The Fourth Trimester

"Aren't you just loving every moment of it?!?"

This was one of the first questions my manager asked when we spoke a few weeks after my oldest child's birth. Her intention had been to celebrate this transition into parenthood (and, for good measure, decide when my first day back to work would be after my leave ended--yikes). Instead, she lost me as soon as I quietly thought, "No, I'm not. There must be something wrong with me."

As a labor & delivery RN, I assumed becoming a mother would be an easy shift. I cared for postpartum birthing people and newborns all the time. Besides that, I had society telling me what a joy new parenthood was. Every Hallmark card featured snoozing, swaddled bundles and soft pastel colors. Nothing could be more simple nor natural than soaking in my newborn and learning to adjust to it all, right?

This was nearly thirteen years ago and I wince at realizing just how clueless I was. I had no understanding that I was entering a really unique period known as "the fourth trimester". This refers to the first twelve weeks after birth when babies adjust to life outside of their snug uterine home and their still-healing parents attempt to bounce back alongside them. The needs for these couplets are pretty profound and often unrecognized. Teeny humans are born with their brains still maturing, the inability to soothe themselves or experience consistent sleeping and eating patterns. They come into the world completely dependent on the grown-ups around them. This is asking a lot when their birthing parent might be wrestling with cascading hormones, stitches or staples in places there weren't before, intense exhaustion and milk leaking everywhere! Very few of us who have experienced this transition would call it glamorous--especially when we're walking around with glorious mesh underpants and air-drying our tender nipples. Where is the congratulatory card featuring that?!?

When I first became a mother, I didn't know anyone who had recently become a parent, so imagine my surprise when family and co-workers who had experienced this transition years before seemed unable to remember just how overwhelming it all can be. I didn't understand that becoming a parent meant experiencing ALL OF THE FEELINGS, some of them a little too intensely that would require medication later, and that ultimately not loving every minute of it was truly okay. I didn't know that this transition was similar to traveling to another country and the culture shock that occurs when settling in. Beyond that, while I was fortunate not to experience significant pelvic floor or abdominal issues, many friends who followed me in this journey did--and had no idea that it wasn't normal and that they could seek help for it. 

What was expected of us? Or rather, what did we come to expect of ourselves? With hundreds of books at our fingertips and now, more than ever, the internet and the magical cropping of images via social media, we expected to be the perfect parent. The information and gadgets are all out there for us, right? The answers to our lack of sleep or feeding woes always feel one Amazon cart click away. Online parenting boards allow us to debate parenting methods. The pressure on us in the midst of this fourth trimester is often to get it all right, for our babies and for ourselves. 

What we often see on Instagram--adorable moments that exude bliss and harmony--misses what is often outside of the viewfinder. We all cry uncontrollably at points. We all have houses in disarray and laundry piling up with spit-up stains. We all wonder how we still look four months pregnant when our baby is four weeks old (and many of us gravitate to the garments in our closet with just enough give to hide it). We all have varying levels of attachment to our little ones, whether we fell in love the moment we met or it took us several weeks, and few of us understand that that whole range is normal and perfectly okay. Some of us are reeling from traumatic births. Some of us couldn't believe our luck at how easy it all was. In short, it's a truly messy, overwhelming and precious stretch of twelve weeks--and no one parent experiences it in exactly the same way.

Now that my children are older and my life has a bit more predictability, shifting gears into doula work has been a natural progression for me. Forming close relationships and providing consistent, tailored support has always been my favorite parts of birth work. I get to enjoy exactly that now as a birth and postpartum doula. I trained through Doula Trainings International (who have provided marvelous mentorship!!!) and am enjoying an incredible business partnership with my dear friend and fellow doula, Eleanor Romeus. Together, we formed It Takes A Village Birth + Family Support, and we serve the Chicagoland area. Assisting families as they prepare for and experience birth is a role many people have heard about for doulas, but it's the care *after* these families come home with baby that can be some of the most important work we do! 

Postpartum doulas provide evidenced-based information and guidance on things like infant feeding, emotional and physical recovery from birth, parent–baby bonding, infant soothing, and basic newborn care. We can be there as early as the first days and evenings at home to ease nerves and normalize all of the newness. We pay close attention to you to make sure you're eating nourishing snacks and meals, getting rest when you can and showering while we keep close eyes on your babe. We answers your questions and squeeze you tight after you've had a good cry. We validate your feelings surrounding your birth story and we provide tons of resources and referrals when you need specific expertise. Many of us also nurture families overnight--and provide loving care for both healing parents AND their babies (which is different than a night nurse, who usually focuses only on baby care). In short, we love to "parent the new parents" through this transition, reassuring and encouraging you as you learn to parent your own baby!

For those out there who are expecting a little one in the coming months, creating a plan for postpartum wellness can be one of the most important things you do for yourself! And for those wearily making it through each day and night right now, it's not too late to reach out for more help and community. Research postpartum doulas in your area, call up your best friend to come in for a weekend to help you or look up a new parent support group in your area. Having others in your circle to build up your own little village is essential. Most of all, know that you are worthy of others lending you a hand in this trying time...and that you really are doing a really wonderful job as a new parent! You are enough!

Here are more books and links to help with all sorts of experiences found during the Fourth Trimester:

Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood - and Trusting Yourself and Your Body by Erica Chidi Cohen et al. 


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


Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers by Nancy Mohrbacher et al. 


This Isn't What I Expected: Overcoming Postpartum Depression by Karen R. Kleiman et al. 


How to Heal a Bad Birth: Making sense, making peace and moving on by Melissa J Bruijn et al. 


This is a fabulous resource page regarding Postpartum Stress:

This is the article I referred to in the podcast (The Difference Between Postpartum Depression & Normal New Mom Stress by Kate Kripke, LCSW):

Finally, a PPD Warmline through Postpartum Support International:


Written by Anna Bonick

Elizabeth Presta