The Beloved 4th Trimester!

By: Shirlea North, PT, DPT, CLT

Congratulations, you had your bundle of joy and made it through 9-10 months of pregnancy and were a champion at the delivery, whether vaginally or C-section and whether with medication assistance or not. But did you know it’s not just 3 trimesters, there are 4! Maybe it should be named quad-mester??

Dr. Harvey Karp popularized this 4th trimester concept and has defined it as the timeframe between birth through the 12th week postpartum. Not only are a lot of changes and developments happening for baby, but also for you, mom!  Your hormones are trying to regulate back to prenatal levels and in the meantime, your uterus is shrinking, your breasts are producing milk, your body is adjusting to the change in blood pressure and weight. In addition, any incisions that were made during either C-section or vaginal delivery are healing.  All this is happening while you are sleep deprived, experiencing emotional changes and adjusting to the ever-changing sleep schedule. The phenomenon of “preggo brain” quickly turns into “mommy brain”.

Overall the traditional thinking in the medical community is that you should be back to your “norm” within 6-8 weeks post-partum but in reality, and according to a new standard of practice by the American College of Obstetrics and Gynecology (ACOG) (resource: Harvard Health Publishing Harvard Medical School), it can take up to 12 weeks for your body to be ready to return to an increase in activity.  As a pelvic floor therapist I believe this should include increased postpartum care for mother, including but not limited to more education on what menstrual cycles postpartum may look like, your emotional and mental health needs, support for return to work or embarking on staying at home with baby, any signs or symptoms for any infections or medical emergency and any typical developmental guidelines for baby during this time.

I am always advocating for perinatal care which will help moms-to-be prepare the muscles in the pelvic floor, learn proper positioning of the pelvis and breath support in prep for labor as well as for postpartum. Think of it as prehab for and upcoming procedure, because basically, that’s what labor is, the procedure to have a baby. Research shows that those that seek prehab before a total joint replacement have a much better outcome and return even better than before surgery. The same can be said for pelvic floor care for perinatal to postnatal care.

Think about it - You created a birth plan for you and baby during prenatal time, but have you set-up a postpartum plan?  Many new mom’s find their healthcare support diminishes soon after postpartum and the focus, as expected, shifts to the baby.  Good compassionate postpartum pelvic floor care can be instrumental in your return to the activities you enjoy.

Enjoy this Mother’s Day and celebrating YOU as Mom and taking care of yourself is the best thing you can do for baby and more importantly, for yourself! Happy Mother’s Day!

 

If you are a postpartum mom whether it was 3 months ago or 30 years ago and are struggling with pelvic pain or incontinence contact our office and schedule and evaluation with our Pelvic Health PT.  We are here to help.