mom hugging her newborn

The fourth trimester, part 2: What to expect after expecting

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“The process of pregnancy renders a woman simultaneously an individual and a crucial part of a dyad: mother and child.” -Martha Fineman

The first three months after birth are referred to as “the fourth trimester” by pediatrician Harvey Karp, as they are a period of adaptation that mother and baby go through following childbirth. Below we’ll focus on tackling some of the transitions that mothers undergo during the first weeks following delivery.

Coming into the world is less a milestone than it is a gradual transition in which the baby relies on the mother’s attunement and help. With this in mind, the end of pregnancy is a process instead of an immediate and clean-cut event. This might not be what some media portrays about the firsts weeks of motherhood. However, it’s what early childhood and developmental psychologists/researchers say, and what actually fits with your intuition or past experiences as well.

Reva Rubin, one of the first specialists in maternal nursing in the 1950’s, was the first to introduce the idea that motherhood as an identity is much more complex than childbirth. Thanks to her we now acknowledge that the deeply transformative process of pregnancy, birth, and motherhood require a period of restoration and adjustment.

The first weeks postpartum are full of intense emotional, social and physical changes for the mother because, according to Rubin, some of the psychological and physical aspects of pregnancy continue after birth. The Association of Women’s Health, the Obstetric and Neonatal Nurses, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologist give some examples of what to expect during this “fourth trimester”:

• Over a six-week-period, the uterus will shrink to its normal pre-pregnancy size.
• Bleeding and discharges may continue intermittently, or a normal menstrual cycle may return. Gynecologists insist that neither this, nor breastfeeding, entail a method of birth control.
• The internal organs that were making room for the growing baby will reposition.
• Some water retention, swelling, and urinary retention may be expected while the body readjusts, and drinking plenty of fluids can help.
• There are still plenty of hormonal changes going on after delivery, so try to be gentle with yourself if you’re experiencing a rollercoaster of emotions.

With this in mind, acknowledge the impressive journey you went through, and let yourself marvel at the unbounded possibilities and journeys that are awaiting while you hold your newborn baby in your arms.


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