By Morgan Michalowski, CNM, WHNP-BC, IBCLC
Researching motherhood while pregnant feels a bit like chasing a runaway train. There’s so much to learn, and every time you turn around someone’s coming out with a new recommendation, tactic, or tool. No matter how much you study up, it never feels like enough.
And I say this from personal experience; I remember re-reading midwifery books between bouts of morning sickness. Like so many expectant mothers, I absorbed every bit of content I could find. If there was a book to read about motherhood, rest assured, pages were read, folded, and underlined.
By the time my baby arrived, I hoped I knew enough to make it through the fourth trimester in one piece … and all that reading did help me with some of the basics. But I soon found myself buried under an avalanche of "no one ever told me" moments, overwhelmed by the realities of postpartum life. There was so much that medical texts didn’t cover, and even more that midwifery training didn’t prepare me for. Parenthood was way different than I thought it would be. So was my baby.
Books can be great, but at best they're informative, and at worst they create unrealistic expectations.
Each mother is an individual, so even the most expert of authors can’t predict what your baby is going to be like, how quickly your body will bounce back, or how to engineer the perfect timeline for developing your rhythm as a parent.
So with that in mind, I’ve created a survival guide that explores the challenges of the fourth trimester, month by month. Here's what I wish I had known to expect during my first month postpartum, and what you can do about it right now (even if you're just starting to experience the first signs of pregnancy)!
Month 1 of your fourth trimester: The newborn bubble
What is the fourth trimester of pregnancy? The fourth trimester starts the moment your baby is born and lasts until she’s three months old. It’s a period of significant change and development for both you and your newborn since you’re both adjusting to your baby’s new world outside your womb. It often involves: hours of rocking, bouncing, skin-to-skin to regulate baby’s nervous system, trusting your intuition because you know best, and many feeding sessions. (Get comfy!)
You know to expect the lack of sleep; you're prepared for that. But the lack of abs, a healing vagina, or a C-section incision might make it hard to sway and bounce your baby the way you imagined. Remember that you're no less of a mother if you can't bend over and pick up your baby without help, but adjusting to a new picture is hard.
Since you’re likely experiencing a disconnect between expectation and reality, you may feel confused, sad, or overwhelmed. (Even if you’re not coping with acute postpartum depression, these emotions are totally normal!) During this time, you can experience the following:
- Matrescence (think awkward teen years: hormonal, unsure of who you are, and a little nervous about your future)
- Baby blues (weepiness, impatience, fatigue, insomnia, sadness, mood changes, all of which may last for up to 2 weeks postpartum)
- Perinatal mood and anxiety disorder (postpartum depression, postpartum anxiety, postpartum PTSD, postpartum OCD, postpartum psychosis.)
If you’re experiencing the normal adjustment period to parenthood:
- Find your most empathetic friend and let it all out.
- Share with them what you imagined this time would be like, and how it's measuring up.
- If an outdated vision of your first months of motherhood prevents you from adjusting to the picture in front of you, your life will feel a thousand times harder. Find ways to make peace with your new postpartum reality as best you can.
- This practice is called radical acceptance. Radical acceptance doesn't mean resigning yourself to things staying the same; it just means you’re acknowledging the reality you're living. When we say “postpartum should be x” or “motherhood should look like y,” we’re denying the fundamental uniqueness of our own postpartum experiences. Do what you can to accept that there’s no “right” way to experience the fourth trimester.
If your baby is fussy and you’re getting fussy too:
- If you have a support person, ask for a break. Go for a walk. Hop in the shower. Take some deep breaths.
- If you’re alone:
- Put your baby down in a separate room to get your bearings
- Put your baby in a baby carrier and get outside. Your breath and heart rate can calm your baby, and the outdoors is soothing, causing relaxation.
- Hop in the bath with your baby for skin-to-skin time. This typically quiets a fussy baby and gives you a mental break.
With all the hormonal, psychological, and identity changes that take place during this first month, no mother sails through the postpartum period with ease. Here’s a cheat sheet to guide you through all those changes:
- When you give birth, your hormones go from the highest they’ve ever been to the lowest they’ll ever be in a matter of hours.
- You produce more estrogen in one pregnancy than throughout your entire life, but within 24 hours postpartum, it drops to baseline or lower.
- Low estrogen leads to baby blues, depression, hot flashes, and vaginal dryness. So no, you're not crying for no reason. Your hormones just ghosted you. It sucks.
- Oxytocin surges immediately after delivery, which may make you feel anxious or on high-alert for danger during the first six weeks postpartum. Just hearing your baby cry can trigger a bout of postpartum anxiety. Because of this, it’s common for parents to experience very mild OCD-like behavior, like repeatedly checking to see if baby is breathing. If this behavior is getting in the way of bonding with your baby or impeding your ability to rest, let your OB provider know.
Tell everyone who comes to your house that they need to bring a gift for you. It can be something physical like a snack plate or a pack of diapers, or it can be an act of service like a clean kitchen or time for you to shower. Don’t be shy about asking for what you need:
- Request foods good for breastfeeding or specific brands of infant supplies, if you want them.
- If you aren’t comfortable asking we can do it for you.
Will my baby ever sleep?
- Expect your baby to sleep 14-18 hours each day in 1-3 hours stretches, but not on any discernible schedule.
- This time is predictably unpredictable.
- Your baby might go to bed late, around 10-11 p.m., during the first few months of life. This is perfectly fine. She has no circadian rhythm when she’s this young; it doesn’t develop until around 3-4 months of life.
- Both the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend letting your baby sleep in your bedroom the first 6-12 months of life to reduce the incidence of sudden infant death syndrome (SIDS).
How much will my baby eat?
- Your baby will eat (breast milk or formula) at least 8-12 times per day, sometimes, if breastfeeding, as often as 4 times in a single hour. Both WHO and AAP recommend feeding your baby on cue instead of on a schedule.
- She has a small belly, and frequent small feedings are the best way to keep her blood sugar stable and tummy full. Get those wipes for baby ready- you're on your way to a mini marathon of diaper changes!
- The good news? You have every reason to order a bell and ring it endlessly from the comfort of your bed to get the support you deserve!
What you can do right now:
If you’re pregnant, imagine your ideal birth and postpartum experience.
- What does it look like?
- Who’s with you?
- How do you feel?
- What is your partner/support person doing?
- What’s your baby like?
Write it down and share with your support people, parents, or other people in your life whom you trust. Talk about what’s realistic and important to prioritize to build the best postpartum support plan (for you).
If you’re postpartum, I promise you’re not the first or the only one saying, “What the heck just happened?!”
- Talk about your experience
- Ask for at least 5 minutes to practice a bit of self-care.
- Remind yourself that you’re creating a new skill that you’ll build upon. The awkwardness you feel is an indicator of learning.
- Take time to consider what you need most right at this moment. Is it time to bond? Time to sleep? Support from others? Pick your number-one priority, ask for help, and flex with the rest.
The biggest hurdle during month 1?
Your baby requires a lot of soothing, which can activate a stress response in your body. Who's going to soothe you when your baby needs soothing? The emotional tug-o-war between your needs and your baby's is in full swing. When your stress response is kicked into high gear, come to us for pro tips from parents and experts that will help you through your first negotiation of “who comes first: baby or mom?”
Looking for support during month 2 or month 3 of your fourth trimester? We’ve got you covered! Click the links below to keep reading this comprehensive postpartum series.
- How to Survive the Fourth Trimester Without Losing Your Mind: Month 2
- How to Survive the Fourth Trimester Without Losing Your Mind: Month 3
If you have questions or are looking for more support postpartum, please click here to reach out to us!