'The Fourth Trimester': Minding Your Mental Health as a New Mom

Welcoming a baby into the world is one of life’s most magical experiences. But for new moms struggling with the physical and emotional changes that follow childbirth, the “fourth trimester” can be a period of major adjustment. Experts say that during these first few months, a new mom needs to tend not just to her newborn but also to her own body and her emotions.

“Women dream about this special time in their life,” says Chay Shavrick, R.N., a women’s health navigator and pre and postpartum RN navigator for the Barbara C. Gutin Pre and Postpartum Program at Boca Regional Hospital Hospital’s Christine E. Lynn Women’s Health & Wellness Institute. “They’ve been through an amazing time – getting pregnant, staying pregnant, the delivery – and now they’re finally home with their baby.”

At the same time, Ms. Shavrick says, a new mom’s hormones are backpedaling from pregnancy, she’s feeling anxious and exhausted, and she may be experiencing the “baby blues,” or postpartum depression.

“For a new mom, this can be a tricky time, physically and emotionally,” Ms. Shavrick notes. “But your fourth trimester is an opportunity to celebrate yourself, to acknowledge how much you’ve accomplished to get to this moment, and to transition from your birth plan to your wellness plan.”

Ms. Shavrick says you need to give yourself permission to mentally transition into your new life as a mom. “It’s perfectly okay to make yourself and your child a priority,” she says. “Just know that as you go through this transition period, as you adapt to motherhood, everything is going to be all right,” she says.  

Ms. Shavrick also offers the following thoughts for new moms to reflect on when feeling overwhelmed:

• You are still the same amazing woman, partner, daughter, friend.
• You are still in control (but maybe less control than what you are used to).
• The dishes are not always done.
• The laundry may pile up.
• Getting out of the house or even out of your pajamas will not be as easy as it used to be.
• Your priorities will likely shift but that is okay!
• You still may love going out to meet friends, but you do it less often now while you are getting into your new routine.
• You are still a great friend, but maybe you talk on the phone or text right now because your hands are full.
• The people who truly care about you will understand that it’s your time to put family first.
• You discover the importance of regulating and self-care.
• It is important to recognize that if you try to go back to doing everything you did before, and the PERFECT way that you did it, you are likely to set yourself up for stress and frustration.
• Meet yourself where you ARE and if the people around you don’t understand that, know that it’s okay.
• YOU STILL DO YOU!
• Put your priorities in order knowing that since they are your priorities, you know what order you want them to be in.
• Take time with your partner to nurture your relationship now that you’re in this new role.

Each child requires a different type of mother, Ms. Shavrick says, and the fourth trimester is a time for a new mom to find her “mommy compass.” She advises new moms to trust their own maternal instincts.

“Becoming a complete mother is a learning process,” she says. “There are many different types of mothering styles – there is no right or wrong approach – so don’t try to mirror other moms or do what everyone else says you should be doing. No one knows better than you what’s best for you and your baby.”

What a baby needs more than anything in the world, Ms. Shavrick says, is for mom to be mindful and present, with her feet on the ground. Sometimes, though, a new mom experiences postpartum depression or anxiety, limiting her ability to be there for her baby. “One in five mothers experiences the ‘baby blues,’ as they’re called, or a more serious condition known as Postpartum Mood and Anxiety Disorder (PMAD),” says Ms. Shavrick.

PMAD comes in many forms and occurs in women across all cultures, races, ages and income levels, according to Ms. Shavrick, yet the illness frequently goes unrecognized and untreated. Symptoms can appear anytime during pregnancy and can occur up to 12 months after childbirth, she says. “Anything can trigger PMAD, including returning to work after maternity leave, having a loss in the family, or even a pandemic,” she says.

Noting that May is Maternal Mental Health Awareness Month, Ms. Shavrick says it’s important to raise awareness of PMAD because every new mom is at risk, and it could have long-term consequences for both mother and baby. “I can’t tell you how many women I’ve spoken with who were told by a trusted relative or friend that PMAD doesn’t really exist,” she says. “Well, let me tell you that the stress of adapting to motherhood is real.”

Untreated and undiagnosed, PMAD can have mental and physical effects on both mother and child, Ms. Shavrick says. Obstetrical risks include higher instance of pre-term labor, higher miscarriage rates and post-delivery complications. “If a pregnant woman is depressed, she is more likely to self-medicate with drugs and alcohol, and less likely to take good care of her developing baby.”

Ms. Shavrick suggests that friends, relatives and neighbors ask the new mom, “How are you really feeling now?” and keep a watchful eye for these common warning signs of PMAD:

• Constant sadness
• Crying easily
• Changes in eating patterns, not feeling hungry or not eating despite knowing it’s good for the developing baby
• Inability to focus and be present in life

Ms. Shavrick encourages women to seek help from and engage in conversation with their partners, supportive friends and family members about the feelings they’re experiencing. Most importantly, she adds, no one should ever be reluctant to ask their medical provider for help or to consider seeing a therapist. “As a new mom, your mental health is so important,” she says. “If you’re feeling depressed or anxious, you’re certainly not alone. But help is here when you need it – all you have to do is ask.”

Despite the challenges that can come in the fourth trimester, Ms. Shavrick says she reminds new mothers to embrace this new stage of their life and be proud of the journey they’ve taken. She urges mothers to take five minutes every day to be still with their baby. “Read, snuggle, just take a moment to savor that special connection between you and your baby,” she advises. “And end every conversation with, ‘I love you.’”