Understanding Postpartum Mental Health: Navigating Postpartum Challenges and Self-Care for Moms (and Dads)

Welcome to the podcast. Unapologetically, I'll over the place with Randy and Jess, two licensed psychotherapists, where we talk about women's mental health, well-being and strategies for coping with life's changes and how it's all normal. You are in the right place, my friends. Welcome to today's episode where we'll be discussing the fourth trimester. This is a term used to describe the first three months after a baby is born. We're going to dive into what it exactly is and why it is so important to be aware about it.

We're also going to be doing a more in-depth series about the fourth trimester and postpartum depression and postpartum anxiety soon, so stay tuned, so find us and more information about the fourth trimester for moms on randianjesspodcastcom.

Have you ever thought where did the term the fourth trimester come from?

Where did all the anxiety come from after the birth of my child?

Why doesn't society open up more about birth and the months after the first baby is born, or the second and third, because it's all different.

Why are we not having this conversation? Right? I'm still mad. nobody told me about mesh panties. Okay, so I feel like a failure because I'm struggling to connect with my baby Do dads and moms also get postpartum. Then you know what They do. They do, okay, what the fuck did I do?

Right, Like holy shit, I just had a baby and I'm not feeling this and that's normal, right?

Or when they hand you the baby and they tell you to go home and you're like I'm sorry, what You want me to do, what? Okay, i want to get in my car and drive off a cliff, yep. So I will say that if you are having thoughts like any of these, it's okay to get help. You can call 988 mental health crisis line or you can call 1-833-9-HELP-4-MOMS. Both are 24 hours.

So what is exactly the fourth trimester for moms and why is it so important?

You know, i had never really heard this term until recently, i mean in my kids. Well, i'm almost a teenager, so this actually goes back until, like I think it's the 70s. There's a pediatrician named Harvey Karp. He's the one that came up with the concept of this book The Happiest Baby on the Block. Oh, i remember that. Right, he's also the dude. I think that made this new. You know that that really super expensive, special, self-rocking, like baby cradle, oh, okay, okay, so that's him. So he describes the fourth trimester as the first 12 weeks after a baby is born, and the reason is is that apparently we are one of the only creatures on the planet that has babies that can't walk and take care of themselves. So we're?

we just have, like. we've just gone through this whole process of like, depleting our body of nutrients, of vitamins, of creating a human being, going through what can often be a traumatic thing birth. you know, it's physical, it's emotional And then all of a sudden, we're supposed to take care of this new human being that is relying on us 1000% for everything that they need.

Right, Because we give birth to babies that aren't quite ready to be born yet, because if we were to give a go through the whole process, they would never fit. So so basically, i mean this is one of the hardest times of having a child, the first three months.

Right, and most people are so focused on the well-being and the care of the baby that they forget about the mom, or in the dad too Right.

I remember like it used to be so cool when I was pregnant you can celebrate your belly, people would open the door for you and they'd be smiling at you Once you give birth. It's like you are an old shoe And seriously, yeah. And they're like, oh, how's the baby? And I'm like, no, no, i'm up here, i haven't slept, i haven't slept. So most people do focus on the baby and not the parents. I think there's a change happening now, where people are starting to, like doctors, are starting to ask more about the moms. How is mom doing? How are the parents doing, all the way up until they're one year old? Right, because every time you go, that's we're supposed to be checking in. How are the parents doing? This is a really hard thing. Whether it's your first or seventh child, every child and every birth is different.

Yeah, And every time whether it, like you said, it's your first time or your fifth time you have a new life, a totally new life. You have a new title. If you're like a new mom or you are a mom of five, that's a new title, It's a new identity, It's a new structure, It's a new household, It's a whole new family And that's a lot. So a lot of the times you're just like what the fuck?

Right. I remember when they handed them to us saying a few minutes ago, is that like they handed it to me and said okay, good luck, goodbye. And I was like wait, no, no, take, take, take her back, wait what am I? supposed to do with this baby And, like I remember, the next day I took her back to the hospital because I was like I don't think she's breathing right. I don't think she's breathing right. I was so anxious and we had such a traumatic birth that they were like no, no, this is normal. And I'm like this is normal, are you sure? And then the doctor there had said, hey, just a head zap. It was a female doctor, she might have some blood in her diaper because of the hormones that you've had. And I was like, wait, what? Sure enough, next day she had a little bit in her diaper because of the hormones and she was like that's normal. And I was like if she hadn't told me I would have taken her back the second day, been like, okay, i broke her already.

What happened? And this is a thing though, too. Like you said, you had traumatic birth. I said I have had two traumatic births. I think birth is just traumatic and we do not preface it. It that way. We're like, oh, it's like this beautiful thing and like motherhood, like no, it's not. It's hard, it's grueling, it's painful, it's emotional And it's never going to turn out the way you fucking think it's supposed to. And it's been, you know, idealized in what like social media and movies and things like that. And it's not, it is, it's trauma, right, they're like get your birth plan together. And you're like I just want to evacuate this baby, i'm ready And they say that all the time, and I have a love hate relationship with birth plans because, like I, like to plan things out and have resources on the go, so I know what to expect. But when these situations happen and you go in and have birth, all that shit goes out the window. And then you have had this idea in your head of how you think you want it to go, or you're envisioning it to go, and then none of that happens. So then you're also grieving that process and that loss of what you assumed or you know, wanted it to be. And it's like here you are.

Right, And we want to talk about how do you survive the fourth trimester right? And I also want to preface that don't be ashamed to feel any of these feelings during your fourth trimester, because this is a very hard and difficult adjustment period, No matter how bad you wanted that baby right, or how wonderful your birth was, or how horrible your birth was, whatever it was, it's okay to have all of these feelings.

Right. It can trigger other emotions or things you've suppressed in the past. It can bring up things that you haven't dealt with Yeah, like from childhood, from other things You don't know. And so that's why this is so important to have this conversation and talk about it in the open, and also why we want to talk about the difference between just having some kind of maybe like mild baby blues, as they would call it, like kind of feeling down, and having full blown postpartum after you've had birth, and that you are, you know, can't get out of feeling down Right, and postpartum is not just depression.

It can be depression and or anxiety. Some women don't get depressed, but they're so anxious And that's part of postpartum, and so we kind of you say, oh, it's just postpartum depression, no, no, no, it's anxiety as well, mm hmm, And we talk more about depression in episode two.

If you guys want to give a lesson, listen. And episode seven about anxiety. If you want a little bit more in depth, talk about that.

Yeah, and I want to preface that it's normal to have the baby blues after you give birth. Your body is going through all of these different hormones and changes, so feeling a little sad, or a little weepy, oh yeah, lack of sleep. Little weepy is okay, that's normal, but if it continues, or if you're having thoughts like suicidal thoughts or thoughts of harming your baby or thoughts of you know, i don't want to do this. That's when we start looking at some of the depression and anxiety, and it can be diagnosed all the way up until your child is one year old Right.

So it's like a long lasting impact versus like just kind of feeling down and out and tired you know and stress for a couple of weeks versus like this is not going away, or you're having like ruminating thoughts that you can't get out of. Like you know, you're overstressed, overthinking, you're in like a you know cycle, And so that's kind of like where those differences come in.

Yeah, And you can be doing fine for like six months and then bam, you could end up with postpartum depression or anxiety. It can hit you, you know, after you think everything should be fine.

Right, you might feel like you have a hold on everything. And then it hits you out of left field and you're like knocked on your ass and like, but I shouldn't be feeling this way. I thought I had it all together and things were going good And it's like, well, maybe things shifted, you know, or hormones changed or something else triggered, or there was a new life stressor and it brings it up to the surface. So it's like that can be dangerous to have that thought that this shouldn't be happening, but it is, and like not wanting to face it And also we're starting to look more at the partners.

Not just, you know, women is that the partners husbands, wives. You know the partners that if you have postpartum depression or anxiety, there's a 50% chance your partner does too Right, and so it's good to get help for you and for them. Yeah, and a lot of times what I see is when mom's not doing well, the partner is kind of holding her up as best the partner can, right, and then once mom starts doing better, it creates this space for the partner to a kind of fall apart and then get put back together, and so sometimes it's it's it's like you know he's fine, he's fine, and then once you get your stuff together, you're like, oh wait, he's not fine at all, he was just trying to make it or she you know partners were just trying to make it, so we were surviving. So but let's talk about, you know, all of the changes that happen right, because there's so many different like physical changes that happen Right.

Like I said, changes to your family, your life, your routine.

So I mean we're talking about, like there's physical changes to the woman right, depending upon what her birth was and the healing process. You know they'll say six weeks she must go back to work, which I think is complete crap.

Or have sex.

Or have sex And you're like no, no, no, no, no, no. Did you see what just happened?

No, i'm not doing that It's like, let's be honest, your vagina was bleeding. You can have continual bleeding afterwards You can have perennial pain. I had tearing. you know that I had to heal from that actually almost took two years and scar tissue and things like that, like some women can you know are cut. some women tear your breasts, you know are like if leaking milk or they become hard and painful, like you know and it's sometimes in it.

This is the other thing too is if you're choosing to breastfeed, fantastic. If you're choosing not to breastfeed, fantastic, exactly.

No shaming here.

No, all we want is a happy, fed baby and a happy mom that is not stressed about either one.

Yeah, And like Justin and I both had issues breastfeeding and it is very common and I personally felt like a failure as a first time mom when this happened. But when I finally realized like I was doing the best like formula feeding her and giving her a bottle, and I could not also not express the relief I had that her dad could help me with the feedings and I could get more sleep.

He was helping.

He was participating, right Participating, thank you. I was like thank fuck, like this is happening right now, because I prefer this.

You know, and I, I always laugh at myself because the formula box didn't tell me to warm up the bottle. So she got room temperature milk her entire life And she was fine. And she was fine. And people are like, oh my God, that is so amazing. You are so smart because now you don't have to find a microwave to warm her bottle.

My daughter loved it cold Like she, so I was like cool, great Like on the go Right, but it didn't say to warm it up.

So why would I warm it up? I was a new mom. I had no idea what I was doing. So I think there's more info out now than there was, say, you know, 10, 12, 15 years ago about giving birth and having babies 100%, but I feel like we still don't talk.

Even though there's more science, there's more research, there's more information, i feel like we just don't talk about it enough still.

And we don't normalize it.

Exactly.

And that's the other part, is normalizing right. Is that? you know, it's the, the making things normal And that's probably why I work with a lot of postpartum moms. Is that I just want to normalize that that thought they have of you know the I just want to drive my car into the center divide just because I'm over it, but I'm not going to do it, but I'm thinking about it. That is a very normal thought. You know. It's a dark fantasy that a lot of women have when they're having postpartum anxiety or depression.

And I think, too, we don't think about because it's like you said, like baby happy oh they're so cute, they're so precious but also that baby is also growing at a rapid rate. Yes, and they also don't know what's going on. You don't know what's going on. Like they're developing vision, hearing, their digestive system, like so they can have colic reflux, they can have a hard time sleeping, like my son is almost eight and he still doesn't sleep. So it's like you know that is very challenging for parents to manage And it is important for you also have open communication with your partner and yourself, like this is a lot, i understand this is a lot. They're going through a lot, I'm going through a lot. So let's all take a deep breath.

And you know. I also want to encourage you. If you think your baby is having a hard time, follow it like feeding or, you know, being fussy really reach out to your doctors and advocate for yourself and your daughter or your daughter, Sorry, trauma there.

Yeah.

Because with my daughter she had a tongue tie and I couldn't breastfeed because of her tongue tie, and nobody caught her tongue tie until she was like two. And so now I tell women to take a look at it, make sure there's not a tongue tie, make sure there's not a lip tie.

Yeah, So we talk about this in our gaslighting episode two. There can be a lot of medical gaslighting. That's episode 13. Sorry, sorry, try to work that in, but same thing. So like when I first had my daughter and she I felt like she hated, hated tummy time and I didn't understand why, and she would cry and scream And then I kind of noticed like she wasn't moving, her like neck a lot and she was sleeping in a certain position, oh. And I was like what is happening? Well, it turned out she had torticolus and so we needed to do physical therapy and she ended up getting like a flat spot like on her head.

So wait, tell people what torticolus is, because honestly. I just figured out what that was a couple of months ago, oh yeah.

So torticolus is basically like a strained neck muscle, so like and this is very common for babies to have this because especially when you have a vaginal birth is that there's a lot of stress from them coming through like the birth canal. They're twisted in the womb and then coming out And so their body can be like strained and like their muscles can be strained and they can be kind of like their whole body is off kilter.

So it can happen very, very fast, like it could be totally normal, and then all of a sudden, like your baby could get torticolus, where they just all of a sudden like their neck kind of changes and they get stuck.

I mean you have to think about yourself as an adult too. Like I have this happen all the time, like I'll get, i'll twist a certain way and like all my neck or my back or my arm or my shoulder will kind of like shift and go out and I'll have pain. Or if you've like been sitting in a certain position all the time, or things like that. Or if you're over 40 and you sneeze wrong, yeah same. And then pee your pants when you sneeze, that's a whole other episode about pelvic floor exercises, anyway. So this can happen to baby too. So but then I went into the doctor and she was like I don't think like she has, i don't think she has a flat spot, i don't think. And I was like I think that she does like this. Her head shape does not seem like super normal to me. And they were like well, fine, if you want to like, well, you can go see the specialist. And this was just a new thing to have a doc band when she was born 17 years ago. So I went to the specialist and they were like Oh Yeah, she does, she has a flat spot. They made her a dock band. She needed to wear it. They helped us with the physical therapy. It was like Is that the helmet? Yeah?

Okay, thank you. The cute little baby helmet. Yeah, let's call it a dock band, it's a helmet.

And so you know, but it wasn't normalized then either too. Like I thought, everywhere I went like people would stare at her, like in this little band, and I put like cute little, like flowers and stickers all over it. But like people were like what You know? and it was like now it's more normal to see that out. But what I'm trying to say is that, as I scrolled off, was that listen to your intuition and push Yes. Because the doctor was trying to tell me no, no, no, And I was like yes, yes, yes. And then when I saw the specialist, they were like yes, and you were right, you know, to push for this and coming in, and I got her And then she was able to develop normally too, because then with the physical therapy, she was able to enjoy tummy time and move her neck and more Right.

And that's what the tongue tie is that I had to go outside of the hospital. I had to get special testing and pay for it. to prove it. I had to go back to the doctor who said no, no, oh, yeah, i guess you're right. And then we had to go over to a surgeon and she had to go into surgery because by two she was like you're not getting anywhere near me with that big tongue thing Right. Well, now they use lasers to do it. Yeah, it's such a easier process, yeah, and what you want to do is actually go to your pediatric dentist, not your doctor, which nobody told me, right? So if you suspect there's a tongue or lip tie, go to your pediatric dentist. They are specially trained to look at that. And with torticolus, the other thing is they do now is sacral cranial therapy for babies to release all of that when there is trauma.

Yeah, and so there's a lot more massage therapy. That's what I'm thinking about.

Yeah, but it's special And it's the sacral cranals, what they call it. If you look it up, we'll post it. It's S-A-C-R-A-I-L.

Okay, don't try to spell it A-I-L cranial. We'll link it on the website.

Yeah, But it's a therapy where it's meant to help them kind of release some of those nerves and twist and turns which I had never heard of that either. So all of these things are changing as we learn more and we talk more openly about this stuff with our kids, because Randy and I, you know, yeah, we have kids who have some similarities, but there are so many women out there like, oh yeah, yeah, my kid had that. Oh yeah, yeah, yeah my kid had that.

Yeah, once you talk about it. though, if you don't talk about it and you don't open up that communication and you don't make yourself vulnerable, you're never going to know if anybody else maybe has some experience, and sometimes opening yourself up to that conversation can lead to kickback from people who think they know it all or like who are have their own negative. you know connotation about it, but you're going to find more often than not you're going to find somebody that you can connect with or somebody that's going to help you through this process.

I personally love getting all the information from someone who knows all of it, who has never had a child or who has never gone through birth or who has never done this, and you're like wait, wait, you cannot talk to me about birth if you haven't gone through this. How? How? It's like having a male doctor If you don't have a vagina? how do you know how?

to tell me what to do with mine. Well, and that's the thing I always say, i was the most amazing parent. before I had kids, i had this list of I would never do this. I would never, i wouldn't, i would, my kid will never. Okay, yeah, just toss that all out the window, because pretty sure you're going to give your kid red, die 40. You're going to let them, you know, run off. This is all. The things are going to happen and you're going to eat your words.

Oh, my favorite story is how my daughter managed to crawl out of the cat door at age like I don't know eight or nine months, yes, dying. Her dad was supposed to be watching her. She was in the room with him, right, he's playing his game. We've got the. both doors are gated off, but the sliding door was open and we had a cat door. She crawled out the cat door and I'm like I'm a good mom. I swear I'm a good mom. right, we're good parents.

This is the thing, though, kids they will find a way and they are fast. One second, and then, like I mean, I've had my whole house flooded, I've had, you know. the list goes on and on. So you are not alone. today, My kid, you know, spread 6,000 perler beads all over my living room. So you know you are not alone.

Yeah, i remember hearing her and I was like where is she? And I was like, hey, where is she? And he was like she's right, oh wait, she found her almost in the front yard playing in the grass and we didn't even have a gate right, like gate had been broken or something, and I was like we're fixing the gates this weekend, yeah, and he was like okay, okay, and she was just happy as can be playing in the grass, you know, just babbling away, and I was like, oh my gosh, it's fast. Yeah.

So with all of these physical changes and baby changes and everything happening and like trying to listen to yourself and like having other people like intervene, that comes with a lot of emotional changes and emotional charge. And so this is huge, especially during this fourth trimester, for moms. For the months that follow, you can have mood swings, anxiety, like we talked about, postpartum depression, and so it is so important to seek that emotional support, whether it's from friends, from your partner, your partner, from a therapist, from a moms group your pediatrician.

Yeah, tell your pediatrician if you're not doing okay.

Yeah, like any, tell anybody and everybody and see who you can kind of form Who shows up, yeah, who shows up for you Exactly.

And if you're struggling, please encourage your partner to also get help as well, because sometimes the two of you are just trying to keep each other afloat between this baby, whether it's the best baby or a difficult baby, exactly. You know it is difficult of trying to change, and then your relationship changes too, and so trying to stay connected with your spouse while trying to figure out what the house looks like with this additional person in it who you know, let's be real, they're cute, but man, they're demanding Yeah, and this leads into why self care is so important and support. Yes, yes, why?

and support so important, And so we talk about caregiving in episode three and self care in episode nine. but it is so essential for both mother, father, partner, during this forced trimester, for moms to prioritize rest eating, hydrating, you know, moving your body a little bit and looking, you know, inward to care for yourself and asking for help.

It's okay to say I'm asking for help. So a lot of us think self care is like, oh, i'm going to go to the massage and do all this stuff, right? No, it doesn't have to be that. Yeah, sometimes that's actually self soothing And really we want you to set yourself up that maybe you have, you know, the meal service coming in, or grandma comes in and helps out so you can shower and maybe take a nap once a week, whether you think you need it or not.

Right, whether that's reading a book or just sitting outside for some peace and quiet. And I always say to you, if you are a new mom and you're overstimulated and baby is crying and you can't do anything, it is always best for yourself and the baby to set the baby down in the room safely, safely in their crib, and walk away, take a deep breath, go in your closet, scream, walk outside, get sunshine, you know, for like 15 seconds, take some deep breaths. Do you know a few minutes of mindfulness, whatever that looks like. You know like throw some darts at the dartboard, whatever you need, and then go back. The baby will be okay for those few minutes that you need to regroup And this is important for your emotional care, your mental health care and your self care.

Right, you know, and one of the main hospitals where we live here has a whole program of don't shake the baby, right, and I'm kind of like, okay, that's great, but let's talk about what we should do, right? I mean, i just don't like the whole don't shake.

We do talk about like what we shouldn't do, shouldn't do, shouldn't do, but like we don't talk about what we should do and how we can care for ourselves and the baby in the same process.

Right and like Randy you were just talking about is taking a few seconds. the baby will be okay, right? you're not going to harm the baby by walking away for 15 seconds and breathing and then going back, and so it's very important. or, if you're at your wit's end, check in with your partner and be like I'm out, i got to tap out. can you tap in Right And try to see if that works? Even now I still do that with my kids that are 17 and 8.

I still, this morning I was like I am going to blow my lid. So I walked my son over to my partner and I was like, please talk to him because I will. This is not going to go well for me if I continue down this road. And he handled it and he was able to be calm, and then I was able to calm down and come back to it, but I still I had to walk away, you know.

And the other thing is too, if you can't, you know you don't have friends or your friends aren't having babies yet, or whatever it is. There's a lot of online support groups too. I'm part of PSI International, which is postpartum international I guess PSI, yeah, and support international And they have support groups for men, they have support groups for women, moms, dads. They have online support groups that can help you And so you can reach out to them and do an online support group. And in therapy I tell mamas bring your baby, don't worry about it, bring your baby. If your baby's crying, just put me down, we'll talk and we can walk. I will work with you and help you figure it out, as will a lot of therapists.

Yes, 100%. When I had new moms come into my office too, they would be like I can't find a sitter. I said it's okay, Or they're breastfeeding, bring the baby. I'll hold the baby too for you. If you want, a good therapist will meet you where you are at. And these are great strategies for coping and tools that you need if you are walking through this Or if you're on the opposite side, like your sister, your best friend, your partner. These are things, too, that you can help with the new mom or with yourself or with a family do If you see that a mom is struggling walking through this walk.

Yeah, And really I tell people that you have to wear clothes unless you're breastfeeding, right?

You got to wear clothes.

If you're breastfeeding, I don't care. I got moms who meet with me who will pump And I'm like whatever, I don't care, As long as you are getting the help you need and you're using the time that you need.

That is fantastic, Like I lived in a rural area when I had my daughter at first, so there was not a lot of access to support groups. So I found an online community of moms who had all had babies the same month And to this day, 17 years later, i am still friends with most of those women. That's awesome And because they were such a huge support system for the first you know, like almost like five years of her life, like as you're going through this and putting them you know through the through the world and trying to make you know them into a functioning human being. It's a lot when you say it that way, and so we need that friendship, that support, to know that we're not alone and things are okay Yeah.

And it did become such a crazy time, like I remember, when I went back to work. I was so hectic One morning I forgot to brush my teeth. I was so thankful, though, that we had a dentist office in the bottom floor of the building, cause I went there and I was like um, can I have a toothbrush and some toothpaste? And it looked at me and, like I'm a new mom, i totally forgot to brush my teeth. I need some help.

I mean I still uh, i'm not a new mom and I still sometimes forget that, So I'll keep you know. extra little mini like toothbrushes in the car, because I'm just running ragged all the time.

Right, but so fourth trimester is, yes, the first three months. There is so much more And I do think we should talk more about it in different episodes, about postpartum and like the first year and the adjustment that it really causes.

Yes, this conversation is not over, so come back. We're going to have more episodes about this fourth trimester and postpartum and coping for moms, and these are also resources you can use, like I said now, whether your kid is five or 10, sometimes we're still struggling because we haven't ever taken these steps to create a support system for ourselves.

I always say we it takes a village. You need your village. You need the people who will show up for you in their jammies at 11 o'clock at night or who don't care that you're sitting on their couch going. I just need to talk, yeah, and those people are out there.

It's just taking that first step to find them. Find a therapist you can connect with, find a lactation consultant that can help you. Find a good pediatrician, find a good baby group. It's out there. You got to seek it out. We're going to put some resources on our website for you too, and we will talk to you guys next week.