The 4th Trimester

Dear Mama,

I created Mommy Matters with the goal of easing the journey to motherhood for every woman through medically informed, functional, stylish, and innovative postpartum products. As a new mama, you are pressured to focus all of yourself on your baby, putting your own needs second. We are here to prioritize you and empower you by providing the comfort, support, and education youneed. Our only goal is to get you back to feeling like yourself again after delivery, because Mommy Matters. While this time feels overwhelming, you will soon be an expert on your baby and the new state of your magnificent body.

In this guide, I have put together my top ten tips which are based on years of helping women and my own experience of becoming a mom. 

In general, a few thoughts:

  • Give yourself lots of grace. 
  • Accept the help that is offered to you.
  • Don't try to be a hero and do it all on your own.
  • Get some cute sweats.
  • Try not to lose your sense of humor.
  • Remember, your parents didn't read every book, have every app, or belong to every online group—yet we all still made it.
  • You will make mistakes, that is part of parenting. It will be ok and your beautiful baby will still be well-adjusted and healthy.

— Dr. Taraneh Shirazian, OB-GYN and Mom

1. It takes a village.

Now is the time to find your tribe to help support you in your postpartum journey. The postpartum period is a tumultuous time with huge amounts of change, responsibility, and healing. Focus as much on your postpartum care as you did your prenatal care.

One of the keys to success during this time is a strong support network. Think of your network as a web of family, friends, and healthcare professionals you can depend on, and who you should ask for help. Encourage your partner to help with daily tasks and take up friends & family on their offers to help.

Women are stretched thin after delivery (pun intended), both physically and emotionally. While self-care may be the last thought on your mind, your health should be the priority. This doesn’t only apply to your first child. A village of support is needed, no matter how many children you have.

Specialist Support

While your primary care provider will be a key figure, don’t forget about additional specialists who may be helpful including lactation consultants, psychiatrists, social workers, postpartum doulas and physical therapists.

Your Support Team

Outside of medical professionals, your support can come from your partner, family, friends, and neighbors. The goal is to have a team of people who you are comfortable with and trust, especially when you are vulnerable and exhausted. These folks are often the first to recognize worrisome signs when a new mom is struggling. Listen to them and take their concerns seriously.

Mental health issues are one of the most common complications that come up in the weeks and months after birth. Let someone know if you are struggling. You are not alone and help is available. Call your doctor immediately if you need help.

"The goal is to have a team of people who you are comfortable with and trust, especially when you are vulnerable and exhausted."

The best time to prepare for postpartum support is before your baby is born. Map out your network in advance so support is a quick phone call or text away. Be sure to speak up if something doesn’t feel right or you need an extra hand. We all want to help!

2. Be flexible.

Just like labor & delivery (and your newborn), the postpartum period is unpredictable. Despite your best intentions, sometimes things don’t pan out as you had planned. Don’t be hard on yourself.

Flexibility isn’t just about having an open schedule and seeing where the day takes you. It might mean scrapping the laundry for today or having cereal for dinner (again). It’s great to try new things when you can but don’t beat yourself up or feel guilty if you don’t. Flexibility at this stage is about finding what really matters each day and letting go of the things that don’t.

What is Flexiblity?

Flexibility does not mean getting every single item on your list done each day, at your own expense. It means accepting where things are and being present with what matters most to you- your new little one, your loved ones and of course, yourself. This will serve you well throughout each unpredictable phase of your child’s life.

3. Bleeding is normal.

You will have bleeding (called lochia) for approximately 6 weeks postpartum – even if you have a C-section. In the first 1-2 days after your baby is born, bleeding is usually bright red. Initially, you may use up to one sanitary pad each hour. Over the next several days, the bleeding will slowly decrease and change from bright red to a pink or brown color and then to a creamy color.

Most women stop bleeding four to six weeks after birth. Also, blood clots (blood that sticks together and forms a jelly-like substance) are normal. In the first 24 hours, clots may be golf-ball sized or larger. The clots should get smaller and happen less often as your bleeding gets less over the first few days. Your body is healing, and your uterus is shrinking back to its pre-pregnancy state.

Keep taking your iron supplements and use products that bring you comfort and help you heal. Mommy Matters HEAL Postpartum Panty will help absorb fluid and leakage. The SOOTHE Perineal Spray helps calm the tissue and provides comfort for tears. It feels great straight out of the fridge when it is nice and cool.

As always, listen to your gut (and your support network) if something does not feel right.

If you gave birth more than 24 hours ago, contact your doctor if:

  • You are still soaking more than one pad every 1–2 hours
  • The amount of bleeding suddenly increases or you pass large clots
  • The blood suddenly changes to a bright red color
  • You feel dizzy, weak, sweaty or have trouble breathing
  • You notice a bad smell from the fluid, or you have a high temperature
  • You are worried that the bleeding is not normal

4. Vaginal tears are very common.

8/10 first-time moms have some degree of vaginal tearing during childbirth. Tears are classified as first to fourth-degree, depending on the severity of the tear. A vaginal tear is a laceration to the perineum (the area between the vagina and rectum) that can occur when the baby is delivered vaginally. The tears are spontaneous, meaning a doctor did not proactively make a cut to the perineum tissue.

The vagina has a big job to do to stretch enough to allow a baby’s head, which is size of a cantaloupe, to come through it. Expect some discomfort with a first or second degree tear for a week or sometimes more. Having a bowel movement, urinating, coughing or sneezing will be very sensitive and may cause some pain. As you progress to week two, the tear(s) should begin healing and any stitches you may have needed will have dissolved. However, the nerves and muscle strength can take several more weeks to heal.

Take it Slow

Sex at six weeks will likely be uncomfortable. Healing for third and fourth- degree tears takes longer. Discomfort during sex, or while going to the bathroom, may last for several months. Take things slow and know that this is normal. Continue to use the perineal spray for soothing comfort. Ice may also help bring relief. Mommy Matters Heal Postpartum Panty is great for absorbing leakage as well as holding an ice pack to relieve some of the discomfort.

5. Breastfeeding can be challenging, especially in the early days.

Not every new mother will have the euphoric feeling that we expected during breastfeeding. While it is natural, it isn’t always easy. Issues vary but can include sore nipples, engorgement, low supply, and challenges with latching.

"While breast- feeding is natural, it isn’t always easy."

Breastfeeding Challenges

Sore nipples, while often short-lived, are one of the most common reasons women quit breastfeeding. This could be due to a poor latch, as well as a pump setting that is too high. Lactation consultants can be a tremendous help here.

Dealing with Swelling

Every new mom has a rather shocking experience when their milk comes in and their breasts become completely engorged. There are products that can help like warm and cold compresses, breast pumps and a good fitting nursing bra. With any luck, this is a short-term hurdle that will subside as you are able to figure out the best ways of feeding for you and your baby.

The top reason women stop breastfeeding is they think their baby isn’t getting enough milk, which is most often not the case. The best way to monitor this is through your baby’s weight. By the time baby is around 14 days old, they should return to their birth weight and start gaining 4 to 7 ounces on average per week.

If your baby isn't gaining enough or is losing weight, that's an indication she's not getting enough. Here again is where a lactation consultant can be tremendously helpful. She can watch as you breastfeed to check your baby's latch. She may have you try to feed more often or pump between feedings to stimulate more milk production.

When breastfeeding doesn't work out...

Despite your best intentions, there are reasons why breastfeeding doesn’t always work out. These can be physical as well as emotional reasons.

We all deal with an incredible amount of pressure to be an ideal mother and making the decision to give formula or expressed milk by bottle can be a very difficult one. The bottom line is you need to do what is best for you and your baby. Find a trusted friend, doctor, or partner and ask for their support.

What Matters Most

The most important thing is that your baby is fed and growing well. While it’s true that breastfeeding offers a lovely avenue to bond with your baby when it’s working, if breastfeeding is not possible, it doesn’t mean you won’t be able to bond with your little one. In no way is it a reflection of your capabilities as a mama.

6. Postpartum is a time of emotional change.

During pregnancy, our hormones increase dramatically. These hormones come crashing down immediately after birth and return to pre-pregnancy levels.

Most new moms experience what is often referred to as "baby blues" after childbirth, which commonly includes mood swings, crying spells, anxiety, and difficulty sleeping. “Baby blues” usually begin within the first 2 to 3 days after delivery and may last for up to several weeks. Being aware that you may experience a roller coaster of emotions is the first step. Along with zig-zagging hormones, sleep deprivation compounds the issues. While the postpartum emotional coaster ride doesn’t have a timetable, the more serious symptoms of postpartum depression do not go away after the first few weeks or can even worsen.

If you have a history of depression, or if you have been depressed or anxious throughout your pregnancy, you should talk to your doctor about putting a plan into place before giving birth. Here again is where your support network can also help. Phone a friend, let your partner know how you are feeling, and be honest with your doctor. Your health is critical to the health of your baby.

7. Pelvic floor relaxation occurs with vaginal delivery.

Let’s put it out there now. The thought that by your six-week checkup with your doctor, you will be feeling 100% and back to your pre-baby body is likely not realistic.

It is also not true that things like pain with intercourse, bladder leakage, and feeling exhausted and weak are your new normal.

Many factors impact how quickly things heal. Every woman is different and heals at a different pace. The pelvic floor muscles stretch (a lot) during delivery. The vulvar tissue is also impacted with all of the changes in hormones. With a vaginal delivery comes relaxation of the pelvic floor which can lead to bladder leakage.

The pelvic floor muscles don’t return to their prior state without intervention. Do your kegel exercises, consider a home use device such as vFit Gold to strengthen the pelvic floor, stay active and don’t ever suffer in silence. Solutions exist to help you feel your best.

8. Go back for your postpartum visit!

A lot has happened in the last six weeks. While life feels insane, prioritize your health by getting yourself to your postpartum visit.

Only 20% of new mothers return for this visit. We know it is a struggle to get out of the house but throw your sweats on and throw your hair in a bun and get yourself to that appointment (you may be able to do this appointment via a video call).

This appointment is as important as any of your baby’s checkups. In these intense weeks after birth, you and your body change and experience a lot. This gives your doctor time to address any issues early and help with any problems. get the support you need and proactively manage any issues.

Let's Talk...

This is not the time to be shy- we have heard it all. Share your concerns honestly and don’t be embarrassed to ask for help. These checkups can be used to help prevent future problems, discuss future pregnancy timing, talk about birth control options, and discuss your sexual health. This is a key time for you to get the support you need and proactively manage any issues.

9. Don't forget birth control.

Although you are newly postpartum, you can get pregnant again as early as 3 weeks postpartum, even if you are breastfeeding or your periods have not returned. Therefore, it is important to use contraception every time you have sex, even the first time.

Both the Centers for Disease Control and Prevention (CDC) and the March of Dimes recommend that women wait at least a full year and ideally 18 months after having a baby before getting pregnant again. The American College of Obstetricians and Gynecologists (ACOG) advises waiting at least six months or more after your last baby's birth before getting pregnant again and cautions against the risks of pregnancy sooner than 18 months after having a baby.

"Use birth control once you start having sex again, even if you are breastfeeding."

Getting Pregnant Again

Conceiving within 18 months of giving birth increases the odds of some complications in the following pregnancy, although experts aren’t exactly sure why that is. It may be because there’s residual inflammation in the uterus from the prior pregnancy and because the body doesn’t have enough time to fully replenish the vitamins and nutrients required for the next pregnancy. On the other hand, some research has also shown that waiting longer (more than five years) is also linked with an increased risk of the same complications, including preterm birth and low birth weight babies.

Bottom line: Talk to your doctor about the best timing for your next baby. In the meantime, use birth control once you start having sex again, whether you're breastfeeding or not.

10. The best care is self-care.

It is easy to focus all of your attention on your beautiful newborn. However, it is just as important to care for the beautiful new mama. You can’t be the best for your newborn if you don’t take care of yourself. You always hear “sleep when the baby sleeps” along with lots of unsolicited advice from well-wishers. Much of it feels unrealistic when onesies are piling up in the laundry room and you haven’t showered in days.

A few things that you should consider as non-negotiable:

  • Follow doctor's orders. If your doctor has given you specific things for follow-up, don’t ignore them (including your postpartum appointments).
  • Get as much rest as you can. This might involve cat naps when baby is sleeping or taking turns on the night shift with your partner.
  • Accept help from your village - they want to help! If a friend stops by, let them help by holding the baby and giving you a few minutes to shower or just do nothing. If you don’t want to let go of that sweet baby, assign them small tasks around the house that are making you crazy (a load of laundry, loading or unloading the dishwasher, washing bottles, etc). Every little thing helps and does wonders for your state of mind.
  • Try to eat healthy meals. When friends offer to make dinner, let them. If you partner asks what you want, have them focus on whole grains, veggies, fruits, and protein. A common issue is constipation, so add a little extra fiber to your diet. Don't forget to stay hydrated, especially if you're breastfeeding. Keep a water bottle close by.
  • Get some fresh air. A walk around your neighborhood can boost your mood and energy levels and give you some light exercise.

Here's to you, mama. You are
remarkable, beautiful, and incredibly strong.