The 4th Trimester: Postpartum Recovery During a Global Pandemic

There has been increasing awareness of the significance of the postpartum period as a time of recovery for both moms and newborns, but it’s clear that there are still many mothers who are struggling during the first 6-8 weeks after giving birth. Our current norm is for expecting parents to spend a lot of time preparing for their newborn’s needs, including setting up a nursery, purchasing baby furniture and supplies, and choosing a pediatrician.

The downside of living in such a “baby-focused” culture is that mothers are often unprepared for the myriad of physical, mental, and emotional changes that they will personally experience after giving birth. This postpartum period of transition to motherhood has recently been coined the “4th trimester.”  

Common physical changes experienced by women during the “4th trimester” include uterine cramping, vaginal and rectal soreness and pain, breast engorgement, edema (swelling of extremities), and problems with bladder control. Mental and emotional changes experienced by new mothers during this period include fatigue, being stressed and overwhelmed, feeling isolated, and hormonally-induced mood changes such as the “baby blues.” 

Aeroflow Breastpumps recently surveyed 394 women about their postpartum recovery experiences and found that 50% of moms did not feel prepared for what to expect and how to care for their bodies in the first six postpartum weeks. Their most common postpartum struggles included breastfeeding (66%), postpartum depression or anxiety (48%), lack of social support/isolation (39%), newborn care (28%), and complications/concerns with postpartum healing (24%).  Additionally, 9 out of 10 respondents in Aeroflow’s survey felt that the current system of educating mothers about what to expect during the postpartum period, along with available resources, needs to be improved.  

Giving birth during a pandemic adds additional layers of stress to a woman’s journey to motherhood. It’s especially important that women who give birth during the COVID pandemic prepare for their postpartum recoveries ahead of time, as many will not be able to have in-person support from family and friends due to social distancing and travel restrictions. In addition, this pandemic creates fears and worries for new parents, including concerns about health, finances, and the well-being of loved ones. Pandemic-related stresses and lifestyle changes put new mothers at a higher risk of developing postpartum mental health problems like depression and anxiety.

The following are postpartum recovery tips for women who have recently given birth (or will soon be giving birth)

  • Be gentle with yourself and remember that you are in the midst of one of the biggest physical and emotional transitions of your life. Try to view this postpartum period as a time for rest and recovery.  Ways you can perform self-care include sleeping when your baby sleeps, getting outside as much as possible, and not putting too high of expectations on yourself in terms of things like productivity, losing weight, and “bouncing back” to your pre-baby life.
  • Do not be afraid to reach out to your partner, family, and/or friends to ask for help when you need it and also to let them know if you are struggling. If you have a difficult time asking others for help at baseline, set an expectation of needing postpartum help ahead of time!  Also, do not hesitate to ask your OB or midwife questions about your postpartum recovery, especially if you are worried about any changes you are going through or new symptoms you are experiencing. 
  • Try to learn about and take advantage of online resources for new moms. These include virtual visits for lactation and breastfeeding support, websites to get connected with therapists who specialize in maternal mental health, i.e. Postpartum Support International, online support groups for parents of newborns, and websites that focus on postpartum recovery and the fourth trimester. 

It’s important for new moms to remember: you are not alone, you should aim to treat yourself with as much love as you have for your newborn baby, and you can do this, mama!


Written by Dr. Jessica Madden, Medical Director at Aeroflow Breastpumps, published with permission. 

Jessica Madden
Jessica Madden
Dr. Madden is a board-certified pediatrician and neonatologist who has been taking care of newborn babies for over 15 years. She is currently on staff in the neonatal intensive care unit (NICU) at Rainbow Babies and Children’s Hospital in Cleveland, Ohio. She also provides in-home newborn medicine and lactation support to new mamas and is currently working to become an IBCLC.

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