A Book Recommendation for the Postpartum Period – A Must Read for Mamas, Midwives, and any Birth Worker!

“Did you know that as a woman we can never be too kind to ourselves?”

– Maya Tiwari

Happy day to you! I spent most of this weekend gearing up to go back to work after a lovely 3 months of maternity leave. I always miss catching babies and taking care of mamas during maternity leave even though I’ve been snuggling my sweet new babe all the day long. And true to form, I cried the whole way home from our first drop off at day care. It gets better though!

Today I have a book review for you on a book that was new to me: The Fourth Trimester: A Postpartum Guide to Healing our Body, Balancing Your Emotions, and Restoring your Vitality by Kimberly Ann Johnson. The book is relatively new – it was published in 2017. I had bought it early in 2020 after it was recommended to me by a midwife student but didn’t have a chance to read it until December. It’s actually the book I brought to the hospital for my induction and I read the first half of it in the hospital and the second half over the next week during all the marathon long nursing sessions of a newborn!

Here’s my recommendation: This is a MUST READ for any individual that partakes in the postpartum period in any way (mamas, midwives, doulas, birth workers….). The book is a call to action to help prepare women for the postpartum period in ways that the majority of woman are not prepared for. It’s a spark to what I foresee is a coming postpartum revolution.

The book is divided into three parts:

  • How to prepare for the fourth trimester
  • How to savor the fourth trimester
  • Beyond the fourth trimester

I’m going to deep dive into my favorite parts of the book today, but there are some parts of the book I simply don’t know enough about the practices to comment on (example: vaginal steaming, belly wrapping and bodywork). It’s also important to mention that throughout the book the author talks about her own story and the level of birth trauma she experienced. Her story offers many lessons for women and midwives but is not a typical postpartum period.

First, Kimberly speaks about the need for a postpartum revolution and that the fourth trimester is an often neglected part of women’s health. She points out that our culture is fast paced and allows access to anything anyone wants but that same culture must relearn how to honor a period of rest for a woman and her family after birth. I love how she phrases it: “What should be innate must be relearned” (p.23). This is all so true. I think you have to have a baby or a miscarriage to realize how terrible the maternity care system is in the United States. I certainly was not as aware as I am after having babies. I knew the opportunities to improve as a nurse and as a midwife before having kids, but after having kids, the vastness of how far the system needs to improve is breathtaking.

Kimblery discusses how the postpartum period encompasses a trial and replenishing of physical, mental, sexual, emotional and spiritual aspects of the human body. This quote in particular rang true for me: “At a time when women need more support than ever, we are left isolated, wondering what happened, who we are, and what we can do about it” (p. 25).

And then she reviews the terrible, lacking definition of the postpartum period. What do you think the postpartum period is? Is it the period from birth to the 6-8 week postpartum visit? Is it until the baby’s 1st birthday? Is it until you stop bleeding? Kimberly discusses the ambiguity in the term among women, providers and our culture.

In the beginning of the book, Kimberly discusses the five universal postpartum needs (and they are worth repeating here):

  • An extended rest period
  • Nourishing food
  • Loving touch
  • The presence of wise women and spiritual companionship
  • Contact with nature

She goes into detail what each of these entails in the book but they are self-explanatory. One of the aspects of postpartum care that I found new and often neglected is the importance of keeping the body warm. The Chinese culture has long practiced this and women are brought warm or hot drinks after birth to promote healing in the postpartum state. Kimberly gives other examples that I found helpful such as: wearing socks, not leaving your hair wet, taking sitz baths and using warm blankets to swaddle your body.

I also found her recommendation to nourish the body with foods high in iron to be a commonly forgotten recommendation. All women lose some amount of bleeding during birth – but how often do providers recommend foods high in iron during the postpartum period to help the body replenish the red blood cells lost from normal birth? Rarely. I think I’ll start handing out my anemia handout to postpartum mamas after reading this book!

A few other honorable mentions:

  • Kimberly offers a nice review of breathing and bodywork exercises for a postpartum mama to complete (with details and pictures on how to do both). She offers a list of interventions – massage, acupuncture, pelvic floor therapy, etc.) that can be done to promote postpartum healing but also offers a lis of things not to do (thai massage) which I found helpful.
  • Kimberly offers a review of maternity and paternity leave in the United States and cites that 25% of women return to work after just 10 days post-birth (I don’t know where this statistic is from though). And she does a nice comparison of how other countries offer support to women after birth compared to the United States. In short, the United States has a very long way to go to improve almost every aspect of postpartum care.
  • Kimberly also reviews writing your birth story. In the book, Kimberly recommends writing out your birth story within 48 hours of birth to reduce symptoms of anxiety and depression from the birth. She spends a lot of time discussing how this is therapeutic and that women will hold onto feelings of their birth for decades and decades. Not allowing those thoughts or feelings an outlet for discussion and processing can carry into your next birth! I’ve seen this countless times and it’s heartbreaking! Mama’s just want to tell their stories!
  • Lastly, if you are interested in yoga, bodywork, yin/yang and returning to intercourse, Kimberly spends a lot of time discussing all of these as well but I am not an expert on any of these!

These are a few other quotes I wrote down that resonated with me and that I wanted to share to any mama, midwife or birth worker:

“All births require treasuring, celebration and deep care” (p. 18).

“Becoming a mother is a profound ego shift that will have your ego struggling to hold on” (p.43).

“Birthing, caring for, and feeding a growing baby and yourself as a new mother is enough” (p. 43).

“What is required energetically at birth – expansiveness, transcendence, and openness – is quite different from what is required of women postpartum – presence, groundedness, steadfastness” (p.108).

I just loved each of these quotes and have felt them all to my very BONES during my postpartum periods.

Last thing, here are my takeaways from the book about the postpartum period – things that I plan to recommend to my own patients and things that I feel I learned during my third postpartum go-around!

  • Make yourself a postpartum plan – be sure to include visitor preferences, a bodywork/exercise plan, nutrition, and help! This Postpartum Plan from Postpartum Support Virginia is my current favorite!
  • Plan and limit your screen(s) time (screen time can complicate sleep patterns and the mental break that our mind needs)
  • Set up a nursing station for yourself (preferably near a window or a nice view); put a basket next to your station with blankets, burp clothes, nursing pads, a haakaa, a book or Kindle for you to read, a heating pad, nursing pillow and blanket for you (I did this for baby #3 and it was AMAZING!)
  • Set up or request a meal train (mealtrain.com, mealbaby.com, takethemameal.com). For mamas birthing their second babe or more, this is one of the best gifts someone can bring you.
  • Nourish your spirit. Get outdoors! Do a puzzle. Do a bible study. Read a book. Call a friend! These all replenish your mental strength and resolve.
  • Visit with a pelvic floor therapist. I’ve talked about this in the past and recommend PFT for everyone.
  • Write out your birth story! YES! We’ve had a bunch shared here on the blog and would love to hear yours. Email me your story at amidwifenation@gmail.com.
  • Lastly, this: mothers know their needs – it is up to us to listen to them. Sometimes one of the best things we can do is sit and listen.

I’ll end the review with this quote! It echos so much of what I hope this blog brings to women. For centuries, women were surrounded by their tribe of women that told them stories of their own births and walked with them through pregnancy, birth and postpartum periods. Our society isn’t structured that way anymore so women have struggle to find their tribes on their own – or worse, they go without the support. This is what I hope for you all:

“You are born with one mother, but if you are lucky you will have more than one. And among them all, you will find most of what you need” – Clarissa Pinkola Estes

If you’re interested in the book, you can find it here:

I hope you found some time for self care this past weekend. I’m headed to do a very long workout with some foam rolling for all the soreness that comes with a toting a 20lb newborn babe and two toddlers around! (Am I the only one who’s body is so tired and sore? Seriously, sometimes my body feels 60 years old…I’m only 34!). Sheesh.

Hugs while foam rolling,

Jamie

Want more postpartum resources? Check out the RESOURCES page anytime! All postpartum resources are reposted here as well. There are some amazing organization across the United States trying to make postpartum care better!

Postpartum depression/anxiety


1 year ago on the blog…Friday Five (#12)


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