Ah the 4th trimester! It’s like a bonus round of pregnancy, but you can breathe easier and move a bit more easily, because your womb-mate has vacated the premises. And instead of craving chocolate and spicy food, you are craving sleep and sanity.
Me, 2 days postpartum
The 4th trimester is the first three months after giving birth and in my personal opinion, is often an overlooked period of time. It is a time of significant physical, mental, and emotional changes for Mothers. You are adjusting to your new role as a Parent (of 1, 2 or 3 kids) while simultaneously recovering from the physical demands of pregnancy and birth.
Let’s be real, it’s a tough time. You are sleep deprived, you are dealing with postpartum bleeding, your vulva hurts, your hormones are all over the place, and you are trying to figure out how to keep a tiny human (or a few tiny humans) alive. All the while you are also trying to take care of yourself and heal any scars-the physical and/or mental ones. For all of the aforementioned reasons, the 4th trimester is not a time that should be rushed. That is why, SLOW is FAST when it comes to postnatal recovery and fitness.
Your uterus needs to come back down to its original size.
You have a large wound in your uterus from where your placenta was attached.
Your muscles, ligaments, and joints are in different positions and need time to adjust, heal and regain strength before you can start engaging in more intense physical activity.
Rushing into intense exercise or trying to get back to pre-pregnancy fitness levels too quickly can put you at risk for injury and delay the healing process. I have worked with many women who told me they were given the go-ahead at their 6 week check up and thought that meant all activity was back on the table. They weren’t experiencing any pelvic floor dysfunction symptoms, just felt sore and weak overall, so thought they would try going for a short run or do a short HIIT workout. Post run or workout, they experienced bleeding, incontinence, or felt pressure in their pelvic floor.
How nice would it be to be able to do that during your 4th trimester? Or just more in general?!
Postnatally, we are not recovering in a bubble with perfect circumstances. There are so many factors influencing your postpartum. Such as:
Your genetics.
How active you were before and during pregnancy.
Labour and birth unknowns such as, how long you laboured, how long you pushed, the positions you laboured and pushed in, if you had a c-section birth, what interventions were used (oxytocin, epidural, forceps, catheter) etc.
Your support team.
Resources and care you have access to (healthcare, childcare etc).
Your hormones.
Here are five reasons, why you need to slow down and be more intentional with what you do during your 4th trimester:
1) Your sleep is disrupted. Like a lot.
Sleep is crucial for recovery and overall health, and an infant makes it really hard to get enough. Lack of sleep impacts your energy levels and makes it harder to engage in physical activity. It's important to prioritize rest and recovery during the 4th trimester. Really anytime when your sleep is disrupted. Rest and sleep allows our body to repair itself and restore our energy levels.
Quality sleep supports:
the regulation of hormones
emotional restoration
minimize exhaustion and prevent burnout
you bonding with your baby since you can spend more time doing skin-to-skin with them
Pushing yourself too hard too soon and ignoring the need for rest and recovery in early postpartum, may increase the risk of injury and lead to long-term setbacks in your recovery and fitness journey.
2) Your priorities have shifted.
After having a baby, your priorities shift. Whether it’s to one baby or to an older sibling and a new baby. You may find that you have less time, less energy, and making yourself a priority is harder. That’s okay and completely normal. Do not try to do it all and balance everything, instead swing your energy, time, and resources to what needs your attention, like a pendulum. You may not be #1 on your priority list right now, but you still matter, so try to spend 5 minutes a day focusing on your physical and mental postnatal recovery.
Here are some ways you can swing your pendulum to making yourself a priority:
Spend 2 minutes connecting to your core, by focusing on relaxing belly breathing followed by 2 minutes of diaphragmatic breathing
Spend 3-5 minutes indirectly or directly massaging your c-section scar
Have your Partner spend sometime doing skin to skin with the baby so that you can go shower or go for a walk.
3. your hormones
The imbalance of our hormones postnatally affects your emotional, mental, and physical state. During pregnancy, a woman's body undergoes numerous hormonal changes to support the growth and development of the baby. Your estrogen and progesterone levels drop quickly after childbirth, and can contribute to mood swings, postpartum blues, and feelings of sadness or irritability. These hormones usually level out to pre-pregnancy levels around 6 months postpartum.
The relaxin hormone that helps your ligaments and muscles loosen during pregnancy to prepare for birth, can stay in your body for up to 12 months postnatally. Estrogen also plays a crucial role in maintaining the health and function of the pelvic floor muscles and tissues. So when estrogen levels are low, that can have a negative effect on your pelvic floor.
As you can see our hormones have a big impact on not only our mental and emotional states postnatally, but also our pelvic floor stability and function. The best thing you can do is be kind to yourself, show yourself grace, and reach out for help from family, friends, counsellors, and Pelvic Floor Physiotherapists.
4. Your mental health
Having a baby is an emotional rollercoaster, and it's important to prioritize your mental health. Just like we don’t know what will happen physically during labour and birth, we do not know what mental or emotional traumas we might experience either. Hormonal fluctuations can have a profound effect on mental health. The sudden drop in estrogen and progesterone levels after delivery, combined with sleep deprivation and physical exhaustion, can contribute to feelings of sadness, postpartum anxiety, or postpartum depression. Slowing down and prioritizing yourself, as much as you can, during this time allows you to better cope with these hormonal shifts and maintain your mental well-being.
Here are some simple ways you can support your mental health:
Set a timer for 5 minutes and complete one or both of these exercises.
Set a timer for 8 minutes and complete as many rounds as possible of 8 glute bridges, 8 bird dogs/side, and 8 incline push ups (hands on the wall or on kitchen table). Get your endorphins pumping!
In a moment of a lot stress or anxiety, make a note of 1 thing you can see, 1 thing you can hear, 1 thing you can smell, 1 thing you can taste, and 1 thing you can feel.
Seek support. Either in postnatal groups/classes where you can connect to other people going through similar experiences. Or through postnatal counselling where a professional can provide a safe and supportive space to address the emotional and psychological challenges you may be experiencing after childbirth.
5) What we do in the 4th trimester sets the tone for the rest of the first year postpartum
The choices made during the fourth trimester can set the stage for long-term habits and behaviors related to your recovery, physical and mental fitness, and overall well-being. By prioritizing yourself, being kind to yourself, and incorporating the right kind of exercises into daily routines, you can ensure a stronger recovery and establish a foundation for a healthy and active lifestyle. You can get back to doing the activities you love sooner and with more confidence.
Things I would recommend you do in your 4th trimester:
See a Pelvic Floor Physio even if you are not experiencing any dysfunction symptoms (incontinence, pain, pressure) at the moment
If you had a c-section birth, massage your scar. In the early stages there are plenty of ways you can indirectly massage the scar (without having to even look at it) and once you are cleared by your Doctor to touch the scar, massaging it directly.
Get mental health support sooner than later. There are lots of free resources (Postpartum Support International and Good Moms Have Scary Thoughts Too) and AHS offers up to 10 free postnatal counselling sessions through the Early Childhood and Perinatal Mental Health program. You do need a referral from your OB/Midwife/GP.
Let go of the all-or-nothing mindset and get good at doing an effective workout in 10 minutes.
It definitely is easier said than done. There are plenty of bumps in the road because we truly are learning as we go in Motherhood. We get to a point where we feel like we have parenting under control and then BAM!, our baby goes through a developmental leap and what worked before doesn’t now. That’s why showing ourselves grace is incredibly important.