The arrival of a child is one of the most defining moments in a couple’s life. In many ways, it signifies the birth of a family. If a child is born from a loving and trusting relationship, most women look forward to this phase in their lives. But pregnancy is not just about the impending birth, it is also about the huge transition towards motherhood. Many mammas spend a large portion of their pregnancies sifting through umpteen options and information revolving around their unborn baby. A major part of pregnancy thus passes and before they realise it, they are facing childbirth and the inevitable role change. We forget that a mamma is born when her baby is born and needs nurture, comfort and reassurance herself. 

The journey towards motherhood requires just as much thought, time and preparation. A small care package with moral, psychological and physical support can be a source of strength and support during the transition.

Personal Support: Something or Someone to lean on

The days and weeks following the arrival of a baby is often overwhelming for a new mamma. A personal care package carefully put together during pregnancy might come in handy during this time. 

• A hospital buddy 

The moment a baby is born, the attention immediately and naturally shifts from the mother to the baby. While the whole world spins around the baby, having someone exclusively for the mamma can be just the support she needs. Someone whom she trusts – a parent, partner or friend – who is around and able to regularly check on her can be the emotional nourishment that sees her through those vulnerable moments.  

• A chore buddy

In many cultures, chore buddies are typically the grandparents of the baby. In some other cultures, friends usually pitch in as much as they can. New parents have a lot to grapple with and in this phase, having to worry about shopping, food and laundry might take a toll on resting and recovering. Planning for a chore buddy during pregnancy might be one of the best gifts a mamma can give herself for the fourth trimester.

• A reflective journal/ friend

A reflective journal can be a best friend in those initial months. When we want to pour our racing thoughts somewhere, a journal might come in handy. This journal can hold some of those emotions, those overwhelming feelings, joy over small wins, a string of  gratitudes, frustrations and worries. For those mothers who find that talking works better than documenting, reaching out to a friend can lend the same kind of support. Sometimes, talking to someone outside might give just the perspective needed to support their own changing dynamics. Both a journal and a friend can show how far we have come and also guide us when it is time to seek help. 

• A support group 

The power of a support group in helping new mothers is largely undervalued. A support group is a small group of mothers, all going through or having recently gone through the changes of motherhood. The members in this group often answer and support each other because they are all walking in similar shoes. Finding or creating a small support group during pregnancy might make the journey towards motherhood smoother while also being a source of great strength in the fourth trimester. 

Excerpt from Promoting Maternal & Infant Health in the 4th Trimester: “Mothers may be anxious about their baby for good reason and providers must respect that perspective as valuable and valid. In order to support maternal and paternal role attainment, it is important to affirm and encourage all that is going well with the parent–infant relationship and caretaking. Women need affirmation of their newly acquired abilities as mothers; they are very sensitive to any perception of guilt or shaming.”

Professional support: Reaching Out 

After the high of the birth, most women who have had a relatively smooth birthing experience return home and this is when everything starts to feel real: the cycles of breastfeeding, sleep deprivation, the sway of emotions, soreness, tiredness and the drastic hormonal changes. In most countries, a new mother is typically not scheduled to see a doctor for up to several weeks postpartum. While new parents are swamped with the task of ensuring everything is progressing well with the baby, mothers are often not asked how they are coping with the changes. 

Excerpt from Postnatal Care for Mothers & Newborns: According to the WHO, as of 2013, “at 10-14 days after birth, all women should be asked about resolution of mild, transitory postpartum depression, also known as postpartum blues. If symptoms have not resolved, the woman’s psychological well-being should continue to be assessed for postpartum depression, and if symptoms persist, evaluated. Women should further be observed for any risks, signs and symptoms of domestic abuse. They should be told whom to contact for advice and management.”

Despite WHO recommendations, the reality is that most women are left to navigate the changes in surroundings where symptoms of postpartum blues or depression go unnoticed. Putting together a self-care team prior to the baby can help new mothers know that they do not have to navigate every crisis alone. 

• Breastfeeding Support 

The uncertainty and questions surrounding breastfeeding are not only plentiful, but emerge in the weeks following childbirth. It might help to see a lactation consultant who can reassure new mothers and help them navigate any crisis that might be brewing in their breastfeeding journey. Sometimes, having a professional perspective from someone who deals with many women going through breastfeeding changes is far more reassuring than talking only to a small group of women who share anecdotes from their personal experiences.

• Postpartum Physical Support  

Many mammas suffer from postpartum perineal pain and some even develop infection from a cut or torn perineum. They return home after childbirth with little or no information on urinary incontinence, back pain, organ prolapse or pelvic-floor weakness. The toll that pregnancy and childbirth takes on women must never be overlooked; mammas need to feel no shame in reaching out to a doctor or physical therapy for support in  the weeks and months following childbirth.

• Postpartum Psychological Support

According to the WHO, about 10% of pregnant women and 13% of women who have just given birth experience depression. In developing countries this is even higher, at 15.6% during pregnancy and 19.8% after child birth. So, postpartum depression and depression during pregnancy is all too real! By neglecting this important transition, we put new mothers and babies at risk. If a new mamma feels consistently low, it is important to reach out for psychiatric help. 

Excerpt from Promoting Maternal & Infant Health in the 4th Trimester: “Listening to women and families, whose opinions and needs often go unexpressed or unheard, or both, is foundational to providing high-quality care. Well-meaning providers and practitioners may assume they know what new mothers want and need, and should do a better job of asking them, phrasing questions in a manner that solicits their goals and engages them in program design and development. It is likewise important to honor mothers and fathers as experts about their babies. Truly, no one can know or understand the infant as well as the baby’s primary caregivers.”

The Fourth Trimester Agenda

• Eat. Sleep. Love.

The fourth trimester to every pregnancy is often the most neglected. A mother has months to prepare for childbirth but soon after the baby arrives, her body goes through a sea of immediate changes necessitating plenty of support and rest. This is a period when the mother-baby dyad must continue to to be looked at as a single entity. The mamma needs external support to sync up to her baby’s schedule, eat healthy, nutritious and simple food, sleep when she feels the need to sleep and have plenty of time to cuddle with her newborn. When this is offered, she has better chances at being able to address the needs of her baby.

By nurturing a new mother, we are not just nurturing the bond between her and her baby, but also supporting the emotional & physical wellness of the next generation.

• Music. Mindfulness. Positivity 

Being in a positive frame of mind is the best gift a mamma can give herself and her baby. But, it might be challenging to wonder how to keep this positivity alive when the body is going through changes. So, creating a playlist of songs that lift you up or put a smile on your face, collecting a few books that help you be mindful and joyful  and surrounding yourself with people who lift you up are treasures to keep at your arm’s reach for those blue days.

• Keeping visitors to a minimum

Sometimes, new mothers are faced with a swarm of well-meaning visitors in the days following birth. While this may be just the source of strength for some, some others find that socialising is overwhelming for both the baby and themselves. From the outside, it is important to respect a mother’s wish and honour this space. The time to socialise will come and when you feel ready, you can step out of your cocoon.

• Making gratitude your friend

Perhaps the most forgotten of all virtues is gratitude – a dear friend to keep close during trying times. Devoting a few moments in a day to just focus on things that are going well can drastically help shift ourselves to a more positive frame of mind. This simple practice can help significantly improve the quality of our lives and also give us perspective when everything seems to be spiralling down.

In The Fourth Trimester Companion, Cynthia Gabriel says, “The work of mothering and fathering is slow paced and repetitive. Parenting challenges can be measured in hours, while joy is measured in moments. If you can believe the difficult moments are just as normal, as necessary as the delightful moments, you will come out of the 4th trimester with more stamina and reserves for the months ahead. 

The fourth trimester should ideally be a nesting retreat for a mamma and her baby. This is a time when we continue to look at the duo as a single unit, depending on each other for physical and psychological support. From the outside, we can offer them plenty of support, understanding and nurture to adapt to their new lives. It takes a village to raise a new mamma and it is the responsibility of all those who surround her to make this beautiful phase as comfortable as possible.