#74 The Fourth Trimester

You are now home with your new baby, but are you ready to face the changes this new family member is bringing into your life? The twelve weeks after the return home with your new baby is sometimes referred to as the fourth trimester. There was a time when new moms were allowed to stay in the hospital until the doctor and the nurses felt they were ready to go home. Today, 24 hours is the usual hospital stay for vaginal delivery. You may have a bunch of CDs tossed at you before you are sent home but are you ready to deal with the demands of a new baby?

Before leaving the hospital, you should create a plan for dividing up household tasks with your significant other. Who is going to do what, when, and where? You need to know who will be responsible for what tasks before you leave the hospital. Plan around how your baby is eating, how much milk you’re making, when to feed formula, when and how to use a breast pump, who cooks and when, who cleans the bathrooms, who gets the groceries, and how to find and choose daycare. When family members visit, make it clear to them that you are taking care of the baby, and they can help by making meals, cleaning, or shopping for you. You shouldn’t be preparing meals while they hold the baby.

Don’t be afraid to supplement breastmilk with formula. If your milk hasn’t come in yet and your baby is hungry, supplement with formula. Your baby needs to eat and gain weight. Because Hospital CEOs/insurances pressure physicians to send new mothers home before their milk comes in in order to “save money,” too many babies wind up being readmitted to the hospital for “failure to thrive.” Lactation specialists often prefer no formula be given, but don’t hesitate to supplement your breastmilk with formula. Crying newborns are often simply hungry.

If you begin to feel as if you are unable to deal with taking care of your baby or you begin to feel overwhelmed, call your doctor. The “baby blues” can appear during your first week home with your newborn, but if you continue to have difficulty dealing with your new baby after a week, you may be moving into postpartum depression. Actually, postpartum depression can develop anywhere up to a year after your baby is born. Left untreated, postpartum depression can last for decades. Postpartum depression is both treatable (with psychotherapy, medication, or a mix of both), as well as preventable (many times by converting stalled grieving into successful grieving). Women often don’t realize that there’s an element of grieving with the birth of a child, grieving for the person they were and will never be again. Successful grieving occurs when women recognize this element of grieving and allow themselves to move through the stages of successful grieving described by Elizabeth Kubler-Ross.

The keys to a happy and successful fourth trimester are careful planning before leaving the hospital and asking for help from your doctor if you begin to feel overwhelmed.