you especially rely on other mothers in your life during this time, including your own if that’s possible. Make a short list, even if it’s just a note on your phone, of who you can call, text or reach out to for support. It may sound too simple, but the reality is during moments of overwhelm we can often forget that we do have people around us waiting for us to ask for help! Before baby arrives, you can also look for local mental health resources specializing in postpartum support, whether it’s a free support group or a professional therapist.

Contact With Nature

Setting yourself up with good food, plenty of rest and some form of body care puts you in deep contact with your own experience, which is grounding and healing. You are an expression of nature and connecting with yourself is a reminder of this.

To bring even more contact with nature into your postpartum space, consider some of the following possibilities.

  • Buy a few house plants before baby arrives and put them near areas you anticipate spending time breastfeeding or resting.
  • Be sure to open curtains or blinds at least once a day in an area where you have a view of the sky, trees or a green space.
  • If it’s possible to sit outside for breastfeeding and still be adequately warm, go for it!
  • Working with herbal medicine, infusions, vaginal steams, sitz baths, aromatherapy and healing foods are all ways to bring elements of nature into your system.
  • Buy yourself flowers or ask someone to bring flowers when they come to visit.

Connecting with your natural environment is widely accessible and deeply regulating and healing. Don’t underestimate these small gestures and their ability to offer you something profound during your postpartum time.

Putting it together

Here I’ve given you lots of ideas around how to offer yourself healing and nourishment in the fourth trimester. It does take some planning and preparation to get the universal needs met but it is so worth it for your long term health and vitality, as well as your child’s. If you feel overwhelmed by all that’s here, focus on one action step you can take or one item that calls to you. Commit to doing whatever it is that you need to do to make it happen! One step at a time, even if you’re having a baby this month!

Currently in western-centric cultures, most postpartum care traditions have been lost, so we are all in the process of repairing this for mothers and families. That means that we as mothers, and even first time mothers, need to speak these needs and advocate for ourselves and our children. There may be some grief involved in that process or some resistance because it’s true that at one time other people surrounding the mother often took care of all of these items.

What has helped me in this process is allowing those feelings of grief to surface and knowing that this is a collective issue and not my personal problem to solve. I have done the best I can to prepare throughout pregnancy for the postpartum time by gathering resources, reaching out for support and asking for help. It’s not always easy and I’ve found that being persistent and creative are some of my best resources in filling these gaps for myself and my family.

If you have any questions about preparing for the fourth trimester or finding the healing resources you need, please reach out to me!

One last thing… I love preparing a postpartum healing basket for myself by gathering items that will support my healing and keeping them all in one place, more on that in the next post! This brings some ritual and deep intention into my postpartum time.

Resources

Postpartum Care for Increasing Vitality

Creating Space for the Postpartum Period

Yoni Care and Healing Vaginal Tears After Birth

The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality by Kimberly Ann Johnson

The First Forty Days: The Essential Art of Nourishing the New Mother by Heng Qu

Innate Traditions Postpartum Care with Rachelle Garcia Seliga

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