12 things no one tells you about the 4th trimester

Postpartum Click with Eva

(Vaginal Delivery & Breastfeeding Postpartum)

Having a baby is beautiful, but healing from having a baby is not all rainbows and sunshine.

There are books and books and more books that the expectant mother can read about to navigate her way through pregnancy. Why aren’t there resources to turn to, in regards to the 4th trimester (the first 12 weeks of postpartum)? I quickly learned that not even my OBGYN gave me enough heads-up on what to expect after I’ve delivered my bundle of joy. I remember feeling so confused about essentially everything I was experiencing after I had my daughter. I Googled practically everything and reached out to a handful of my mom-friends, to make sure what I was feeling was “normal”.

In reality, labor was one of the most difficult things I’ve ever done and postpartum is the opposite of glamorous. You’re sent home with a tiny human and hardly have a clue about what you’re doing. Everyone tells you “it’s tough” and that the first few weeks are challenging — but no one shares the nitty gritty details of what to expect, without sugar-coating it.

Now, I’m not sharing these things to “scare” any new mom — I genuinely just hope to inform first time mothers of some things that I wish I had known, to mentally prepare myself a bit better.

So without sugar-coating it, here are 12 things that no one tells you about postpartum:

1. You will be sore

I remember the morning after delivery, I felt like I had been hit by a freight train. Every muscle was so sore, especially the muscles in my low back, pelvic floor, hips and hamstrings. General soreness, especially in your perineum is totally normal for the first few days after having your baby. Your body just went through A LOT. Placing ice maxi pads in your underwear/diaper helps a ton!

2. You will be afraid to have your first poop

When I reached 10 cm and it was time to “push”, I was instructed to push hard, while holding my breath, as if I was trying to have a big bowel movement. So with that action fresh in my mind… the first bowel movement after having my baby was a doozy. Not only did it feel like slight PTSD from just recently pushing a human out of me, but I had some pretty good soreness down there from tearing 3 times. My biggest tip: take the stool softener when it is offered to you! Constipation is totally real and super normal after labor because of tired pelvic muscles and side-effects of some pain medications.

3. You will bleed…like…a lot

I knew I’d bleed. I mean, duh, right? I just had a baby. But I didn’t know I’d bleed that much. The first time you go to the bathroom is a bit of a shock. It practically looks like a crime scene in the toilet. But this is normal, I promise.  With all the bleeding on top of the vaginal soreness, you won’t want to “wipe” with toilet paper. I highly recommend using the Frida Mom Peri Bottle (a mini hand-held bidet). The nurse will provide you some mesh panties and some big hospital pads. Once out of the hospital, I opted for some sexy Always Discreet diapers (they were just more comfortable) with overnight pads in them. The amount of blood is more than a typical menstrual cycle and can contain some intermittent blood clots. I did not know about the blood clots and it freaked me the F*<K out at first. As long as the clots are smaller than a golf ball or plum, it’s considered normal. It will also be normal to bleed for several weeks. I had heavy bleeding for about 1 week and then it lessened up significantly. Moderate bleeding continued for about 4 weeks and then I stopped bleeding completely around 5 weeks. If you have any concerns at all about your bleeding, make sure you reach out to your doctor for peace of mind!

4. You will stink

Lochia is the name of the vaginal discharge/bleeding that you have after delivery and this ish stinnnks. It’s stale and musty and overall unpleasant. Going to the bathroom the first few times almost made me feel queasy, mostly because of the smell itself. Luckily, this stench only lasted a couple days for me. If this smell lasts a long while and/or intensifies in odor, contact your doctor to be sure you don’t have an infection!

5. You’ll probably pee your pants

Your perineal muscles have been through a lot. They’ve been stretched like crazy and they helped push a human out of you, for goodness’ sake! These muscles are tired and weak and because of this, you will likely have some sort of incontinence for a short period of time. Sneezing, laughing and coughing would usually cause me to leak some urine or lochia into my underpants. This usually improves within a couple weeks postpartum as you continue to heal. If it does not improve by your 6 week check-up, make sure to bring it up to your doctor. Pelvic Floor Physical Therapy is an excellent option to help improve this!

6. Your poor nipples may crack and/or bleed

Breastfeeding is no joke. It’s so hard in the beginning. Your baby is just learning how to nurse and your poor nipples are trying to keep up. They’ll get sore. They’ll probably crack. They might even bleed. Nipple cream is a must! I made sure to lather some nipple cream on between each feeding. My nipples ended up getting so sore though, that it eventually became horribly uncomfortable to wear a nursing bra or even just a shirt. To prevent my nipples from rubbing against fabric, one of the nurses provided me with some Medela Breast Soft Shells for Sore Nipples. These were a life saver! I placed these in my bra and they created a great barrier so that my nipples could breathe. 

7. Baby latching hurts in the beginning

For the first week, not only were my nipples cracked and bleeding, but my baby struggled to figure out how to properly latch to my breast. The pain associated with all of this is TOE CURLING. I would feel this discomfort for the first 5-10 seconds that my baby was on my breast, and then it would feel fine for the rest of the feeding. Pro-tip: BREATHE. Unclench your fists, relax your shoulders, and breathe through it. Over time, your baby will figure out how to latch better and your nipples will heal and that initial pain will go away!

8. Breastfeeding makes you thirsty, tired and hungry

Breastfeeding releases the hormone Oxytocin. The release of Oxytocin can make you feel really thirsty. It naturally affects your thirst cues to encourage you to drink enough water to stay hydrated and make breast milk. Make sure you keep a water bottle with you at all times while nursing because you’ll feel so dehydrated (at least I do!). Breastfeeding burns a lot of calories which can be tiring, and Oxytocin can make you feel sleepy too. Not only may you feel really thirsty and really tired, you might also feel really hungry from burning all those calories. ALL of this is super normal — and I never knew any of it until I started experiencing it myself!

9. Uterine contractions

After you deliver your baby, your uterus shrinks back down to the height of about your belly-button. It gradually gets smaller and smaller over time and it can take up to 6 weeks to return to it’s normal size. In order for the uterus to shrink though, it must contract. In fact, if you breastfeed, you’ll probably feel your uterus contract every time you feed your baby — which is why you’ll probably bleed during those first few breastfeeding sessions, too. To me, these contractions felt like strong menstrual cramps and they seemed to be the most intense while breastfeeding for the first few days after giving birth. They then tapered off and were very mild for only about another week. Why does no one tell you this?? 

10. Your breasts will become engorged when your milk comes in

This seemed to affect me the most and even contributed to my postpartum anxiety. My breasts swelled so significantly that I hardly recognized myself. The tissue was so swollen that it was physically hard to the touch. I learned a trick to know how engorged you are:

  • Poke your cheek: this is how your breasts should feel when they are normal (no engorgement)
  • Poke your nose: this is how your breasts would feel with moderate breast engorgement
  • Poke your forehead: this is comparable to severe breast engorgement

Not going to lie, when you’re breasts feel as hard as your forehead, it’s not fun. In fact, it’s quite painful. Unfortunately, it’s pretty challenging to relieve this discomfort in the first week or two. The one thing I can promise is: it DOES get better! Here are some tips to alleviate your engorgement:

  • Wear loose clothing. Avoid bras with underwire and loosen the straps on your nursing bra
  • It was recommended to me by a certified lactation consultant to hold off on pumping until ~3 weeks postpartum so that it doesn’t signal to my body to produce more milk. If you feel like you have to use your pump, only use your pump for relief. Do not pump to empty.
  • *INVEST IN A HAAKAA!* I can’t recommend this enough — it was a total game changer for me. Use the Haakaa on the breast that you are not nursing on. It will help catch your let-down and relieve some of the pressure without signaling to your body to make more milk! I still use my Haakaa often — especially when my baby sleeps >8 hours straight through the night and if I’m engorged by morning!
  • Heat compress on your breasts and/or warm shower before you nurse/pump
  • Ice your breasts after nursing/pumping to help with inflammation
  • Take an anti-inflammatory (i.e. Advil, ibuprofen)
  • Certain foods help with the inflammation too. I have a glass of pineapple juice almost every day. I also swear by eating cucumbers and watermelon. Try to avoid processed, sugary foods.
  • Place cabbage leaves over your breasts, in your bra. No, seriously (haha) it works. But don’t do it too too often, as I hear it can eventually negatively impact your supply.

11. Your boobs may leak

If you’re anything like me — you’ll leak. I’m pretty much a friggin dairy cow. It’s technically a “good” problem to have, but it’s something I wasn’t totally prepared for. I specifically remember having an emotional moment, sitting on the toilet before I took a shower and I felt several droplets on my thighs. I thought, “I didn’t think I was crying that hard for tears to hit my legs?” and then I realized it was MY MILK haha. I highly recommend purchasing some breast pads to help manage the leaking! Be sure to change them out often though — damp breast pads make a good home for bacteria and could cause a yeast infection on your nipples, known as thrush.

12. The Baby Blues

About 4 out of 5 moms will experience the Baby Blues (or Postpartum Blues) and this is totally normal. These blues can occur a couple days after birth and can last up to 2 weeks because your hormones are outta WHACK. If your saddness lasts longer than 2 weeks, you should talk to your doctor.

I was not prepared for the amount of emotion I would have. I felt sad and cried A LOT. I weirdly felt lonely and overwhelmed. I questioned if I was meant to be a mom. I felt super moody — like one moment I’d be so happy and the next moment, I’d start crying and I had no idea why. One time I found myself crying because I just loved my daughter so much and thought she was so cute. 

I feel it’s important to know that the Baby Blues are even a thing. To know that it’s normal and that it happens to a lot of women. I feel it’s not only important for you to know about, but for your partner to know about too so they can be a helpful support system for you. The biggest piece of advice I can give is to be gentle with yourself and give yourself lots of grace — because you are amazing and you are the best parent for your baby!


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