The best way I’ve heard giving birth described: You’re in a major car crash. You’re given a 48-hour hospital stay, bandaged up, and sent home with a total stranger you don’t know who was also in the same car crash… and you’re in charge of taking care of them. Sounds crazy, right? It kind of is!
The physicality of labor and delivery, and the recovery it entails, is so often glossed over. It’s a shame, and it does women a real injustice. New research is finding that it takes women’s bodies much longer than previously thought to recover from childbirth. If you knew everything that has to happen, physiologically, for you to grow a human being from scratch for nine months, expel it out via tiny birth canal, and then attempt to return to some semblance of its pre-pregnancy self, you’d probably be in awe – and also have a whole lot more respect, kindness, and patience for your body.
All of this is to say… women’s bodies are freaking amazing. And we should spend more time not only talking about how freaking amazing women’s bodies are… but also normalizing a lot of the things that can happen to women’s bodies after they do said amazing things.
Here are ten things people don’t tell you about the “fourth trimester” – or what to really expect after having a baby. I knew some of these things beforehand, but many I became very aware of after having a baby of my own this past Spring. (For those curious, you can read Brady’s birth story here!)
Women who’ve had babies – Is there anything I missed? Did any of these things surprise you, too, after you gave birth?
What is the fourth trimester?
The fourth trimester is the 12 weeks immediately after your baby is born. This time – just like the 3 trimesters of pregnancy – is filled with a ton of physical, emotional, and hormonal change. The journey doesn’t just end after a (hopefully) healthy birth outcome, and just like during pregnancy, your body is working in overdrive during this time. Throughout history, different cultures have given much more emphasis to this time period than we do now. (A great book on this topic is here, and I highly recommend it!) Unfortunately, society today places less emphasis on a woman’s necessary recovery and healing and more on a quick ‘snapback’. But you can choose not to give into these pressures!
10 things people don’t tell you about the fourth trimester
1. It takes a while for your belly to de-swell.
I don’t think everyone knows this, but your belly doesn’t deflate right after your deliver a baby. It stays big and puffy for several weeks (even months) afterwards. Basically, even if you ‘deflate’ really quickly, you’ll still go from looking 9+ months pregnant, to about 5-6 months pregnant at best. The best way I’ve heard this described – think of your stomach as a balloon. When you have the baby, the balloon doesn’t ‘pop’… it just slowly starts letting air in to deflate. It was a really weird feeling poking my post-pregnancy stomach and wondering what was in there. It did indeed feel like a deflating balloon! When you leave the hospital, you will still have a big (albeit smaller than when you came in) belly, and every woman will experience a different timeline of how quickly it shrinks back from there.
2. You’re going to bleed afterwards. A lot.
You and your baby will both be wearing diapers for a while. Yes, it’s as amazingly glamorous as it sounds. At some point you stop trying to layer on 3 giant maxipads at a time and just switch to the Depends, at which point it’s life-changing. I bought a bunch of the Frida Mom boyshorts when I was preparing for labor in my third trimester – but I ended up liking these so much more. (Also… pro tip: take as many supplies from the hospital as you can! Squirt bottle, stool softeners, dermaplast, instant ice packs… they’re ‘free’ and for your use!)
You can expect to bleed for anywhere 3-6 weeks or more. Yes, that’s bleeding every day for 3-6+ weeks straight! Another reason to be kind to your body! (And also to make sure you get your iron levels checked postpartum!)
3. You’ll probably sweat through your pajamas every night for a while.
Postpartum night sweats are real – and can be really intense. This I had no idea about, and I thought it was just a ‘me’ thing. Turns out, it’s super normal, and it’s just your body’s way of getting rid of a lot of the extra fluid it had built up during 9 months of pregnancy. Fortunately it should taper off after a couple of weeks. In the meantime, be prepared to sleep in light or minimal clothing, or on a towel over your bedsheets. Or just be ready to do a lot of laundry!
4. Your hair might fall out. (It’ll come back, though… don’t worry.)
I was totally in denial that postpartum hair loss would happen to me. I didn’t lose any hair until 3 months in, at which point it started coming out in ribbons every time I brushed my hair. Fortunately I have a ton of hair, so it hasn’t been noticeable to anyone but me, but some women may notice temporary bald patches. Don’t worry… it all comes back! And it sounds much more traumatic than it is. Once again, this is your body ‘undoing’ something that pregnancy did – which is grow thick, luscious hair that didn’t shed as much as normal. Now it’s shedding ‘extra’ in order to catch up. Not all women will experience postpartum hair loss, but for those who do – it’s said this typically lasts 3-4 months, or the time it takes to go through a full hair growth cycle.
5. Rest as much as possible. No matter how ‘good’ you might be feeling.
Remember the car crash analogy. Your body has just been through this crazy, traumatic event. No matter how ‘good’ you think you might be feeling, it’s so easy to overdo it in the first couple of weeks. Even (and especially) from things that might not normally seem like ‘work’ – like climbing the stairs too many times, or just being on your feet for too long of periods. This article does a great job of summarizing why rest is so important, and gives some guidelines for the first couple of weeks. The consequences of overdoing it are scary – so make sure you educate yourself, and make sure those around you understand why you need to rest, too.
6. If you’re planning on breastfeeding, have a good support team and make sure to advocate for yourself.
Breastfeeding is the single thing I felt the most unprepared for after having a baby. I knew breastfeeding was hard – but I didn’t know just how hard it is, and how much work it entails. I also didn’t expect to want to breastfeed – and continue breastfeeding – as much as I did. I was fortunate to almost exclusively breastfeed Brady for the first five months of his life. At around four months, I noticed a big supply dip that I couldn’t seem to recover from, and I ultimately had to wean him. However – there are so many things I will do differently the next time around! I didn’t understand how the supply-and-demand of breastfeeding works, how supplementing inhibits that, etc., and I unknowingly made a lot of ‘mistakes’ as a result.
That’s all to say… if breastfeeding is something you think you might even remotely be interested in… make sure to educate yourself really well ahead of time so you’re prepared. Some tools that helped me in my breastfeeding journey… LOTS of nursing bras (since it’s all you’ll be wearing), a Boppy or My Breast Friend pillow, comfy, breastfeeding-friendly clothes that you can either pull down or up, easy snacks you can eat one-handed (like bars and energy balls), and a well-recommended lactation consultant. (If they can come right to your home, even better!)
7. Your six week postpartum check-up is not carte blanche to return to all activity. (Also… postpartum care for new moms kind of sucks.)
When you’re pregnant you have monthly, then bi-monthly, then weekly doctor’s appointments. After you have your baby and are discharged from the hospital, your only ‘postpartum care’ is a single doctor’s appointment at 6 weeks. At this point, they either give you the ‘all clear’ to return to exercise, and life as usual, or not. However, life at 6 weeks postpartum is anything but normal! And especially, life with a 6-week-old newborn is anything but normal. It’s important to remember that 6 weeks is a semi-arbitrary number, and that nothing *magically* happens right at the 6 week mark.
Also, while you might be cleared to exercise at 6 weeks, that doesn’t mean you can, or should, return to all exercise. The new research on returning to running postpartum states that most women should wait 12 weeks before running after delivery. (More on this to come in a future post.) While walking and some strength training is fine at 6 weeks, it’s advised to wait much longer before returning to high-impact activities.
8. Incontinence is very common, but is NOT ‘normal’!
Peeing yourself or losing control of your bladder when you run, jump, or sneeze is very common after having a baby. However, it is NOT ‘normal’! This is a sign of pelvic floor dysfunction, and unfortunately, because there’s been such a lack of education for so long, older relatives or friends may try to convince you this is just ‘the new normal’ once you have kids. That is not true, and if this is something you’re experiencing, you should see a professional to correct it and to strengthen your PF. I highly, highly recommend all women make an appointment with a pelvic floor physical therapist after they deliver. Whether you have any symptoms of pelvic floor dysfunction or not, it’s great preventative care and can help you stay on top of any issues down the road. Fellow Rhode Islanders – I used Jennifer Reynolds of Reynolds Physical Therapy and can’t recommend her more highly!
9. Everything gets better after the first two weeks – and then in two weeks increments after that.
This was the single best piece of advice I received after having Brady. The first two weeks after having Brady were a complete haze of sleep-deprivation, feeling overwhelmed, and feeling really unlike myself. At right around the 2 week mark, we started getting a little more confident; we started being able to read and respond to Brady’s cues better; and we started getting (slightly) longer stretches of sleep… all of which felt like a godsend. This happened again at the 4 week mark, and then the 6 week mark, and then the 8 week mark. During tough times, I started using the motto, “We just have to make it through the next 2 weeks, and then it will get better!”
10. This, too, shall pass.
The most important thing to know about the fourth trimester is that ‘this, too, shall pass.’ Some people love the newborn phase, and some people do not. But whatever you’re going through, it really is all temporary. Connecting with other moms – whether IRL or online (via Facebook groups, for example) – can help reassure you of this and be a source of comfort. It can really help to have others going through the same things you’re going through and to hear that you’re not alone. Other moms will also do a really good job of showing you how much better and easier things get with time!
If things are not getting better for you and you feel stuck, depressed, or at a low point you just can’t work out of, there are amazing mental health professionals who are experienced in exactly this type of thing. Never be afraid to advocate for yourself and reach out to talk to someone.