Thriving Through the 4th Trimester: Knowing What to Expect

Welcome to the last post in this series, Thriving through the 4th Trimester. Follow me as I share what I learned applying traditions from other cultures to my own postpartum journey. It is my hope that this knowledge will serve as a guide for how to truly care for a woman, as she transitions from maiden to mother, in the most wholistic way possible.

Each pregnancy is different. Each birth is different. And in turn, your body’s response to these unique events will be different. But it helps to know what you might experience, so that you know what range of things are “normal.”

  • You might bleed for several days, or it could last upto six weeks. If you overexert your body, that bleeding could increase or come back. If you stand for too long, you may experience pain in your lower back, buttocks, or pelvic floor, especially if you have had stitches. This is normal. Listen to that pain. Just like the increase in blood, this is the body’s way of saying, “It’s past time to lie down.” Do it. And if your bleeding feels excessive, tell someone. Reach out to your OB or Midwife.
  • You might shake significantly after giving birth. This is a combination of adrenaline and hormones. The shaking generally lasts for several minutes after giving birth and typically subsides within an hour. This is normal. If you experience shivers or shakes in the days following your delivery, this could be a sign of infection and you should notify your OB or Midwife.
  • You might have cramping pains. The cramps might start as early as immediately after giving birth. It is just your uterus shrinking back to its normal size. A nurse or Midwife will likely be checking on your uterus by pressing down into your abdomen. This is not comfortable, to say the least. Your cramping pains might increase during breast-feeding sessions. They can last up to two weeks. This is all normal.
  • You might feel swollen. During pregnancy, your blood volume increases by as much as 50%. You do lose blood during childbirth, but you might still have an overabundance. This extra blood, as well as any IV fluids you received during labor or a C-section, will have to find a place to go. As a result, you may notice swelling in your lower legs, vaginal, and labial areas. This is normal. However, if the swelling persists past two weeks after you’ve had your baby, notify your OB or Midwife.
  • You’ll still pee a lot. As your body tries to get rid of this extra fluid, you’ll need to urinate frequently. Birth can take a toll on your urinary tract. You might not be able to feel when you have to pee in the first couple of days. Make sure you go to the bathroom and empty your bladder after each time you feed your baby for the first few days. You may leak when you cough, laugh, or sneeze. It’s normal to have a little incontinence the first few days. But tell your doctor if this leaking persists after you hit your 6 week mark. Leaking when you cough laugh or sneeze, past six weeks postpartum, is not normal. It is incredibly common, and has been accepted as a norm in our society, and this is a travesty. Leaking means that there’s either tension or weakness (or both) in the core/hips/pelvic floor. This should not be a part of your new normal. Please reach out to a pelvic floor physical therapist.
  • Some days, you may feel weak. You might feel like you need help getting up out of bed, toileting, or showering. Ask for that help. Other days, you may feel vibrant and energetic- like you’re perfectly capable of deep cleaning the entire house and taking on the world! Try to resist this urge. But either way, in the first few days postpartum, this is normal. If you are still feeling significantly weak to the point where you need to have assistance getting to the bathroom past those first few days, reach out to your OB or Midwife.
  • You may not feel hungry. You may forget to eat. You may feel ravenous and want to eat everything in sight! Listen to your body and try to apply the food principles from Nourishing the Mother with Food to help you restore your digestion and heal.
  • It may hurt to poop. And that’s part of why eating foods that aid digestion are so helpful- smooth poop hurts less! Difficulty toileting in the early postpartum stages is normal. Difficulty toileting past six weeks, may not be normal. Please tell someone. And if that someone doesn’t give you sufficient help, tell someone else. There are physical therapists out there, like me, who specialize in pelvic floor therapy. You don’t have to live with long-term changes in urination or defecation. Reach out sooner than later.
  • You may feel like you’re in a completely different body. There is a shift in how we carry our bodies during pregnancy vs immediately postpartum. There is an empty space in your midsection. Some parts of your body might feel looser than ever. Some areas might feel tighter than ever. You’re also carrying around a newborn in your arms, and that changes everything. It all might feel foreign. This is normal. If you’re experiencing pain in your body, that is not normal. That does not have to be come part of your new normal. There are practitioners, like me, out there who want to help you feel better. Reach out. And the sooner the better.
  • Nursing might hurt. Some pain during nursing is normal. Persistent pain, blisters, bleeding cracked nipples, are all very common but not necessarily normal. You may want to see a lactation consultant to evaluate your baby’s latch, check for lip/tongue tie, and get advice on positioning during feedings. A little help and advice early on from a trained professional can make a world of difference.

You are not alone, and you don’t have to go through this alone. There are many people in your tribe that have gone through this before you, and many that will follow after. They want to help. Now is the time to lean in.

Talk to the women in your “village.” Even if those women say, “That happened to me too!” It may just be a common issue. That doesn’t make it normal. They may not have known to reach out for help. If things don’t feel normal to you, reach out to a professional. There are plenty of us out there wanting to help you feel better again.

Here’s a little exercise to keep in your back pocket: When you feel like you are really struggling and it’s hard to pull yourself out of that negative headspace, ask yourself, “What will I miss about this stage when I’m looking back?” Even if it feels impossible, come up with a few positive things. When times get really hard, try to focus on those things, instead of the hard stuff.

And remember Mama, This is temporary. The days are long, and the years are short. Try to enjoy the ride!

I hope you found this postpartum series helpful. I’d love to hear your feedback!

If you are currently pregnant or have just had a baby, consider sharing this with your support group so that they can provide you with the kind of help you need to be able to focus your time where it’s really important!

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