You have probably spent the last few months, weeks, days planning and envisioning your baby’s birth day. Maybe you have researched about natural birth or epidurals, exercises to help you in labor, delayed cord clamping and the perfect breast pump. And then, like a flash, the day has come, you are holding your long awaited baby and packing your bag to go home from the hospital.

But then it sinks in… “wait, they are letting me go home with this baby? They think I know how to be a mom?!?”

Yes! You are a mom and although it may be much anticipated, it also can be scary and overwhelming. So let’s talk about the 4th trimester or postpartum.

Rest/Sleep

In some cultures, new mothers are given reprieve from all obligations except caring for their baby for 40 days. This corresponds to the 6 weeks off most women receive from work after delivery in the US. Although it may be hard to let go of cleaning the house or cooking meals, really the most essential thing you can do for yourself is get adequate rest.

Whether you are nursing or bottle feeding, your sleep will be interrupted by feedings in the middle of the night. The relentless lack of adequate sleep can accumulate to make one fatigued mom. Take naps when your baby does. If people want to visit, ask them to throw in some laundry for you or grab some groceries or take out for you on the way. Ask them if they would mind watching the baby while you nap. Most people want to help but don’t know what you need, so by giving them a task, they probably will feel better about their visit. You do not need to entertain! You do not need a clean house! You do not need to cook! But you do need to recover from your delivery and have time with your baby.

Nutrition

Many new mamas are anxious to lose their pregnancy pounds ASAP. But in the midst of caring for a newborn — and if you are breastfeeding, being the sole nutritional source for your baby — and recovering from your delivery, you also need to make sure you are eating well and hydrating. For you nursing moms, you will need additional healthy calories – it takes more energy to feed a newborn than when your baby is inside you during pregnancy. You may find you are more thirsty, so make sure you have some water nearby all the time.

Exercise

Just like with your diet and losing weight, the same advice holds true for exercise – you need to recover from your delivery first. That being said, getting outside for a short walk, can feel good. But in terms of returning to your previous exercise routine, wait 6 weeks and get the okay from your doctor. Once you are ready to start exercising, take it slow and build up to where you were pre-pregnancy. For those who had c-sections, your restrictions include not lifting anything heavier than your baby. Also for you c-section moms, you may want to limit going up and down stairs, so have all your diaper changing supplies, nursing supplies, water, and any other needs both upstairs and down so it is easily accessible.

After 6 weeks, a helpful thing to get your pelvis and abdominal muscles stronger is to see a physical therapist that specializes in women’s health. They can help you with pelvic floor exercises to avoid issues like leaking urine when you jump or cough. They can also help you avoid or treat diastasis which is a separation of your abdominal muscles.

Hot Flashes and Night Sweats

Having hot flashes? Waking up drenched in a pool of sweat? No, you are not going through menopause! But, holy cow, what the heck is going on? You have just gone from the ultimate high of hormones to a deep canyon of low in a very short time. This huge hormonal shift will cause the sweats and hot flashes. It will settle down as your hormones come back on line. But in the meantime, have an extra set of pajamas nearby, wear layers, maybe even have a cool cloth around.

Sex

This may be the last thing on your mind between getting no sleep and healing from your stitches. You may also be scared that it is going to hurt, definitely a valid concern after your vagina has been stretched beyond anything you imagined! A couple things to keep in mind – no sex for 6 weeks so everything can heal. Secondly, just like with the symptoms of hot flashes and night sweats from your hormones dropping, you may also experience vaginal dryness. Have some lubricant available to help with the dryness. If sex is still painful, see your doctor.

Postpartum Blues/Depression

Not only have you gone from the center of attention to taking care of the center of attention, you have also gone through a huge hormonal shift, you are probably fatigued and juggling feedings, diaper changes, and maybe even a colicky baby. And if you had any complications with your pregnancy or delivery, you may need to process these unexpected events. Having moments of doubts as a mother, crying at the smallest things, and or yelling at your partner for no good reason can all be part of the postpartum adjustment. Give yourself some space to feel your feelings. But if you have a history of depression, talk to your doctor (preferably before you deliver so you have a plan in place) about your history and if you have taken any medications in the past. If you find yourself not able to get out of bed, enjoy moments in your day, have thoughts of harming yourself or your baby, you need to reach out for help immediately. You are not “going crazy” or are a “bad” mom, but you need some support and there is no shame in getting some assistance.

No matter what your pregnancy or delivery experience is, no matter if this is your first or fourth pregnancy, we all need support as mothers. It really does take a village! Reach out to your village which includes your doctor for any postpartum questions or issues.

Andrea Eisenberg

Andrea Eisenberg

Andrea Eisenberg, M.D. has been in practice for over 26 years and is certified by the American Board of Obstetrics and Gynecology. She graduated from Wayne State School of Medicine in 1989 and completed her residency at Sinai Hospital in Obstetrics and Gynecology in 1993. She is affiliated with William Beaumont Hospital which now includes the ability to deliver at the Karmanos Natural Birth Center. She has delivered countless babies and enjoys being a part of such a special time for families. Her special interests include family planning, infertility, adolescence, menopause and helping women transition through different phases of their lives. Dr. Eisenberg also has an interest in narrative medicine and originated a program with the residents of Beaumont hospital. In 2020, she was awarded CREOG’s National Faculty Award for excellence in teaching. She also has been published in Intima, Journal of Narrative Medicine; Pulse, Voices From the Heart of Medicine; The Examined Life Journal; ACOG District V Special Delivery, and After Rounds as well as having her own blog, www.secretlifeofobgyn.com.

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