Of course, we’ve discussed “the fourth trimester” on Mother here and there. But with the new book of the same name (The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and RestoringYour Vitality) getting rave reviews, we thought it only right to ask author, doula, and mother Kimberly Ann Johnson to give us her take on every woman’s needs during this crucial post-birth period. Check out her wise words below.
These days, women prepare for birth with a fervor. From choosing a doctor or a midwife, to deciding who will be in the room—these are the things on most women’s minds during and even before pregnancy. What hasn’t been given much attention is the postpartum period. Sure, you’ve read a few baby books, and you have an idea of what your infant will need. But the truth is, mama’s needs, after giving birth, are crucial. Taking care of the new mama is essential, and not only for her healing postpartum. Studies have shown that infants who experience a connected, present mother will be more well-adjusted later in life.
What follows isn’t a self-care article, in the traditional sense. This is a model of community care. You will need rest, true rest, first and foremost. What’s most important during the first 40 days after giving birth, is ensuring that you will be taken care of by your partner, your family, your friends, and your community so that you can rest. You will need nourishing meals, bodywork, conversation with mothers who have been through what you’re going through, and contact with nature. A plan for requesting and receiving this care is essential in ensuring that you heal well, and protect yourself from experiencing health problems down the road. While this may seem excessive and luxurious, when these needs are not met, new moms often feel isolated, lonely, lost, and yes, depressed. The following are the necessities of every new mom, including women who have experienced miscarriages and loss. It should be noted that there are remarkable similarities in the ways that women are cared for all around the world after they give birth. While specifics may differ, what is shared across cultures is the attention to creating an environment that respects these five universal postpartum needs.
An Extended Rest Period
Around the world, new mothers are expected to rest for the first twenty to sixty days after giving birth. Women are literally sequestered in order to rest. Women are cared for so that they can direct all their care toward their babies. A new mother is supported in resting so as to give her body, mind, and spirit time to harmonize and process everything she has just experienced. Both classical Chinese medicine and Ayurveda view this time as the most critical in ensuring a woman’s long-term health. The Chinese call this period zuo yuezi, which means “sitting out the month,” sometimes translated as “confinement.” It’s also been referred to as the golden month. In India, this period is called the sacred window, and women move from their marital house back into their mothers’ houses so they have no household responsibilities: they know if a woman is in her own house, she won’t resist housekeeping! Vietnamese women respect this time called nằmổ, “lying in a nest,” by eating tonics and soups, and sitting over charcoal steam prepared by their aunts and mothers. In Mexico and Guatemala, this forty-day rest period for healing and mother-infant bonding is called la cuarentena. This immediate forty-day window postpartum is considered so potent that a woman can heal lifelong illnesses and restore her health, or she can become vulnerable to diseases that take a lifetime to attend to. As noted just above, our modern six-week postpartum health-care checkup is a nod to this knowledge that the six-week mark is a significant moment in the health of mother and baby. Yet it is not accompanied by the intensive nurturing between the birth and the visit itself.
Food is a fundamental human need and makes up the building blocks of our body. More importantly, food is medicine. New mothers need special foods during this time. A new mother should consume certain herbs and foods, so she can complete the cleansing of the uterus, eliminate any old blood still remaining, and rebuild her strength. These foods also help a woman to produce milk with more ease. Since a new mother is vulnerable to cold and wind, she needs foods that are both warm in temperature and that have an internal warming effect due to the spices used. In Hong Kong, women are fed special soups, first for elimination and ease of digestion, and then to rebuild blood and life force. In Korea, soups are made with many kinds of seaweed, which is full of rich minerals. While there are variations in ingredients and spices from culture to culture, what the postpartum foods have in common across cultures is that they are warming, easy to digest, mineral rich, and collagen dense.
During the birth and postpartum period, women’s bodies are going through tremendous changes. Organs are returning to their optimal positions. The body is returning to a normal blood and fluid volume. Hormones are recalibrating. To assist in all these changes, to flush the lymph and to optimize circulation, bodywork is an integral part of a woman’s recovery to vibrant health. Because of this understanding, Asian cultures pamper new mothers. In Korea, a new mother gets a massage every day for forty days to help restore organ position and circulation. In India, women receive abhyanga, circulatory massage with herbal-infused oils, from sisters and aunts. In Mexico, women are taken through a “closing of the bones” ceremony that includes massage, herbal steam, cathartic release, and being tightly wrapped. In the Indo-Malay tradition, women’s bellies are intricately wrapped, and that practice is now also in Singapore, India, Nepal, Taiwan, and Hong Kong, too. It’s important to have caring touch during this time period, whichever tradition you decide to incorporate into your healing.
Presence of Wise Women and Spiritual Companionship
In most cultures, birth and new motherhood are still considered the territory of women. Therefore, women are surrounded by and tended to by other women who are in different stages of life and who can offer them soul comfort as well as knowledge from experience as aunts, mothers, and grandmothers. There are the practical considerations, such as how to breastfeed, how to care for any small vaginal tears, and what to eat. Then there is the very real fluctuating emotional state, and having other women who have been where you are and can share their experiences is balm to the sensitive heart and nerves. In many countries, this post-birth time is respected as a delicate one, physically and spiritually, for mothers and babies. In Hopi and Mayan traditions, unmarried and elder women take care of new mothers, so they are relieved of their normal duties and responsibilities and can simply care for their babies during this time. In Turkey, women are kept in the company of loved ones for forty days. The idea is to distract the evil spirits and to keep people from looking directly into the baby’s eyes, possibly stealing a part of their spirit. Women need to know that they are not all alone, that they can relax because there are other women around who can care for the home, care for the baby, and care for the mother in this new, vulnerable state.
Contact with Nature
In our high-tech, fast-paced lives, we often forget about the tremendous teacher and resource we have in the natural world. In nature, a seed sprouts, a flower bud blossoms—each process in its own time. We can’t force it to happen faster. We can provide the conditions—the right soil, sunlight, and water—for optimal growth, but we cannot push it to happen any faster than its natural rhythm. This is the same in the fourth trimester; life takes on its own pace, one that is entirely unique in its golden languorous quality. Connection to nature can help you feel the beauty and rightness of the slower pace at this time. It’s not necessary to go hiking or camping to feel the power of nature. You can do simple things. Set up a nursing station near a window with a view. Take a sponge bath in warm herbal infusions, as the women do in Mexico, Guatemala, and Brazil. Relish the multilayered flavors of herbal teas. Imbibe the earthy qualities of herbs in your sitz baths and steams. Trade screen time for sitting outside, bundled up, absorbing the feeling of the elements around you. Allow yourself to breathe fully. Feel the air coming into your body, follow its trail and then consciously exchange it back out into the environment. These are all simple ways to reconnect with the elements of nature, the life force around you.
In places where the culture is not explicitly designed to honor this time immediately after birth, women have to take measures to create their own sanctuaries of relaxation and restoration. At first, the amount of support we need seems surprising, maybe even excessive, especially given the superwoman ideal currently prevalent in the Western world. Women are supposed to give birth and bounce back without missing a beat. Yet the truth is, a new mother needs to be mothered herself. Everything the baby needs—a quiet, calm space, eye contact, swaddling, soothing sounds, and frequent nourishment—a new mother also needs. Use the five universal needs to guide you in the process of building a Postpartum Plan. Your attention to building a community of support at this time will be rewarded exponentially in your radiant health, and yes, even bliss at this time.
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