The Fourth Trimester by Kimberly Ann Johnson

This is a book review written by Doula Vanessa Orsborn.

This is the first book I’ve read which has focused on the postpartum phase of motherhood, rather than the pregnancy or birth, and the focus really is on the mother and her transition. There are many books devoted to the same period of time in a mother’s life, but they focus on the baby’s development and parenting styles, not on the actual transition into motherhood.

It is a raw and honest account of that transition, with no sugar coating or fake social media imagery of complete bliss with bodies shrinking back into supermodel shapes in weeks. It looks at the transition to motherhood from a spiritual, emotional, social/relational and physical level.

Kimberly starts the book with her own story of how she planned her idyllic birth and gave no thought to what would happen afterwards, and she documents how things do not go to plan, how her body suffered trauma alongside her mental shock at coping with a newborn. She takes us through her path of healing her body and mind over a period of a few years, and the methods she discovered. She went on to open a postpartum centre in the USA to support women using the techniques and practices she discovered and also to start pregnant women prepare for this period. Her story was a real eye opener for me because we often imagine those mothers who really prepare themselves for childbirth, with all those natural birthing techniques and education, having a blissful birth then happy breastfeeding ever after…  but some still end up with trauma, pelvic dysfunction and an ongoing struggle with adjustment to motherhood. It really highlights the lack of support that western women in particular get during the postpartum period in comparison to more traditional cultures with stronger postpartum practices.

The next section of the book (part 1) covers pregnancy but it is not going over things already covered in other books. It’s focus is on preparing for the postpartum period and covers often not discussed subjects like sex, sexuality /sensuality, exercise plus some great information on breath work and pelvic floor information. It was quite refreshing to have these subjects discussed with such practicality and with great advice.

Part two is the main bulk of the book and really delves into the postpartum period.

There are five main areas:

  • Balancing your emotions
  • Restoring your vitality
  • Rebuilding your body
  • Understanding Medical realities
  • Deepening intimacy

In balancing your emotions she again covers an area often not discussed, all the different hormonal changes that happen over the 4 weeks postpartum (including great “baby blues” advice) and the “motherbaby” unit that should not be separated and that sometimes postnatal depression has be diagnosed when it could be a whole host of hormonal imbalances that should be checked first.

Restoring your vitality and rebuilding your body discuss the dangers of trying to jump back into society and the desire to fit into pre-pregnancy clothes within record time. Instead women need to look at Chinese and Indian cultures where they build up a women’s life force and energy levels. Suggestions include warm foods, lots of rest, keeping warm, sitz baths and avoiding cold drafts, limiting hugely physical exercises, cold raw foods etc. When it comes to exercise she talks about breathwork and gentle body work to start restoring the pelvic floor and core. As a Pilates instructor who specialises in pre and postnatal women I recognised her suggestions to be good sound advice.

The medical realities section is of huge importance for any women who has undergone any type of intervention, tearing or suffering from any pelvic floor issues. It is the section that I feel all postnatal women struggling with the emotional and as well as physical symptoms need to read above all else. Even as a single mother of three older children, I really connected with her advice on self-care and the need for mental space to heal.

The fourth area is a section on examining your birth, debriefing it, taking ownership of what happened, and maybe mourning what didn’t happen, so that healing may start so that future births may be embraced with less fear and traumas.

Deepening intimacy again focuses on a much less common topic and that is the difficulty in keeping intimacy with your partner during this time and little tips on quick, fairly effortless techniques that can help keep your bond strong.

The final section of the book looks past the postpartum period into the looming life of not so much a baby growing but the growing of a mother and one that is confident in her own mothering, owns her mistakes and reclaims her body through more physical exercise and rediscovers her sexuality in whatever form that may take.

I cannot emphasise how much I loved this book with its new perspective and it’s wonderful advice that never tells you what to do, but just offers wisdom from a mother that has really explored the whole process of motherhood transition on all levels. I wish I had had this book available to me when I was pregnant with any of my children, it is not necessarily aimed at first time mothers, I felt that any pregnant women would get benefit from it. It is the perfect accompaniment to the natural birthing books out there as it goes beyond these books into the next level. She is also a Doula and advocates for the help a Doula can bring throughout.

My name is Vanessa Orsborn and I am training to be a doula with the Doula Training Academy. I specialise in supporting women to birth their way as we are all unique with differing needs. I offer pregnancy Pilates and nutrition support plus hypnobirthing training. I am located in Bayside area of Melbourne and if you would like more information about my services, please contact me:

Business Name:     All About Mothers
Email:                      [email protected]

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