The 4th trimester: Postpartum support beyond childbirth



MDW is proud to feature Jamie Justice, Board Certified Women's Health Specialist, Physical Therapist, and co-owner of Empower Women's Health & Wellness in St. Charles, Illinois, to talk about post-partum recovery and how adding a 4th trimester is crucial to moms everywhere.




“The body takes nine months to miraculously adjust to a growing baby and deliver a tiny human being into the world, yet there is an unrealistic expectation of a six-to-eight-week postpartum time to heal and restore.


There are living systems in your body that have taken on an enormous task including - connective tissue, muscle memory, trauma from delivery - and that make this time frame of recovery unrealistic.” - Jamie Justice, PT, WCS






Tired. Overwhelmed. Scatterbrained. Sore. Yet filled with love.


Can you guess what time of a woman’s life this is?


You got it – postpartum!


This can be a roller coaster of a time, experiencing the highs everyone tells you about – the instant love you have for your child; however, the lows can be there too – and those aren’t always the times that women relish over.


Yes, it’s true we often forget the pain of childbirth as soon as we see that baby. Yet the lows some women experience healing from childbirth can add a few more unexpected drops to the roller coaster.


After treating hundreds of postpartum women, it pains me to hear new moms say: “I’m done having kids because the recovery was so rough.”


There are plenty of reasons one may decide not to have another child, and yes sometimes medically it may not be recommended.


But pain, bladder and bowel issues, or weakness should never be the reason.


The American College of Obstetrics and Gynecology now have recommendations for a 4th trimester for new moms. This includes closer follow-up of women after birth, provides doctors with specific recommendations, and emphasizes that a change in reimbursement policies is needed to support individualized, continuous postpartum care for each woman. The fourth trimester is the idea of a transitional period between birth and 12 weeks postpartum during which your baby is adjusting to the world and you’re adjusting to your baby.


This small shift in mindset is wonderful progress allowing moms to receive the medical care they need.



But what about the women that medically have no symptoms?


- No complications with vaginal delivery or cesarean

- Moms is healing fine

- Not experiencing high blood pressure or glucose issues.


Medically women may be “cleared” or “doing well” yet there are elements of recovering from childbirth that require additional support. - Persistent neck ache and tension

- Weakness, making getting out of bed difficult - A nervousness to have sexual intercourse or do anything physical


The body takes nine months to miraculously adjust to a growing baby and deliver a tiny human being into the world, yet there is an unrealistic expectation of a six-to-eight-week postpartum time to heal and restore. There are living systems in your body that have taken on an enormous task including - connective tissue, muscle memory, trauma from delivery - and that make this time frame of recovery unrealistic.


Appreciating the scope vaginal deliveries and cesareans helps women to rehabilitate from these events.


Shoulder surgery? Knee surgery? Major abdominal surgery? Rehab is warranted and expected.


Empowering women when they are pregnant and new moms about what they can expect physically are so important. When women have the knowledge of what they can begin to do postpartum, they can resolve pain, begin to feel stronger, and use daily practices honing in on posture to help them realign (core muscles are an excellent example).


The pelvic floor and core muscles are the center of the body.


They are similar to the foundation that the house sits on.


So many women, after having children, have cracks in the foundation.


With a crack like this, we can all imagine what will happen to a house over time.


Now begin to understand why neck pain, a nagging shoulder injury, or hip pain after returning to exercise is so common after having kids. It’s possible to positively enable women with the knowledge they need to keep that foundation intact – sooner rather than later.


Recovery is more than simply “doing your Kegels”


One key element is learning the right way to do a Kegel contraction and why it is important to do them daily. Beyond that, women need to learn how to use the pelvic floor with the deep abdominal muscles. Think about these tissues - completely stretched out and weakened during pregnancy. The body is very sneaky and will start to do things to compensate for a weakened pelvic floor and core.


The body's resilience to counterbalance a problem, along with effects from delivery, can lead to problems such as urinary leakage, bowel leakage, pelvic organ prolapse, residual pelvic pain, and pain with intercourse.


So, what’s the solution?


With medical care, a 4th trimester will allow women the tools they need to fully heal and regain core strength. A conscious focus on what they should or should not be experiencing with their bodies is important to feeling less anxious about recovery.


Empowering women with this knowledge could actually improve their health 10, 15, and 20 years down the road when symptoms from urinary incontinence or pelvic organ prolapse can begin to affect the quality of their life.


A healthy mom is a happy mom.


She should have the education and tools to regain her strength and truly feel like she can take care of that wonderful new baby.


For more information about Jamie and Empower Women's Health & Wellness, visit empowerwhw.com. Don't forget to follow her for tips and support on Instagram.