Note: This blog was written before I gave birth, and I will, in a future blog, address how much of this was true for me.
It wasn’t until I reached my third trimester that I found out that there was a fourth trimester, for both baby and me alike. In his book, The Happiest Kid on the Block, Dr. Harvery Karp explains that babies really need an additional 3-4 months in the womb to be ready for the real world, but nature evicts them at around 10 months because they would be too large at 13-14 months to deliver vaginally. Karp further notes that “one of America’s top pediatricians, Arthur H. Parmelee, Jr., … observed that many parents naively expect their baby to be born smiling and interactive. And they’re often shocked when they’re handed a ‘fetus-like’ newborn whose shrieks could shatter glass” p. xxiv. Karp’s book then focuses on ways to emulate the experiences and sensations of the womb to calm an upset baby.
This blog post, however, will not be focused on the baby’s fourth trimester, but mine. While the average person knows that a woman might experience morning sickness in the first trimester and back pain in the third trimester, people don’t talk about what a woman’s body goes through after she gives birth. In fact, many trends encourage the idea of “bouncing back” after a woman gives birth, as if a woman could ever return to her pre-pregnancy body, mind, and experience. In sharing her birth story on The Birth Hour, Elana Edwards states that after labor and delivery, you have a new life. This is not just the new life of your child; the parents now have a new life. One’s old life comes to an end when you have a child. If I could not accept this fact, I would experience more suffering in my recovery process than I might otherwise.
Realizing that my old life is coming to an end, I am not in a rush to give birth, even though the baby gets a little heavier every day, my back has a greater weight to support, and the August heat makes carrying around your own personal oven less than ideal. I know that the fourth trimester will be the hardest of them all. Whether I give birth vaginally or via caesarian, I will have a difficult recovery ahead of me. For instance, I will bleed for about 4-6 weeks after giving birth, maybe longer. I may tear my perineum (the skin and muscle between one’s vagina and rectum) during the delivery of the baby. These tears come in four different degrees from a first-degree tear of just the skin, to a fourth-degree tear of skin and muscle. Depending on the severity, I may need stitches. My pelvic floor may be weakened, leading to incontinence. I may also have the worst hemorrhoids I’ve ever experienced in my life. In other words, going to the bathroom in the weeks after delivery would likely be painful. In fact, even just sitting would likely hurt.
And of course, that’s not all.
I know that breastfeeding is going to be difficult at the beginning. I may have sore or chapped nipples from the baby not latching on properly. I may have engorged breasts or blocked milk ducts. There is even a chance of mastitis, which if not resolved with antibiotics may lead to surgery. There is also the constant concern of not making enough milk. Is the baby getting enough food? Is he or she meeting her weight goals? How many soiled diapers did the baby have today? Should we supplement with formula? Is the difficulty latching because the baby has a tongue-tie? If so, should we try to fix it surgically?
And that’s just tip of the iceberg of physical recovery; I haven’t yet mentioned the mental.
There are post-partum mood and anxiety disorders (PMADs), which includes postpartum depression. While postpartum depression gets the most media coverage, it is possible to develop obsessive compulsive disorder (OCD), anxiety, the “baby blues,” or a host of other mental issues. Never heard of the baby blues? It’s not the same as postpartum depression. WebMD offers the following guidelines to help you distinguish between the baby blues and postpartum depression:
When It’s the Baby Blues
Your mood swings quickly from happy to sad. One minute, you’re proud of the job that you’re doing as a new mom. The next, you’re crying because you think you’re not up to the task.
You don’t feel like eating or taking care of yourself because you’re exhausted.
You feel irritable, overwhelmed, and anxious.
When It’s Postpartum Depression
You feel hopeless, sad, worthless, or alone all the time, and you cry often.
You don’t feel like you’re doing a good job as a new mom.
You’re not bonding with your baby.
You can’t eat, sleep, or take care of your baby because of your overwhelming despair.
You could have anxiety and panic attacks.
Here’s the thing, according to the American Pregnancy Association, “Approximately 70-80% of all new mothers experience some negative feelings or mood swings after the birth of their child” (para. 2, bold in the original). That means around 4 out of 5 women will experience some form of the baby blues after giving birth. This is about the same rate as women experience morning sickness in the first trimester, but I’d never heard of it. It’s as if once the baby is born, we stop concerning ourselves with the mother and her experiences. Yes, the baby blues are not as bad as postpartum depression, but it doesn’t sound fun either. Women who are not prepared for them may become insecure, wondering if they are bad mothers.
As I learned more about the fourth trimester, I came across the term “matresence,” which describes the transition that women go through into motherhood. You can find a short (5-minute) TED Talk about it here. Imagine all the physical, mental, emotional, and other changes that you experience in adolescence. Women who are going to have a baby go through a similar change in their physical, mental, and emotional being. The very ways our brains are wired go through major changes in preparation for and during motherhood. When you look at what’s taking place in the mind and body, the idea of “bouncing back” or being the person you were before pregnancy and birth is ludicrous. It’s like expecting an adult to be able to go back to being a child after puberty.
You might be the kind of person who thoroughly enjoyed your adolescence and would want to do it again, but I would be fine not experiencing those years again. The insecurities, unchecked emotions, and uncomfortable changes in my body that I had during that time of my life are enough to make me cringe today. Knowing that I will be going through a similar transition into motherhood makes my first trimester of throwing up 3-5 times a day sound like a breeze.
Up until I learned more about the fourth trimester, I assumed that once the baby was born, I would be so amazed by the gift I’d been given, I’d reach the state of “It was all worth it” and not care about the lack of sleep or any other sacrifices I had made or would need to make in the future. However, that feeling does not necessarily happen right away, or it may come and go, especially in that fourth trimester when the baby is adapting to our complicated world. Not every woman feels a rush of love for her child after the baby is born. That feeling of love and connection may not come until months later. In the meantime, she has to deal with pain, lack of sleep, insecurities, mood swings, and way too much unsolicited advice. In fact, my favorite line from Karp’s book is “I think America’s favorite pastime isn’t baseball… It’s giving new moms unsolicited advice” p. 6. In addition to all the ways in which you are physically and mentally changing and the emotional roller coaster your hormones send you on, the expectation from family, friends, or society that you’ll be the person you were before, or an even happier, more loving, and more compassionate version of yourself (because, you know, you just had a baby) can completely overwhelm a new mother.
I could already see what the fourth trimester would be like, and I was preparing for it to be even harder than expected. So, when people say, you must be so ready to give birth to that baby, I’m honestly thinking, “Nah, he or she can take her time.”
There’s quite a bit of irony in that thought though, as you’ll learn in the next post where I’ll write about my experience of labor and delivery.
**The featured image is photo of my with my legs up in order to counter swelling.
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