The postmodyrn Midwife: Planning a Successful Fourth Trimester
As a midwife, I often talk to couples about their “birth plan.” While creating such a plan is a worthwhile exercise, I remind my families that we ultimately have little control over our birth experience.
The postpartum period is different. We still don’t have complete control (sorry, folks!), but in my experience, anticipating the changes will make them less disruptive. Understand now that in the 4th Trimester, you will be overwhelmed. You will wonder what just happened – to your life, to your body, and to everything you knew as "normal." But this is a new normal. And you will get there - you will shift - as long as you give yourself the time you deserve.
One way I help my families prepare is by talking about traditions developed in other cultures to care for new mothers. For example, in Indian Ayruvedic tradition, mothers are pampered at home for 22 days after birth, a period of rest considered crucial for both the mother's and baby’s nervous systems. In Holland, a special nurse stays with the mother and child for 8 to 10 days, focused exclusively on their care. In Southeast Asia, the new parents’ house is closed and a sign is placed on the door announcing the baby’s arrival. The community then knows that the family needs quiet. A fire is lit near the mother’s bed, and the mother and baby are wrapped in warm blankets and kept for several weeks in this womb-like environment. Also in Southeast Asia, the father traditionally collects firewood throughout the pregnancy, preparing to protect, care for and warm the mother after the child is born.
Now, I get that your partner is not expected to head out in search of a firewood. But I do want both you and your partner to consider how other cultures respect the 4th Trimester. I challenge my families to embrace this respect.
During your pregnancy, the postpartum period seems far away. We long for it, but it's more of a concept than a reality. After all, you can’t even see your baby, and you can't really know what to expect. But this is the time to plan, so I equip families with my favorite tips, and encourage them to work through the list as the due date approaches (and stick to it after the baby comes).
1) Adjust Your Expectations. Expect your world to change. Expect the tears. Expect the lack of control. Don’t expect Pure Mama Bliss all the time. There will be bliss; you will be in love with this new baby (although maybe not right away, which is completely okay). But this is not the movies. This is not your best friend’s experience or your mom’s experience or your sister’s experience. It is yours. It has never been done before. There are no expectations. Just a new path for you to create. You are the best mother your baby will ever know.
2) Adjust the Expectations of Family and Friends. Talk with them, and prepare them too. Let them know that you have no idea what this new reality will look like, and it may take some time for you to feel ready for visits.
- Explain that your new family needs this time to bond. You will be resting, recovering and relishing in your baby – you are not obligated to share this time. Remind your family and friends that there will be many opportunities for them to see you and the baby, but you only have one opportunity to share this sacred time with your new family.
- Ask family and friends to limit their visits to an hour. You’ll need to rest, or eat, or feed your baby, so visits must be short as you heal and recover.
3) Redefine Sleep. Every postpartum woman needs sleep to heal, and every child needs sleep to grow.
- Forget “nighttime” and “daytime.” Every “time” is an opportunity for you to sleep. A wise doula told me - which I pass on to my families – calculate the number of hours of sleep you need daily, and make it your goal to get that number of hours. Stay in bed. Don’t shower. Don’t brush your teeth. Don’t do anything you don’t need to do until you get those hours of sleep. Sleep is sleep and it adds up, so get it when you can.
- How to achieve this much needed rest? Dress the part. Stay in your pajamas. When visitors come over, don’t look ready to entertain. If you look disheveled and un-put-together, it will be awkward for guests to stay - and that's okay! They should not stay. You are not a hostess. You are a new mother.
- In the two weeks after birth, aim to spend 5 days in the bed, 5 days on the bed and 5 days around the bed.
3) Prepare Your Home.
- In the days (and months!) after birth, you will be HUNGRY. If you are breastfeeding, you will be STARVING. Honor these feelings. Fill your freezer with nutritious food, at least enough for the first two days at home. Choose meals that you know you’ll want to eat.
- Stock up on fresh fruit and veggies. Ask a friend to drop off local goodies from a farmer’s market, or consider signing up for a food delivery service.
- Stash take-out menus from your favorite restaurants and mark your go-to dishes so all you’ll have to do is pick up the phone.
- Buy more laundry detergent than you ever think you could use.
- Create a nursing spot in more than one room, including snacks and water bottles. A place to prop a book, favorite magazines or your iPad. Yes, take the time to enjoy your baby, but this is your time too.
Over the next few weeks, I will be writing more about ways to prepare for the 4th Trimester. Next week I will focus on the theme of support. Until then, be well.
Ellie Griffinger-Guidi, CNM is a private practice midwife at Alta Bates Summit Medical Center in Oakland, CA. Ellie works in partnership with clients to create individualized birth experiences where women feel supported, empowered and in charge of their health care. Ellie graduated from University of Pennsylvania School of Nursing in 2011 and become a Certified Nurse Midwife. A Bay Area native, she was born at Alta Bates hospital herself. Her practice fulfills a lifelong calling to be an advocate for women’s health.
Photos: Laura Kudritzki Photography
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