My OB warned me that the first six weeks after the birth of my son would be the hardest. And she was right. Surprisingly, one of the trickiest parts of the transition was figuring out how to tend to my own needs alongside the needs of my newborn.
Michelle Peterson, mom of two in Sedona, Arizona, agrees. She recalls her first postpartum experience as a period of intense loneliness fraught with stress and health issues. “I couldn’t think straight. I let my body hit total exhaustion because I wasn’t doing little practices of self- care,” says Peterson, who is the author of Seven Sisters for Seven Days: The Mothers’ Manual for Community-Based Postpartum Care. She believes the acute stress may have triggered her autoimmune thyroid disease.
Knowing that in order to best care for others we have to care for ourselves, Peterson carefully examined her priorities in preparation for the birth of her second child. By planning ahead and assembling a postpartum care team of supportive friends and family, she enjoyed a healthier, more balanced experience with baby No. 2, and she now teaches moms and caregivers to do the same.
Of course, there’s no one-size-fits-all formula, but knowing what to expect week by week during the so-called “fourth trimester” can help you customize a plan that works inthe best interest of you and your newborn
Week 1 | Don’t worry, it’s normal
Welcome home! You’re probably feeling tired and physically sore. Your priorities this week should be rest, recovery from birth and bonding with your baby. With surging hormones, your emotions may run the gamut, hitting high and low notes like a toddler plink-plunking on a piano.
“Some women are almost euphorically happy and over the moon when they bring that new baby home, and some women have a little bit more anxiety and feel overwhelmed. Both are completely common, and neither makes you a better or worse mother,” says Kristi Weaver, DO, OB/GYN at Specialists in Women’s Care in Kansas City, Kansas. “We have just given you a tiny little human, and we’re expecting you to keep it alive with your boobs! This is very anxiety- provoking, and that’s normal.”
To help make sleep and recovery a priority, Peterson recommends creating a rest station. Have everything you need within arm’s reach of your bed, including a changing pad and extra diapers for your baby. Remove distracting digital devices that can disrupt sleep.
Furthermore, assign a friend or family member to act as an intermediary to any drop-in visitors, so you can get the rest you need. Some moms might be more open to company than others. Consider what makes you feel the most calm, grounded and nourished, advises Julia Aziz, LCSW, author of Lessons of Labor: One Woman’s Self-Discovery Through Birth & Motherhood. “Some women don’t want to see anybody, and the idea of people coming over and bringing food is horrifying, while others feel happier having a constant stream of visitors.”
Skin-to-skin contact with your little one is essential as you begin bonding with your baby and figuring out feeding. Your milk will come in between days three and five.
This is a good time to have a journal handy to help you process your emotions and record your baby’s birth story, notes Peterson. “Usually, when the milk comes in, so do the tears,” she says. “Your hormones are changing so much.”
Follow a high-fat, high-protein diet, especially if you’re breastfeeding, and drink plenty of water, which will help replenish the fluids lost during labor and delivery. Fluids and foods high in fiber can also help you manage constipation, which is common after birth. If you’re breastfeeding, keep a glass of water nearby at all times. You’ll need to drink between 4 and 6 liters of fluids a day.
Take sitz baths, which are low baths that can help heal any tears, scarring or soreness from childbirth. Also, keep up with your pain medication, especially if you’ve had a C-section.
“The first couple of days you feel worse than you did in the hospital,” Weaver says. “This is a natural progression of recovery. We’d rather women take their pain medication than not take it and then not be able to get off of the couch.”
Week 2 | Live in the moment
One of the hardest adjustments to new motherhood is the sleep deprivation and the sense that you no longer control your life. Before your youngster arrived, you ate, slept, met friends and ran errands whenever you liked, without having to consider the needs of a tiny dependent. To avoid frustration, take this time to simply live in the moment.
“A newborn takes over your life,” Aziz says. “Eventually, you’ll be able to have more choices about what you are doing, but I think it’s easier if you nix your plans and learn how to surrender in some ways. Let go of the ‘plan’ or what you want to do.”
Physically this week, your bleeding should slow down. If you’ve had a C-section, your doctor will want to check the incision, which should be healing but may itch.
Weaver advises all of her new moms to take a shower and brush their teeth daily. “Doing those simple acts once a day just changes your entire outlook on life,” she says. You’ll probably be able to increase your activity level, but try not to do too much.
Accept help—and ask for help—from supportive friends and loved ones. If you’re struggling with breastfeeding, connect with a lactation consultant, join a breastfeeding support group, or reach out to your local chapter of La Leche League International. Say “yes” if your friends and family members want to bring you meals or offer to sit with your baby while you take a nap, shower or step outside.
At the same time, realize that advice from well-meaning loved ones is likely to pour in, which can contribute to feelings of anxiety, inadequacy and overwhelm. Trust your instincts as you try to intuit your baby’s needs, and don’t hesitate to consult with
your care provider anytime you’re unsure.
“Be gentle with yourself. You’re not supposed to know what to do right away,” Aziz says. “This fourth trimester after the baby is born is a learning curve when C you’re growing fully into your role as a mother.”
Week 3 | Take breaks
Be ready, mama! This week is likely to be the hardest of all. Physically, your birth wounds are healing, but emotionally, baby blues can hit hard. The rush of newness has worn off. The onslaught of exuberant friends and family has dissipated as people return to their own lives. Your partner may have returned to work. A profound sense of isolation can easily set in, and on top of that, you’re now several weeks sleep-deprived.
“We’re just different people when we don’t have proper sleep,” says Daniella Silver, board certified holistic health coach and facilitator of a moms group and walking club at New Birth Company in Kansas City, Kansas. “Nobody understands how crucial sleep is to your mental health until you don’t have it.”
Follow the old adage of sleeping when your baby sleeps, and continue accepting offers from friends and loved ones who wish to lend a hand.
“Part of self-care is being willing to let people come and help, which is one of the biggest blocks most women I meet have,” Peterson says. “Self-care is not selfish. It’s a necessity for a mother to be functioning in a healthy way because children are going to be pulling your energy for the rest of your life in different ways—and I don’t mean that negatively. It’s just a fact.”
Begin stepping out of the nest to take time for yourself. “Go get your nails done. Go see a movie. It’s OK to leave that baby for a little bit of time and refresh yourself,” encourages Weaver.
If you’re breastfeeding, feed your baby before you go, and then hand her off to your partner or a helpful friend. Often female friends who volunteer to sit with your little one are moms themselves, and they’d love nothing more than to snuggle a new baby again.
“It’s not like you have to do something every day, but in the course of one week, if you could go have a coffee with a friend and go have a massage, your life is completely turned around,” Weaver says.
Week 4 | Connect with others
Emotionally and physically you should start feeling more like your old self this week. You’ll experience more energy and want to reconnect more with the world outside.
Keep sprinkling one or two activities on your calendar. If you haven’t already, practice short outings to get your baby used to the car seat and learn how to manage logistics like getting the car seat into a stroller, packing the diaper bag and breastfeeding on the go.
Silver says that scheduling a couple of activities to look forward to made a big difference in how she felt overall and helped her become more confident taking her baby out.
“There would be days in a row where I didn’t get out of my pj’s and didn’t take a shower. I felt gross. I didn’t want to interact with people,” she recalls. “But I found that when I started to say: ‘OK, on Tuesday, I’m going to take a walk, or I’m going to visit the farmers market,’ it really helped.”
These days most of us have to create our own villages because extended family is often far-flung or unavailable. If you haven’t already, seek out supportive moms groups in your area. (Find one through your hospital or health care provider, or look online.)
Silver says the transformation moms go through during just one hour of connection in the moms groups she facilitates is powerful. “Moms come in— hair in a messy bun, spit-up on their shirt. You can see the frustration, the stress that they’re going through. They leave here almost different people,” Silver says. “They have this understanding that they’re not alone—there are people who understand and relate.”
Week 5 | Start thinking ahead
You should now feel much better both inside and out. Are you headed back to your job soon? Start mentally and physically preparing yourself for this next transition. If you’re breastfeeding, begin pumping milk and stocking it for your day care provider. Find out if your employer has a lactation room where you can pump while at work. Add a daily bottle or two to your baby’s schedule, so she can transition to another’s care more easily.
Give your relationship much-deserved attention by planning a date with your partner. Between sleepless nights, short tempers and negotiating duties, adjusting to life with a newborn can create emotional distance and put a serious train on a couple. Ask a trusted friend or family member to sit with your baby for an hour or two while you and your partner go for coffee, lunch or dinner. Continue reaching out to other moms. “It’s good to have one friend who is going through new motherhood with you and one friend who has been through it before you,” Aziz recommends.
If you’re going back to work, join or form a working moms group that meets on Saturday mornings, as a periodic lunch bunch, or one evening every few weeks.
Week 6 | Know you’ve got this
Physically, your body is mostly healed from the birth, and you’re hopefully getting better quality sleep now. You may be disappointed that you can’t fit into your prepregnancy clothes yet, but be patient. It can take up to a year to shed your pregnancy weight. Continue to eat healthy snacks and meals, and find ways to fit gentle exercise (like walking, swimming or yoga) into your routine. These activities are good for both your physical and mental health. If you’re headed back to work, purchase a few outfits that boost your confidence. Most of all, don’t skip your six-week checkup with your health care provider, which is as crucial as your prenatal appointments. “This is our opportunity to make sure you are adjusting to mother- hood,” Weaver says. “We can troubleshoot any issues right there in the office.” During this appointment, your doctor will check to make sure bleeding is normal, ensure that there are no signs of infection in the uterus, discuss contraception and evaluate for postpartum depression.