Ask the Expert: How Can We Prepare for our Fourth Trimester?

Don't forget to plan for when Baby arrives. Many mamas-to-be spend hours researching and drafting their ideal birth plan, which is great. But I believe that making detailed preparations for after baby arrives is just as important.

Nearly halfway through my second, and likely final, pregnancy, I began to ponder how I wanted to savor slow moments with my newborn and allow space for healing after giving birth.

I stumbled across Kimberly Johnson’s book, The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality, at just the right time. Once I picked it up, I found it was an extremely delicious read that I did not want to put down.  I am grateful for her guidance and am looking forward to having a plan in place to honor rest and adequately nourish myself postpartum.

Related: Why Postpartum Self-Care is so Important

I was lucky enough to score an interview with Kimberly. Here’s what she had to say:

Q 1. You define the Fourth Trimester as the three months after Baby is born. Why is this postpartum period so sacred and what prevents many women from honoring this time? 

A. The Fourth Trimester is a sacred time when the veil of the worlds is still thin, and new mothers have access to cosmic intelligence. At this time, women can heal from lifelong illnesses. Unfortunately, if illness sets in at this time, they can be harder to heal. This is a time when women need to be protected and nurtured so that their body can reorganize physically, emotionally, and spiritually.

The postpartum time is a rite of passage in and of itself. Many women don’t know that this is a special time with unique needs; instead, they follow the cultural suggestions of getting back into shape as fast as possible so they can fit quickly into pre-pregnancy jeans.

If a woman hasn’t had any practice at down-regulating her nervous system, it can be very hard to roll with the languorous rhythm of the immediate postpartum period.

We also don’t have many cultural supports in place for women at this time, so women who have just given birth are often already worrying about returning to work. We really need to support women and new families at a community, corporate, and governmental level.

Q 2. I love how you share the Five Universal Postpartum Needs in your book. How did you determine these needs and why are they important?

A. After my own difficult postpartum recovery, I realized that I was not just experiencing a personal problem, I was experiencing the outcome of a cultural void. So I began to research.

I traveled to Thailand and Malaysia to study Asian postpartum practices and returned to studying the Ayurvedic postpartum care approach. What I found was that from Brazil to Korea, Mexico to Indonesia, women were cared for in a special way after they gave birth.

I identified five universal needs that each culture sought to meet: extended rest, mineral-rich collagen-dense food, loving touch, the presence of wise women and spiritual companionship, and contact with nature. I believe that these are like Maslow’s Hierarchy of Needs.

Q 3. What is an important thing women can do in the fourth trimester?

An extended rest period is the most critical.

She may have all of her other needs met, but without the rest period, a woman will not fully recover. The recommended rest period is 30-45 days. In the West, our 6-week postpartum visit is a nod to the importance of this time.

In most cultures, birth and new motherhood are still considered the territory of women. Therefore, women are surrounded by and tended to by other women who are in different stages of life and who can offer them soul comfort, as well as knowledge from experience as aunts, mothers, and grandmothers.

Connection to nature can help new moms feel the beauty and rightness of the slower pace at this time. Whether it’s breastfeeding in a chair near a window, or drinking a cup of fresh herbal tea, touching in with nature allows for our nervous system regulation and is good medicine.

New moms need everything their baby needs at this time. They need eye contact, to eat on demand, swaddling, and loving touch.

Q4. What wisdom can we glean from Ayurveda and Chinese Medicine as far as nourishing our bodies after giving birth? 

A. Both Ayurveda and Chinese Medicine are treasure troves for the postpartum period. Both suggest that women are having a huge life force energy transition, which requires attention and nourishment. Both encourage long-term vision rather than short-term solutions.

Each considers an extended rest period as essential, calling it the Sacred Window and the Golden Month, respectively. Both also share the view that a new mother needs to be warm, hydrated, and have sufficient oils. A new mom should wear warm clothes, eat warm foods, and generally make sure that she is well-protected from the wind. She should have enough fluids — warm teas and water (never ice) so that her hormones balance and breast milk production is optimized.

They both suggest eating either animal fats, or ghee in the case of Ayurveda, so that the tissue can heal and all the minerals and fats don’t go straight to the baby. While there are variations in ingredients and spices from culture to culture, what the recommended postpartum foods have in common according to these traditions is that they are warming, easy to digest, mineral rich, and collagen-dense.

Related: Easy Recipe: Postpartum Seaweed Soup

Q 5. How can women advocate for themselves if they feel that something is not right (physically or emotionally) in the postpartum period? 

A. First, women need a network of women. It is other women who form the base of support. Many new moms feel lonely, isolated, and anxious because they are alone at home all day with a new baby. Any woman would feel depressed from that!

Second, women need to know that all postpartum problems have been put into the category of mental health. So, most care OBGYNs and midwives don’t know how to evaluate structural or biomechanical problems.

Third, all women should have a postpartum visit with a physical therapist (PT) and  STREAM practitioner or Sexological Bodyworker. Women will have to ask their health care provider for that referral.

Fourth, my book The Fourth Trimester guides women through a process of understanding what the source of their discomfort is. The postpartum time is one of deconstruction and reconstruction. Our identities change, so it can be confusing to figure out what is contributing to our confusion or discomfort.

The book helps you identify if what you are feeling is biomechanical, biochemical, trauma and emotion, or scar tissue. It may even be a combination of all of these. Identifying where the source of the symptom is will help you decide what kind of care to seek.

About the Expert: 

Kimberly Johnson is a Certified Sexological Bodyworker and Somatic Experiencing Practitioner. She is the Author of The Fourth Trimester: A Postpartum Guide to Healing your Body, Balancing Your Emotions, and Restoring Your Vitality. For more information on birth support, postpartum healing and sexual health, visit her website:

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