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The Pregnant Athlete Series: The 4th Trimester (First 3 months postpartum)

The fourth trimester is not recognized by most healthcare providers. Anyone who has given birth will agree that there is such a thing. The fourth trimester is the first 3 months after you give birth. Everyone is focused on the baby, including yourself. In North American culture we forget that the mothers just went through an extraordinary event that has left your body weakened. North American culture promotes the delusion of a super mom, who does everything effortlessly. We need to understand, that is the opposite of reality and mothers need to stop striving for that ideal. In Indian culture all the “aunties” come over to the new mother’s house and pamper her. They realize how much stress you have just put your body through.

The first few weeks after having a baby end up being a blur. You are tired from having given birth, and that is only the beginning. If you decide to breast feed there are many stressors that come with that. The baby latching, how painful it is, is the baby getting enough food? How do I know that I am making the right decision? What if breast feeding isn’t for me, does that make me a horrible mom that puts her baby on formula? The list of self-doubt and questions goes on.

Now that we are moms, we are magically supposed to be morph into a superhuman. We can do it all, even if we are in the most depleted state we have ever been. I must get through this with a smile! One of my favourite comments is, “Everyone else has done it, you should be able to too!” My advice is block it out. You are going develop your own style of parenting and it is going to take time. The fourth trimester is about bonding with your baby, getting your milk supply up, and trying to sleep as much as possible. Do not think there is anything more important than healing yourself. You will not be able to take care of anyone for any length of time if you have not taken care of yourself first. The analogy of putting on your own oxygen mask before helping anyone else on a plane holds true. You are not going to be sustainably available if you do not make your own health a priority.

Now we should talk about the fun hormones, and mental health issues that will appear after you give birth. Eighty-five percent of women will experience mood disturbances after giving birth[1]. We typically hear about postpartum depression, but there are other mental health issues that you should be aware of.

  • Postpartum blues: Typically considered normal where you are more tearful irritable, have mood swings and feel more anxious. This should randomly disappear after the first 2 weeks1.
  • Postpartum Depression: happens after the first 2-3 months after giving birth. It is clinically indistinguishable between regular depression.
  • Postpartum Anxiety or OCD: You can develop panic attacks or hypochondriasis (needing everything to be clean). Little has been researched on the anxiety aspect because there are a lot of overlap symptoms with Depression. Further study needs to be done in this area1.
  • Postpartum Psychosis: This rare and the onset happens 48-72 hours after birth. Symptoms are; rapidly shifting depressed or elated mood, disorientation or confusion, and erratic or disorganized behavior. Delusional beliefs are common and about the baby. Hearing voices that tell the mother to harm herself or her baby can happen. Risk for infanticide, as well as suicide, is significant in this population.1

It is important to make sure that you get out of the house every day and try to go outside. With or without the baby. This has been shown to help with mood in the fourth trimester. Always keep an eye out on your mood, and know that it is normal to have mood swings. It is not normal to be thinking about suicide or harming the baby. You are going to feel overwhelmed. You have been thrown into a situation that you really couldn’t have prepared for. You need to be gentle to yourself.

My Athlete mommas… they key here is be gentle to yourself. You will need to heal. If you do not give yourself the proper time to heal, You will cause long term harm to your body. Your pelvic floor will be weaker, organ prolapse and incontinence happen. There are a few tricks to help you heal:

  • Wear a belly wrap for the first 8 weeks after giving birth to support your abdomen.
  • Check out the Mutu System. This is going to tone the pelvic floor
  • Go back to your pelvic floor physio therapist to help you heal. They will also tell you how to rehab your belly. If you had a C-section, they are going to give you techniques so you will not develop the post C-section shelf.
    • They will also tell you when you are ready to go back to running and heavier weights.
  • No intense physical exercise for at least the first 8 weeks. C sections can be longer.

Next week we will talk about getting your body back and realistically what to expect.


[1] Post partum psychiatric disorders. MGH center for women’s mental health. Retrieved Nov 16, 2019. Updated 2019. https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/

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