I am a physical therapist who works with women. The fourth trimester facts are set straight in my works.

image of new mom and her newborn
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“The postpartum period is a time when a mother is in a state of change. It doesn’t mean that it’s always rainbows.”

You may be feeling scared, overwhelmed, lost, isolated, unhappy, exhausted, sad, or not connected to the baby yet. Postpartum anxiety, depression, rage, and baby blues may be concerns. Your mental health and emotions are valid and important, and you deserve a support network ready to help you navigate this period.

Along with caring for your mental health, you need to care for your physical health and body. It is important to rest and recuperate during this time, but it is also important to start moving your body a bit, something that can help your state of mind.

“It is important to early mobility to help with physical healing and to help mitigate health risks that increase from being immobile, like deep vein thrombosis and injury caused by muscle weakness. Many people don’t know where to start.”

Postpartum physical therapy is possible. If you work with a physical therapist who specializes in post-Natal care, you can start moving again in a safe, supported way and also have some time to work through any challenges you may be facing in the fourth trimester.

“Postpartum physical therapy is often overlooked, underutilized, or simply unknown. There are a lot of myths that prevent people from seeking help with a post-partum condition. Let’s get you on your way to recovery by busting those myths.”

The fourth trimester is defined as the time period from birth to 12 weeks, and so much happens during that time that sometimes it’s hard to even know which way is up, which way is down, what day it is, and when you last showered.

If you have a baby already, you know what I mean. If you are about to have a baby, listen up.

“When you get that all clear sign, the 6 week check up is usually the best time to get your stitches healed. We have all done these things, even me, so let’s dive into the myths and mistakes of the postpartum time period.”

Myth 1: If you don’t have any symptoms, you don’t need to schedule

Nope! If you wait to drink until you are thirsty, you will be dehydrated. Mental health and physical rehabilitation are the same after having a baby.

It is so beneficial to schedule and establish care with a provider or team BEFORE your baby comes, so if and when you need someone you are ready to go. I’d recommend considering this for both mental health support and pelvic floor physical therapy (PT).

There is a ton of evidence that support patients coming to PT as a preventative measure (1, 2, 3). If you’re able to talk with a provider or establish care prior to having symptoms (like pain, leaking, prolapse, etc), we can help decrease the risk or severity of those things happening and also improve recovery.

To make things easier on new parents, many health care professionals now offer virtual sessions. Even if you don’t have access to a postpartum physical therapist in your neighborhood, you can book a complimentary consultation from one of our DownThereDoc providers to get your team in place now.

“If you don’t need us, great! We are here for you if you need us.”

Myth 2: You’re completely healed and recovered at 6 weeks postpartum, and ready for anything

Oh lord, I am so sorry. How much time do we have to talk about it? This myth is the beginning of my career.

Recovery and healing are not the same thing. Your tissues may be healed at 6 weeks, your scar is stable and closed, and you are bleeding less and less. Recovery is different from tissue healing.

Recovery can take months. Some people are having issues after having a baby. You are not recovered at 6 weeks after the baby is born.

Some birthing persons feel awesome at that time and don’t experience any issues after birth. But some do, so let’s consider: what we “comparing” our postpartum recovery to? What is the 6-week standard we are measuring against?

“We wouldn’t encourage patients to go into a full-blown sport or activity 6 weeks after an injury with zero rehabilitation. It doesn’t happen.”

“We don’t tell patients to rest for 6 weeks after an injury or surgery, and then they have to do everything.”

“Recovery is different from healing. At 6 weeks, magic doesn’t happen, like at 5 weeks and 6 days you can’t run, and then at 6 weeks you can.”

Our bodies take longer to heal from having a baby, it is normal.

Myth 3: You have to get back to your pre baby weight or jean size to “bounce back” from baby

Nope… once again… The media and society want us to look like we never had a baby.

“I am pretty sure you just had a baby, so why is it bad to look like you didn’t? The term bounce back is used when a baby makes my skin crawl.”

“You didn’t lose your body in the minivan. It is not gone. You don’t need to find it. Pre- baby weight and jean size are irrelevant to healthy, functional, happy, and happy bodies.”

Losing the weight comes easy for some, and for some it doesn’t. Some of us lose weight when we breastfeed, some of us do not. Some of us pop a baby out easily, most of us do not. And that’s ok.

You should not be focused on losing weight so you can look like you did before. It should be focused on what makes you happy, what gives you balance, what helps you heal and recover, and feel healthy and strong.

Postpartum health and recovery is a big part of your life and should be structured. It is ok to look like you have a baby. We bounce back and forth.

Myth 4: Leaking, pain with sex, prolapse, and other pelvic floor issues are “normal” since you’ve had a baby

“I’m not going to beat a dead horse.”

We have to unpack the idea that having those symptoms is what we want to be a parent for.

“Which is also terrible. We know that these issues don’t go away on their own and that most women experience these issues throughout their lifespan, which is why the pad and incontinence industry is so lucrative.”

So we know that these don’t go away on their own, and we know that we’ve been told for GENERATIONS that we have to suck it up and deal with them on our own. But I’m here to tell you: having a baby is not a life sentence for pelvic floor dysfunction.

Postpartum is a problem that can be solved.

Myth 5: You’re a bad parent if you don’t…

If you want to be available 100% of the time, you have to sacrifice things you love doing, like breastfeeding, quitting work, and taking the brunt of the housework and child care.

Let me explain something: mom guilt is real, mom-shaming is real, and feeling inadequate as a mom is very common. I didn’t even touch store-bought baby food or Pampers because I thought I would be a bad mom or judged.

I was paralyzed by guilt and anxiety the first time around, but things changed with the second kid. I was so tired I cared less.

You’re not a bad mom if you choose to formula feed, or sleep train, allow your baby take naps in the stroller, or go back to work, or whatever. We are all doing the best we can, and our babies know we love them. If only they knew how much we agonize over the littlest things, with their best interests in mind. It’s exhausting.

Your recovery after birth is the same. It is ok to take some time for you to acknowledge the things that you are feeling, and to go at your own pace.

Both C-sections and vaginal deliveries are hard on our bodies. You’re not a bad parent, or “weak,” or being “too sensitive” if you realize that you’re not happy with how you are feeling. You are paying attention to your body and prioritizing your health and happiness. It’s a good thing to do.

Myth 6: Pelvic floor treatment is too expensive, so I’ll just watch some YouTube vids and do Kegels at red lights

“Yes, the grand ol’ interwebs can be helpful. How often have you scrolled and scrolled until the wee hours of the morning and still felt lost and unsure? It is overwhelming.”

Also, let me tell you: postpartum recovery is not just about “Kegels.”

Most women do kegels and squeeze their vaginal muscles wrong when they are told to do it. That is the reason why people say they do Kegels.

The orchestra has just one instrument, and that is the Kegels. You have to learn how to perform them in different ways, how to connect them to your breath and abdominal wall, and how to do them in different positions.

Parents are active and have a good body, but they still need some guidance to get on the right track.

It is important to decide what is important to you and what you want your baby to look like. Sometimes appointments are expensive. It is possible that Pelvic floor is not covered by your insurance.

You have to think about this as an investment in your health, wellbeing, and happiness. How much do you value being intimate with your partner without fear or pain, having more babies, and having a better recovery?

I think it is worth it to spend a little on yourself upfront so that your long-term outcome is better. Think about how quickly we can drop the Benjamins on a stroller, a purse, baby clothes, and the latest swing for the kids.

If you want to enjoy that stroller run and not have to worry about leaking, you should re-direct some of that investment to you.

“The fourth trimester can be very long. It definitely doesn’t feel like it when it’s 12 weeks by fast.”

“Don’t wait until you have a problem to ask for help. Think about mental health, postpartum doulas, housecleaners, lactation consultants, dog walkers, playdates for your toddlers, before the baby arrives, if possible.”

It is not too late to find support if you have already had a baby.

“Don’t allow anyone to dismiss you or tell you that leaking pee, painful sex, and other issues are normal. If you need a second opinion, call my team at the down theredoc and we will make sure you are taken care of.”

“Postpartum issues don’t disappear. Don’t believe the myths you hear. Think about what you want your future to look like and then claim the right to create that future for yourself.”

Marcy is a board certified women’s health physical therapist and has a passion to change the way women are cared for during and after their pregnancies. She’s the proud mama bear to two boys, and loves the ocean, horses, and a good glass of wine. Follow her on Instagram and visit her website to learn more than you want to know about vaginas, and to find links to her podcast, No Mama Left Behind, blog posts, and other publications related to pelvic floor health.