The Four E’s of the Fourth Trimester- Mental Wellness in Postpartum

Photo cred David Yarrow Photography

Addressing maternal mental wellness in postpartum is a bit like trying to eat an elephant, and you know what they say about that. And so, today on World Mental Health Day, a day aimed at raising awareness around mental health and  helping people feel hopeful by empowering them to take action toward lasting change let’s take it one bite at a time.  

Let’s have hard but important conversations about how difficult the fourth trimester can be.  Let’s have open-minded conversations about changing the stigmas still wrongfully attached to postpartum depression and the confusing sadness that can infiltrate a season women may have long romanticized as guaranteed blissLet’s ensure that women are made aware of and have access to support before their mental health and well-being are jeopardized.

With that, I’d like to tell you a story about a perfect stranger meeting a broken woman in the parking lot of a church on a Thursday morning and saying “come anyway.”

“But the semester is half-over, the class is full and the administrative assistant said there was no more room.”  To which, renegade that she is, the hero of one of my stories said, “Come anyway.”

I was very late the first day I showed up, with half of my house and my tiny new human in tow.  Dazed and confused does not begin to cover my state of affairs.  She said, “come anyway.” I cried a TON.  Having not seen or conversed with many adults in awhile, I awkwardly dominated the conversation in the circle that day.  You guessed it, she graciously said, “come back.”    

This “Jesus with skin on” hero of mine would go on to become the next 2019 Arizona Mother of the Year and a cherished friend for life.  During a season of complete darkness and isolation she made a seat for me in a circle that I now cannot imagine doing without, one I lovingly refer to as my “Christian moms who cuss book club.”  Little did I know at the time, she was an LPC and the Managing Director of Women’s Health Innovations of Arizona. She is the reason I found the world of maternal mental health support and eventually an adaptive information processing model called EMDR Therapy.   

Listen, I’m going to mention elephants a lot here.  So, while I am at it, let me address this one standing in the proverbial room. The words “Jesus” and “church” might have spooked you.  You might want to stop reading right now. That’s okay.  I know they can be polarizing words. I dare you to read on. This is not an invite to agree with all things majority culture.  This is a call to talk about important things like bad-ass sisterhood, centuries old worldwide postpartum care traditions that have been forgotten in America and the importance of circles.  The only thing I am proselytizing here is that the fourth trimester is one of intense vulnerability and that we should learn from our friends, the elephants, and find our circles. It might take some trial and error. I tried on plenty of circles that weren’t for me.  For instance, I loved and appreciated when selfless volunteers would sit with my infant for two hours while I tried on one circle.  Turns out, I am just not a crafting on a Tuesday kinda gal. Every Halloween costume donned in this household for the next decade will come straight from Amazon. No question.  So, hear me, the building, group, cause or mission of the circle you find will likely be very different from the one that I did.  Rock on! Just find a shoe (and circle) that fits and keep going back. 

And Now “Four Words and Four Tips to live by in the Fourth trimester”

Elephants. Encircle. Encourage. Empathy.

Here’s is a question many of us, myself included, may never have considered. What kind of care does a new mom actually need and receive after birth?  We’ve all heard “When a child is born, so is a mother.”  But do we really hear and process that?  After all the time and energy spent reading “What to Expect When Expecting” and all of the monitoring of the fetus during the first three trimesters, we fail to actually consider what to plan for with the post-birth recovery needs of the mother.

Postpartum care traditions that have been effectively practiced for centuries are a lost art in modern day busy America. Mother, grandmothers, aunts, cousins and sisters do not live next door or even in the same state anymore. We are spread out and isolated.  We are busy and in a hurry.  We have to hustle… bounce back.  Get our bodies back, our lives back, our careers back, our balance back or mojo back.  Circles aren’t presumed and many a new mom is vulnerable prey to the depression, isolation and confusion of the fourth trimester. This is one of the many reasons I encourage anyone around me making a tiny human to consider at doula. They are such critical advocates for the mother during a vulnerable time.

Speaking of making plans, make some proactive ones and consider the elephant. Now I would never call my support network of sisters “elephants,” but I am forever thankful that I had an intensely fierce pack of sisters ready to rally around me like this.  All new mothers need and deserve that.

I heard Jen Hatmaker speak recently and she taught me something about elephants.  To paraphrase: In Mother Nature, when an elephant is giving birth, her strongest stateswomen circle around her in tight formation. They come in, shoulder to shoulder, so that the vulnerable mama cannot be seen in the middle. They kick up dirt to throw attackers off any newborn scent. They surround their friend with protection, sending a clear signal to predators that if they want to attack their friend while she is vulnerable, they will have to get through 50 tons of female ferociousness first.

When the baby elephant is delivered, the sister elephants do two things: they cover the newborn in dirt to protect it from the sun, and they begin trumpeting, celebrating new life, sisterhood and beauty amidst the odds of attack. According to researchers at Amboseli National Park in Kenya elephants usually take this formation in only two cases – under attack by predators or during the birth of a new elephant.

So yes, elephants have a thing or two to say about the importance of encircling, encouraging and offering empathy.  When our sisters are vulnerable, when they are giving birth to new life, new ideas or when they are under attack- this is how we do it, we form a tight circle, we surround them, we get in defensive formation so they can create, deliver, heal and recover. We bring over hot enchiladas and sit amongst dirty dishes, unfolded underwear and salty tears.  

And when the darkness has passed, however long it takes for our sister to stand back up, we trumpet, we cheer, we say “come anyway,” “come back,” and “you are welcome here.” We stand up for our sisters. There is no time like a big transition or change to make us vulnerable. Fortunately, there is also no force like a community of women.  

When it comes to the transition into motherhood, I had a good friend say it best in her recent and highly insightful article about matrescence, the process of development experienced by women as they form a new identity through motherhood.  Give it a read.  In it, she implores all of us to “begin thinking about matrescence in the same way we would adolescence. To view it as a developmental rite of passage that can be messy, challenging, but ultimately rewarding and necessary in order to grow into the next season of life.”  Yea.  So good, right?  

With that, here are four tips to ease your transition into becoming a mother.

  1. Sign up for one of the many supportive services or coaching programs designed to help moms and moms-to-be though the postpartum period and beyond at Mamaste. Or grab this free guide for making self-care a non-negotiable in your life. Or, sign up for the Mamaste blog and get a super nurturing postpartum bath blend recipe delivered to your inbox.  Yes please.  Ok, that was clearly NOT one bullet point, but dude, she’s got some good stuff. You’re welcome.
  2. If you or someone you love is suffering from perinatal mood and/or anxiety disorders (PMAD’s) or recovering from a traumatic event check out the highly specialized and supportive perinatal coaching and counseling opportunities available through Women’s Health Innovations of Arizona
  3. Save this remarkably resourceful Postpartum Support International link to your browser bookmark. Start perusing this “library of congress” of postpartum resources with your partner every night before your baby arrives and you both become the legions of the unslept.
  4. Enroll in a “Beyond the Birth” workshop here or the three part free mini-course on “Self Esteem and Self Worth” here

My wish for all women, having their first baby or their fifth, is that they would have the support and resources needed to not just survive the fourth trimester but to truly flourish in that and any of the hard seasons of motherhood.

To the Art of Becoming