“The complex truths of motherhood will continue to make every uncomfortable and ashamed until they are articulated readily and repeatedly.”
- Dr. Molly Millwood, PhD
If you’re pregnant, you’ve probably heard of the book What to Expect When You’re Expecting. But what about what to expect after giving birth? We, the founders of Nyssa, found ourselves studying all about pregnancy and birth....only to wind up with babes in our arms and zero idea about what was happening to our Fourth Trimester bodies and emotions.
One of the reasons we started Nyssa was to help prevent the next wave of mothers and birthing people from having to navigate the confusion and disappointment we experienced. We do that by talking about what we (or rather society) call the ‘unmentionables’ of postpartum — the things you may expect to encounter in the days, weeks, months, and even years after childbirth. The Fourth Trimester is now being recognized by many midwives, doulas, and OB-GYNs as lasting a full year following birth.
Of course, just as everyone’s pregnancy and birth experience differs, your postpartum recovery is completely unique to you. And while we have brought together information and guidance provided to us by vetted professionals in our network, we are not healthcare professionals. If you have any cause for concern during your postpartum recovery, please reach out to your doctor, pelvic floor therapist, lactation consultant, therapist, etc. as needed.
Think of these 6 tips as a window into what we wish we had known about postpartum recovery before we embarked on our own journeys.
Over 90% of people who give birth vaginally for the first time will experience tearing (Royal College of Obstetrics and Gynaecology, 2014). We know that can be hard to hear if you are currently pregnant or planning to get pregnant. The majority of tearing is 1st or 2nd degree; 3rd and 4th-degree tears are more severe.
Nyssa supporter and NYC-based photographer Frances F. Denny wrote an extremely honest and well-researched account of perineal tearing for Harper’s Bazaar and you can read more about vaginal tearing on the website for the Royal College of Obstetrics and Gynaecology.
We also dedicate a whole edition of our free deep-dive newsletter, Body of Knowledge, to vaginal tearing in childbirth. It features video interviews with a leading OB-GYN and birth trauma therapist on the physical and emotional impact tearing may have on someone recovering from childbirth.
What can I do? If you have a birth doula or midwife, speak to them about ways to possibly minimize your risk of tearing. Stay informed about the delivery interventions (such as forceps) that increase your risk of a more severe tear. Be sure to have a pair of FourthWear Postpartum Recovery Underwear on hand, along with a stash of Between Legs and Uterine Reusable Ice/Heat Packs. Ice & heat therapy are proven to help ease the pain, discomfort, and recovery time of postpartum vaginal swelling.
We’d also recommend having our VieVision Between Legs Mirror on hand to stay on top of your swelling and stitch sitch, so you can be ready to inform your medical provider about any concerns.
File under: things we’d wish we’d known before giving birth. Everyone bleeds pretty heavily, even if you’ve had a c-section. Lochia is a discharge of blood, mucus, and uterine tissue. This shedding is not totally unlike having your period because it's made up of the same kind of blood and tissue. But lochia happens on a much larger scale because of how big the uterus grows during pregnancy.
Usually, lochia lasts for about six to eight weeks, so as long as you're within that window and your lochia is gradually decreasing in volume, it's probably normal. If it's getting stronger, you should call your doctor immediately. Here is a good guide on what to expect with lochia.
What can I do? Load-up on postpartum pads. We created our Organic Cotton Extra-Long Postpartum Pads especially to support postpartum bleeding. The perfect partner to our FourthWear Postpartum Recovery Underwear, they are designed to help with bleeding and leakage post-birth and feature an organic cotton top sheet to help keep you dry and comfortable as you heal.
Repeat after us: the idea of ‘bouncing back’ to your pre-birth figure is a load of nonsense. But self-love and body acceptance is complicated. The pregnancy and postpartum experience transforms our bodies in incredible, yet sometimes uncomfortable, ways. Despite the immense pressure women feel to "bounce back" after pregnancy, there is little support and even less research exploring the scientific impact of pregnancy on body image.
What can I do? By buying into the myth that the whole purpose of postpartum is to ‘get your body back,’ we miss the boat in our opportunity to truly honor and nurture ourselves in this amazing journey.
We recommend following people who are keeping it real (we love @thebirdspapaya) muting anyone on social media that isn’t sending a positive message about postpartum recovery and reminding people that your postpartum body is not open to comments. If anyone does remark on your figure, you might want to say: “Perhaps you could ask how I’ve been feeling instead? And remember: there is no bouncing back, only bounding forward.
We hear a lot about how wonderful breastfeeding is; the bonding; the feeling of confidence as you see your baby grow; the incredible simplicity of a baby falling asleep and resting against your breast. What we hear less about? Just how challenging breastfeeding or chestfeeding can be.
What can I do? Use data to inform your decisions. We highly recommended reading Brown economist Emily Oster’s book Cribsheet prior to giving birth, as it tackles the polarizing topic of breastfeeding with candor, pragmatism, and empathy (and check out our interview with her on Nyssa: The Unmentionables). If you feel strongly about trying to breastfeed and are having trouble, see a lactation consultant if you can. Most importantly, remember: the best decision you can make is the one that is right for your family and totally unique to you.
The birth of a child often represents motherhood. But when a child is born, so too is a mother. If you’ve never heard of the term “matrescence”—coined by the anthropologist Dana Raphael—it is defined as the process of becoming a mother. It’s a word used to describe the physical, psychological, and emotional changes people go through during the monumental transformation that is motherhood. Yet, despite the enormity of this change—and beyond some attention in anthropology as well as the fields of psychiatry and psychology—the process of becoming a mother has been largely unexplored in the medical community as the focus remains mostly on the baby.
It can be helpful to think of matrescence in relation to adolescence. The transition of adolescence into puberty is recognized as this bumpy, tumultuous time where your body changes and your attitude and hormones are raging. And thank god we get through it. Matrescence is the same thing about becoming a mother.
We respect adolescence as a crazy time in life. Matrescence happens and we think of it as this beautiful, blissful, natural ‘thing’ that should happen to every woman: that it’s maternal destiny. NOPE. It’s like a nuclear bomb; it’s a big deal. The truth of the matter is that when a person becomes a mother, everything changes. And new mothers need support—arguably more so now than ever.
What can I do? In a well-known 2017 New York Times essay, reproductive psychiatrist Alexandra Sacks, M.D.—who regularly writes about and talks about matrescence—discusses some of the changes that often take place in the transition to motherhood.
They include identity changes; changes in family dynamics (think: with a partner); feeling emotions like ambivalence, guilt, and shame; and even struggling with what you imagined motherhood to look like versus what the reality of your motherhood is (her TED Talk on the topic of matrescence has almost two million views).
Simply being aware of these changes, the emotions you might feel, and the clashes you might experience between expectations and reality can help you better adjust to motherhood. After all, while you will experience incredibly beautiful moments with your baby, motherhood is the unfiltered stuff—and it’s not always accurately displayed.
Many of us spend so much time, money, and energy preparing our baby’s nursery, folding dozens and dozens of onesies, and daydreaming about the first cute outfit they’ll wear. We get it, it’s fun. We did it, too. But what if we reassigned some of our pre-baby energy into putting together an effective postpartum recovery plan rather than spending all our efforts decorating a nursery our newborn won’t even notice and buying things they don’t really need?
What if friends and family combined baby showers with postpartum showers, distributing items for both baby and the new parent(s)? After all, there are only so many sweet swaddles your little one needs. What if we knew what really happens to our bodies after birth and packed our hospital bags with postpartum healing in mind?
What Can I Do? If you’re planning to have a baby shower, let friends and family know that it would be an excellent idea to combine it with a postpartum party, too! Or have a stand-alone postpartum shindig, where loved ones can focus on showering you with love, advice, and things to help you feel comfortable and cared for as you focus on caring for your babe.
artwork: jill lavetsky
More to help you prepare for the fourth trimester: