Top Tips for Thriving (not surviving) in the Fourth Trimester! – Dr. Julie Schurr

As an OB/GYN for over 26 years, I’ve been curious when we as a medical community, and as a civilized culture, would recognize that a pregnant woman’s journey doesn’t simply end with the delivery of her child. Wonderful and exciting as this is, I’ve learned through personal and professional experience that the really hard part comes afterward in the newly touted “fourth trimester”. New in that in May 2019, the American College of Obstetrics and Gynecology (ACOG) acknowledged that postpartum women need on-going care and surveillance almost as much as they do when pregnant, but surviving and thriving in the first three months postpartum has been anything but a new development and has been a challenge since the beginning of time.

Over the years I’ve come up with a few tips to thriving as a new mom in the now classified “fourth trimester”.

1. Breastfeeding: Practice Makes Perfect. Nursing your baby isn’t always so simple. Give yourself (and your baby) some Grace. It’s a learning curve for both of you and sometimes fraught with pain, blistered nipples, latch or low milk supply issues, breast pumps, creams and shields and typically a lot of anecdotal advice from well-meaning friends and family. I remember my husband asking what could be so hard about breastfeeding? “Just plop the babe on the boob.” Hmmm. It’s more than that. Educate yourself on nursing, ideally before you deliver, and utilize a certified Lactation Consultant like our two midwives in our office to ensure correct and safe technique and boost your confidence.

2. Sleep: It Does a Body Good. Sleep deprivation is a universal experience as a new parent. Look on any social media and find cute t-shirts, coffee mugs and wall art that proclaim “Tired as a Mother”. The first three months are often the roughest; recovery from a long labor and delivery, acute and dramatic hormonal shifts and an often overwhelming sense of insecurity as a new parent. Add interrupted and irregular sleep patterns to the mix, and you’re a wreck. I tell my patients to nap when their baby does and to greet well-meaning visitors in your bathrobe so they don’t stay too long. You need to focus on the basics: eat, sleep and feed your baby, then repeat. Entertaining, laundry and housekeeping will have to wait. Sleep assists your physical recovery as well as your mental and emotional state. Tap into support resources: your partner, a night nurse, your mother, sister or anyone else you trust to assist you in getting the sleep you need. Develop sleep schedules at night with your partner. Even four consecutive hours a night can provide you with a new lease on life.

3. Bringing Sexy Back takes Patience and Planning. It is a rare patient I see at a postpartum exam that is eagerly looking forward to having sex, and I let my patients know it. It breaks the tension (and fear and guilt) a new mom typically has about returning to intimacy with her partner. There are many different concerns surrounding sex postpartum and I usually let the patient define hers: pain, bleeding, dryness, pregnancy, libido, fatigue, body-shaming and sexual performance are just a few. Proper protection against pregnancy (yes- you can get pregnant early in your postpartum recovery) and use of lubricants and/or intravaginal estogens can assist in reducing discomfort. Even so, sex may not feel comfortable or “back to normal” for a few months. Patience is a virtue here, as is understanding and respect from both parties.

4. Motherhood is Not a Competative Sport. So much judgement in so little time. Just about every patient will compare how she or her baby are doing with friends and family. Social media ups the ante as women voice concerns over not returning to their size 2 jeans postpartum like the latest celebrity mom or why her baby isn’t sleeping through the night like her best friend’s. Stop beating yourself up. It isn’t helpful, it’s hurtful. As a parent, especially a new mother, we seem to gauge our worthiness by what the rest of other new moms and babies are doing, wearing, reading, eating and so on. I tell patients one thing all moms are universally good at is maternal guilt. It reigns supreme in the first three months after delivery when poor sleep, hormonal shifts and often well-meaning, but misdirected advice makes us feel inadequate. Keep your eye on the prize-is your child healthy, happy? Yes? Carry on! Plan a time for yourself every day and make it a priority- lunch with a friend, a walk on a sunny day, a hot bath, postnatal goat yoga. You choose! Self-care boosts your confidence and self-worth. It is an essential part of your postpartum recovery.

5. Depression Happens. Postpartum depression is more than feeling emotional and fatigued after delivery. It isn’t a weakness or character flaw either. All of our postpartum patients are screened using the Edinburgh Postpartum Depression Scale (EPDS) at each of their postpartum checks. Persistent feelings of hopelessness and disinterest in your babe or an EPDS of >9 warrants consideration for medication and/or therapy. Early detection and intervention gets you back to feeling yourself and back to caring for your baby.

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