The Fourth Trimester

While I was pregnant, I was very focused on what the needs of the baby were going to be. As well as the needs of my spouse. I worried about schedules, breastfeeding, sleeping, babywearing, household chores. I was absolutely obsessed with the vision for my family and the comfort of every member, except myself. I had forgotten that I needed to take care of me. And it didn't really hit me just how much until I was knee-deep into my fourth trimester and in an IBD flare. By then, it was too hard to pick up the pieces by myself.

Self-care and motherhood

I wish I had had a plan of action in self-care and the transition into motherhood. There are so many elements of new motherhood that were beyond my control. There were so many elements of living with IBD and extraintestinal manifestations (EIM) that were beyond my control. I had never had a baby before and didn't understand what was happening to my body. And without proper healthcare, I was unable to see a doctor for follow-ups after 6 weeks postpartum.

I had symptoms of IBD I never knew existed, I didn't know what an EIM was. I was out of my element. Because we lived so far away from my mother and my spouse worked for almost an hour and a half away, I was alone most days with my disease and a baby. Uneducated in IBD, miseducated in postpartum motherhood, I felt ill-equipped to do a job that actually came naturally to me. But I was stricken with fear, grief, and a lack of confidence.

Unable to do the same tasks as other mothers

The mothers in my mom group were able to work out, complete household tasks, and find time to get their nails done. I was struggling to get a shower. I cried almost every day for 7 weeks and didn't tell anyone. Everything I ate tasted like sand. I developed uveitis but was told I had pink-eye and stayed away from my baby for 10 days. Nursed him with a mask and cloth diaper on my face.

I developed severe arthritis in my hands, while clumps of hair decorated my pillow every morning. I was sad more often than I was happy. I logically knew I had to be happy because I had everything I wanted and needed. But I didn't feel happy. I felt inadequate. Yet, I still suffered in silence. My breastmilk disappeared, as did the pounds and the color in my cheeks. I was spiraling. Ignoring what was happening to me and focusing all my attention on the other two people in our trio. As long as the big and little man were satisfied, then I could go and push through.

Suffering in silence about the impact of UC

But they weren't. No one was happy. Everyone was being polite. Everyone was suffering in silence. No one asked if I was okay. But I'm not sure if I would have answered truthfully if someone had asked. I believed that the role of being a strong mom, a good partner, and the organizer of a household required strength. Strength didn't look like self-care, because I believed self-care to be something that one received as a reward. Self-care is not a reward or a treat. It's not a privilege but a necessity.

Self-care is an exercise that should be practiced every single day. Every day you have to do something for you because as a mother and a partner, you are doing something for someone else every day. It doesn't have to be grand, it's usually something very minimal and doesn't take much time or effort. But it should be a designated time for you. I think about that hour and a half drive my son's father had to decompress, call friends, enjoy a cup of coffee, listening to music, or just sit in silence.

As a stay at home mom, there was no commute. My boss was in the bassinet right next to my bed. I needed something for me, a break. Instead, my weekdays ran into the weekends, and I was never off. Not only was I getting up throughout the night with the baby, but I was on call for him from 5:30am until 9pm. Then from 9pm-11pm, I dedicated my attention to his father. Seven days a week. Yet somehow, I felt guilty for asking if he could watch the baby while I got my hair or nails done, or went to the grocery store alone. Because I believed my work as a stay at home mother to not be comparable to the parent who worked outside of the house for a salary, and that self-care was a reward for hard work. I didn't value my role in the family. I forgot about me.

What I would do differently in the fourth trimester

It's been 10 years since my fourth trimester, and I've been thinking about having another child. There is so much focus on the fourth trimester in the mom community now. It's comforting to know the narrative is changing. I think about what the fourth trimester would look for me now and what I would do differently.

Utilize your village

The first thing is, I would create a village. I have a strong one through motherhood and IBD, but I would actively engage them. When someone offers help, I will give them a duty. My friend made a list and put it on the wall of all the things she needed. People who came overtook a task from the list. The list consisted of everything from washing bottles to picking up her favorite food. Also, invite people over for after the baby and any other children go to bed. It doesn't always have to be about the baby. Your friends want to see you too.

Discuss any new symptoms

Communication with your team of doctors is vital. Discuss any new symptoms, even if you don't think it's essential. It's also important to discuss your emotional changes. If you are struggling with mental health and feel overwhelmed by the prospect of adding another doctor's appointment into your schedule, check out the mental health apps that connect you with a certified therapist through talk, text, or video call. There are also apps for in-home doctor visits that can help with regular wellness checks. There are options available to you.

Postpartum doula

If you can afford it, a postpartum doula is a gem. It's important to have someone there to answer questions, someone who is experienced to help transition you into parenthood and to calm fears. There is a difference between a labor & delivery doula and a postpartum doula. The L & D doula will be that support system during your third trimester, through labor and your delivery period. She will help you through your post-delivery care until you go home.

A postpartum doula will come to your home and help you transition your family into settling in together at home. There are PP Doulas who are familiar and experts in autoimmune diseases such as IBD, and you must ask your doula whether she is familiar with IBD when interviewing her.

Practice self-care

I cannot stress this enough. Take time for yourself. There is no right or wrong answer to this. It can be meeting with your friends for coffee or just enjoying a few pages of a book on the porch during naptime. Whatever it is that settles your soul and brings you peace. Find time for it every day. Put in the calendar with an alarm if you need to. Do not feel guilty for taking that time for you.

Your fourth trimester should be as joyous and exciting as your pregnancy. You should be enjoying all the little milestones of your baby and relishing in the fact that you made a whole human being. You shouldn't be haunted by IBD, mental health complications, and exhaustion. If it starts to feel like a burden more than a blessing, it's time to tell someone. Motherhood is never supposed to hurt.