The Fourth Trimester
In 2018 The American College of Obstetricians and Gynecologists updated its guidance on postpartum care. Rather than one visit at 6 weeks, they recommend a series starting at 3 weeks and transitioning at 12 weeks to “well-woman care”.
As one friend put it, “During pregnancy, it’s all about ‘Mom and baby.’ and as soon as I left the hospital it’s like the medical professionals forgot I was even involved.”
Can we talk about why it took until 2018 for that update? Ok, that’s another topic.
Let’s talk about some unexpected postpartum changes to know about:
Hair loss or change in hair texture - If the hair loss continues after a few months, ask about having your thyroid checked.
Emotional changes and swings are normal. If depression or anxiety are more serious conditions, we’ll discuss below
Hot flashes and lots of sweating due to hormonal changes
Shaking and shivers in the first hour after birth
Support for after the baby arrives
We spend lots of time and effort planning for caring for the baby after birth. We need to plan for taking care of the mother as well. Here are some tips for your care plan.
Let other people do for you. They will be offering and you should accept help on everything from laundry and dishes to watching the baby so you can nap.
That said, say no to visitors if you aren’t feeling up to it, simply want to cherish this time or they will be as much a burden as a help.
Consider adding a lactation consultant to your care team. Breastfeeding is hard!
Add recovery items to your shopping list along with diapers.
The best thing you can do to take care of your newborn is to take care of yourself!
That includes your mental health.
There is no “right” or “normal” when it comes to the myriad emotions you experience after giving birth. It is important to remember that taking your mental and emotional health seriously is an important part of your recovery from giving birth.
For 40 weeks, your body has gone through an amazing transformation and that doesn’t stop with giving birth. It can take as long as six months for your hormones to balance after birth. Changes include:
Immediately after the birth (including delivering the placenta), levels of progesterone and estrogen drop dramatically.
Oxytocin rises both to stimulate contractions and to prepare breast tissue for lactation.
Your body prepares for breastfeeding by releasing prolactin
These changes, as well as the changes to your life after giving birth, give rise to a wide range of emotions from joy to anxiety and fear to empathy.
Can we stop saying “baby blues”?
As many as 50% to 75% of people experience some level of sadness postpartum mood changes, mild anxiety, sadness, or feeling overwhelmed. Discussing these with your healthcare provider is an important part of your recovery. And critical in the event you are experiencing a more serious condition. The two most common are postpartum depression and postpartum anxiety.
If those become more severe and persistent, you may have postpartum depression. You aren’t alone - 1 in 9 women experience postpartum depression.
What to look for: Panic attacks, excessive crying, hopelessness, guilt, and inability to make decisions or concentrate are all signs of a serious condition.
When to get help: If these last more than 2 weeks or are interfering with doing daily tasks and caring for yourself or your baby, you need to get help from a healthcare professional.
Lesser known than postpartum depression, postpartum anxiety affects between 11% and 21% of people.
What to look for: Physical symptoms can include nausea, inability to be still, changes in appetite, and a racing heart. Emotional and behavioral symptoms include obsessive thinking, repeatedly checking and rechecking completed tasks, and worst-case scenario thinking.
When to get help: Again, if these feelings are severe or interfere with your daily life, seek professional help.
Both of these disorders can be treated with psychotherapy and, if needed medications.
Can we all agree to share real postpartum experiences to eliminate stigma and know that you aren’t alone?