22 Tips From Real Moms for the Fourth Trimester

Try as you might, nothing can ever really prepare you for motherhood. It’s not until you hear the sound of your child’s voice (usually in the form of a cry) for the first time that it all begins to sink in.

In those first few cries, you realize that your heart is now living outside of your body. And if you’re anything like me, panic soon follows (actually, the panic came when the nurses dared to send me home from the hospital a day later, assuming I was just going to know how to care for this new human without them. That was a panic I was not prepared for).

Within the first few days at home with my daughter, I began to see the fallacy of that baby registry I worked so hard to create just months before. The gadgets that all of my friends so lovingly gifted to me at my fancy baby shower didn’t help with the deeper emotions and experiences that were happening for me in this accurately named fourth trimester.

In an effort to prepare you in a way that I wish I had been prepared, behold this list of advice for navigating the fourth trimester in a healthy, supportive way. This is a compilation of tips both from my own experience, as well as from the community of mothers I serve through my podcast, The Mom Feed.

We offer these tips to you with love.

22 Tips From Real Moms for a Healthy Fourth Trimester

What to do Before Baby Arrives:

1. Pelvic Health Physical Therapy.

   Growing a human in your body puts a lot of pressure on your pelvic floor, and the degree to which you care for this region will be correlated with how you carry your pregnancy and how you deliver. If you read nothing else on this list, let it be this: make an appointment with a pelvic health physical therapist as soon as possible. This is the single most important piece of advice I wish someone had given me before I got pregnant, and certainly during pregnancy. I don’t mean to be bossy but this is a step you simply cannot skip. Your body will thank you.

2. Research Formula.

   You’ve probably researched different birthing methods and interviewed different care providers to determine how you’re going to birth this baby. However, there are a few areas that can get overlooked in the preliminary pregnancy research. You may plan to breastfeed, but in the event that you are unable to or that you find that you actually don’t want to, the time to research the best formula is now. Not when you’re panicked and hormonal and sleep deprived and judging yourself for not being able to produce enough and/or not wanting to continue down the breastfeeding path and/or needing to supplement with it for whatever reason. Research the best formulas now so that - in the event that you need it - you're already well versed in and comfortable with the choices available to you. And if you don’t end up needing it, no harm done.

3. Educate Yourself About Postpartum Mood Disorders.

   Unless there is a history of mood disorders in either yourself or your family, you may not think to get familiar with the various types of postpartum mood disorders that may occur in both pregnancy and postpartum. Motherhood comes with a huge identity shift, sleep deprivation and changes in relationships, among other things, so it’s safe to say that your mood will be impacted. But it’s important that both you and your partner familiarize yourself with postpartum mood disorders like postpartum anxiety, depression and psychosis so that in the event that it happens, you are equipped to know what to do.

4. Get Comfortable Asking For Help.

   There is a reason for the phrase “it takes a village to raise a child.” Because it does. And unfortunately, we don’t live that way anymore. Parents are raising their children in single family homes, often far from their families and with little to no support. That is not a recipe for a healthy fourth trimester. So set yourself, your partner and your child up for success by asking for help. What should you ask for, you wonder? Keep reading.

5. Interview Nannies and Babysitters Before Baby Arrives.

   I wouldn’t leave anyone with my daughter alone until she was almost a year old (besides my husband, and even then, I wasn’t comfortable). That made it hard for me to maintain a sense of autonomy. In hindsight, I wish I had interviewed and hired either a nanny or a babysitter before my daughter arrived so they could form a bond, and so that I would have felt comfortable much earlier leaving her with someone else. If this isn’t in the budget, I understand. Set yourself up for success differently by reaching out to family and friends and creating a schedule of when and how they can help you in the first few weeks and months postpartum. There may even be an eager high school student who could come over and help with other chores while you care for baby.

6. Get Clear on a Visitor Policy and Set Healthy Boundaries Around It.

   When that baby comes, everyone will want to come and visit and everyone will somehow feel entitled to holding them. They may even judge you when you’re not readily eager to hand your new child over to them. Get clear on two things: First, who is allowed to visit and when? Second, how long can they stay? What can they bring? Will they get to hold the baby? By a stroke of serendipity, Dr. Harvey Karp, author of The Happiest Baby on the Block, was my daughter’s first unofficial pediatrician for the first few months. She was beta testing the Snoo (yes, she was one of the first babies to test that miracle bassinet that has become all the rage). In order to limit germ exposure, Dr. Karp suggested that we ask visitors to put on a fresh t-shirt over their clothes when they visited if they wanted to hold the baby. This may or may not be something you want to do, but just know that what you and your partner want to do is all that matters. As far as timing goes, I remember having about a 20 minute tolerance for visitors in the first few weeks and months postpartum because I was so tired, and engorged, and still learning how my daughter functioned, and how to breastfeed. With that said, as part of setting yourself up before baby arrives and asking for help, you may have scheduled your mom or mother in law or sibling or some other family member or close friend to come and visit for a few weeks after the baby is born so they can help. Just make a schedule, know your limits and set them beforehand.

7. Pregnancy Nutrition. 

   In addition to having an amazing prenatal vitamin (I personally recommend WeNatal), having a nutrition coach or guidance during pregnancy will be very valuable in helping keep your nutrients on track, and in setting you up for a healthy postpartum health experience. I am a big fan of Ryann Kipping AKA The Prenatal Nutritionist. Her Instagram feed is pure pregnancy nutrition gold, and she has also created a comprehensive prenatal nutrition library. I’m also a huge fan of celebrity health coach and holistic nutritionist, Kelly LeVeque for both pregnancy and postpartum nutrition. A mother herself, Kelly has a very simple eating practice she coined the FAB 4. It’s an incredibly intuitive and healthy way for anyone, including for pregnancy and postpartum, to eat for optimal health. The FAB 4 combines fat, fiber, proteins and greens at every meal and snack (if possible). 

8. Get a Life Coach or Therapist.

   You’re about to go through a huge identity shift, lady, especially if this is your first baby. I wish someone had told me that. I wish someone had told me that when a woman births a baby, she also births a new version of herself: mother. I wish I had been working with a coach or therapist before I gave birth so I could have had someone to support me through all of the emotions that came up. Your partner can be supportive in other ways, to be sure, but the fact is that no one who hasn’t birthed a child can know exactly what it feels like. That’s a job for a woman, and a professional one at that. So, find a great life coach or therapist that focuses on mothers that you feel comfortable with. And lean on them as you transition into motherhood.

9. Hire a Couples Therapist or Counselor.

   Again - you’re about to go through a huge identity shift, and so is your partner. Encourage them to get their own solo support, but you’ll also want to have support as a couple. You may think your relationship is solid now - and it probably is - but throwing children into the mix is like throwing a grenade into your relationship. Things can go south fast. Your relationship is the nucleus, and it must be protected. Empower yourselves by regularly seeing a couples therapist or counselor throughout pregnancy and postpartum. 

10. Consider Hiring a Postpartum or Sibling Doula.

    You really want to pad the amount of support you can get during the fourth trimester, and I cannot recommend having a postpartum doula enough for this. I wish I had done this for myself. It would have made such a difference in my healing, and in my relationship with my husband. A postpartum doula can be a support to you in this period just like a birth doula, and if you have other children, a sibling doula can help with the transition your first child will inevitably go through.

11. Have a Division of Labor Conversation.

    We often get so caught up with getting the nursery together and diapers and clothes stocked that we forget what is about to happen. Namely, that your entire life and way of living is about to change. Overnight, your list of responsibilities will grow, and the time with which you have to do them will shrink. Sit down with your partner and make a list of all the chores that currently happen in your household and who is currently responsible for them. Things like meal planning, grocery shopping, cooking, taking out the garbage, laundry, house cleaning, etc. Ask your parent friends what chores and responsibilities will be added to that list: diaper changing, changing the diaper pail and replacing the bag (key point), washing the breast pump and/or bottles, replenishing the diaper/wipes/formula supply, etc. Then, talk about the sleeping arrangements. Who will do night feedings? Who will do day feedings? Will there be time for self care/fitness/time with friends for each of you, and if so, what does that look like? Who will go back to work and when? And who will take care of the baby if you’re both going back to work? If one of you is tasked with childcare, how will finances work? And if you both go to work, who takes on what chores when you both get home from work and on the weekends? Work all of these details out as much as you can before the baby arrives, and know that this is a living, breathing list. It will change. But make it a priority, because otherwise, one of you will become the default parent and eventually, you’ll feel resentful for having to take on what feels like the majority of the work. And that will not be good for your relationship.

What to do After Baby Arrives:

1. Mind your adrenal health.

   The adrenals are small glands just above your kidneys that are responsible for the production of hormones that help regulate your body, including your metabolism, immune system, and response to stress. Your adrenals take a serious hit when you give birth, even if your birth was relatively “easy” (no birth is ever easy - a human came out of your body. That’s a big deal). Add in the fact that you don’t get the time to heal after you give birth because your child wakes every few hours to feed, and the hormonal fluctuations that come with postpartum, and it’s safe to say that your adrenals are negatively impacted. This article from board certified naturopathic endocrinologist, Dr. Jolene Brighten, offers six ways to help support your adrenals in this fourth trimester. 

2. Adjust your sleep expectations.

   I remember the first night after my daughter was born vividly. I was exhausted after four days of labor. I wanted to sleep. I expected to be able to do that. My daughter wanted to eat. And cry. I felt resentful. I felt angry. I was exhausted and I needed to heal. How was I expected to do that when I couldn’t sleep? Adjusting your expectations around sleep - and knowing that you won’t get much of it - during this fourth trimester will be very helpful for your mental health. My life coach, Shelli Lawrence, always reminds me that when we fight reality, when we tell ourselves that things should be different than they currently are, we suffer. So, adjust your sleep expectations during this trimester and just know that your job is to get sleep when you can, not necessarily when you want to. When baby is older, you and your partner can discuss sleep training tactics. For now, just settle into this slower pace of life and sleep whenever you can. 

3. Get a Pelvic Health Physical Therapist.

   Yup, this again. If you don’t already have a pelvic health physical therapist, you need one now. There isn’t a woman who wouldn’t benefit from being seen by a pelvic health physical therapist after giving birth. Your body 3D printed a human and moved all of your organs around in order to do it. Your pelvic floor carried all that weight. You need to take care of it. What’s more is that if you don’t correct the dysfunction in your pelvic floor from pregnancy and delivery, you will directly impact your next pregnancy and delivery.

4. Trust your partner.

   At one of the first visits with our pediatrician, they told me that the relationship my husband has with our child will be different from mine. And that is ok. In fact, that’s exactly what is needed. Your child needs to have a relationship with other adults other than yourself. Your child needs to know that they have a network of adults who love and support them. It can be tempting to grab your baby from your partner when they are crying, or to just do things yourself because your partner does things differently than you do. Try to resist the urge to do that. Give your partner the opportunity to develop trust in themselves as a parent, and to let your child develop trust in them.

5. Mind your self care.

   It can be easy to forget to take care of ourselves when we have a human being relying on us for their survival 24/7. But if you’re not ok, your baby is not ok. And sure, you can push yourself beyond your limit (and you will…more times than you’ll be able to count), but not having a self care plan is like thinking you can drive a car that needs an oil change on empty - and being upset when it breaks down. Self care is different for everyone. Decide what yours looks like. Maybe it’s weekly massages. Maybe it’s weekly at-home face masks and baths. Maybe it’s indulging in an hour of mindless TV. It’s easy to let yourself fall through the cracks when you’re in the intensity of the first 3 months of motherhood - and also throughout motherhood in general. Set yourself and your relationship up for success and be a stand for your own care. And be a stand for your partner to do the same. 

6. Set Realistic Expectations for Your Postpartum Body.

   There is no bouncing back after having a baby. There is only bouncing forward. Your body grew an entire human, and then that human came out of it. Your organs had to move out of the way to make room for that growing baby, and now it has to put itself back together again. Internally, you’ve now also got a gaping wound where the placenta used to be, which is about the size of a dinner plate. If you had an open wound the size of a dinner plate on the outside of your body, would you push through or maybe give yourself a minute? And on the outside, you either have a C-section wound or a vaginal wound. I interviewed a Santa Barbara based pelvic health physical therapist, Dr. Christine Pieton, a few years ago and she told me that a woman’s tissues don’t heal for approximately 3-6 months postpartum! That’s quite different from that infamous 6 week postpartum check up where the doctor checks your stitches and gives you the thumbs up to have sex again (if you want to know how I feel about that check-up, check out this viral reel). So, embrace your new body, and take your time with your healing. It took you nine months to grow your child, give it at least that amount of time to heal. And with that...

7. Set Realistic Postpartum Fitness Goals.

   Adopt this mantra: Go slow to go fast. Work with your pelvic health physical therapist to determine what is the best exercise for your unique postpartum body. Some women can get right back into running and hard core workouts within a few months. Others have to wait a little longer. It’s all ok. The fourth trimester - and the entire first year postpartum - is such a short period of time in the grand scheme of your life. You’ll have plenty of time to workout later. With that said, exercise is medicine, so if you’re itching to get back into something without stressing your body, I personally love mat pilates. It is a targeted workout that’s perfect for postpartum women because it’s an exercise based on rehabilitation. I am a huge fan of this online platform, Unicorn Wellness Studio, but you can find anything that works.

8. Process Your Birth Experience.

   Whether you had a traumatic birth or pregnancy or it was smooth sailing, it’s important to integrate the experience. You birthed an entire human being, and whether you gave birth naturally or by adoption, you are an entirely new person now. Work with a coach or somatic practitioner to integrate this transition into motherhood. I highly recommend the work of award-winning birth educator Brita Bushnell, PhD, along with her book, Transformed by Birth. It’s a book I believe every mother needs to read.

9. Get outside.

   There are profound benefits to being outside. It can help with circadian rhythm, immune response, stress response, and so much more. There is even a practice called forest bathing that was first studied in Japan in the 1950s whereby you spend time in the forest to improve mental health. You don’t need a forest, though. The natural light is enough to be healing. Try to stay off your feet as much as you can in the first 40 days postpartum, and sit outside with your baby often. When you feel comfortable moving again, start some gentle walks. This can really help to regulate your hormones and stress levels, which in turn will help baby too.

10. Process Your Emotions Through Meditation and Journaling.

    Motherhood can often bring up unhealed traumas and wounds. It acts as a mirror for things we’re working on that we may not want to see (especially as our children get older and begin to test boundaries). It can also bring up generational wounds that need to be healed too. It can be intense. Working with a coach or therapist will be integral, but meditation and journaling will be helpful for processing emotions as they come up.

11. Expect to Feel Overwhelmed.

    Once upon a time, you were just you. And then suddenly, overnight, you were expected to be the CEO of someone’s life, a someone who you only just met. And you were expected to be good at it from the start. No, excellent. Motherhood is overwhelming, mama. And you may be used to knowing what you’re doing all the time. Expect to not know what you’re doing half the time. Expect to feel overwhelmed. And give yourself all the grace and support you need. You don’t need to have it all figured out. You just need to lead with your heart. Everything else will work itself out.

As you can see, I and my community of mamas have a lot to say about the fourth trimester. And I’m sure many mamas reading this can add to the list. Take what resonates and leave the rest. Postpartum is a time to go slow, which is probably in direct opposition to how you were living your life before your child came along (society seems to define productivity as putting as much on your plate as possible, and then pushing harder still). Let this be the permission you didn’t need to slow down, take in this time, and soak it up. You’ve got this, mama. With a little help from those who came before you.

Yours in honest motherhood,

Lauren

xxx

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