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How I Planned My Fourth Trimester to Survive Postpartum Depression

The concept of a fourth trimester, drawn from maternal nursing and midwifery, refers to the crucial three to six month period after birth when many of the physical, psychological, emotional, and social effects of pregnancy continue for the mother.

Learning about the Fourth Trimester

I was five months pregnant with my second son when I picked up the book, “The Fourth Trimester.” At the time, I was visiting my brother and his family on Bainbridge Island in Seattle. We were window-shopping and stopped into their favorite independent bookstore out there. Cashing out, my stack included an activity book to entertain my kid with during our upcoming flight home, a couple of Harvard Business Review essay books, and that life changing book written by Kimberly Ann Johnson. 

I’m not sure if it was the cover’s promise of, “A postpartum guide to healing your body, balancing your emotions, & restoring your vitality” or the back cover describing the book as a, “… holistic guide offering practical advice to support women through postpartum healing on the physical, emotional, relational, and spiritual levels” that convinced me to buy it, but thank goodness I did.

I started it later that day. About twenty pages in, I began searching my brother’s kitchen drawers for a highlighter. Every word was resonating with me, sparking ideas for how to survive having a second baby. I started to compile a list of dreams for my postpartum months with him. By the time I finished the book, the margins were full of notes and its pages were tabbed to share important takeaways with my husband. 

Anxiety ridden and full of worry whenever I pictured my first son “on his own” during my recovery from the second birth, I was motivated to create the best-case scenario. It might be important to note that I was reaching for a very low bar when I say “best case.” Not exaggerating, being totally honest with you, I truly saw myself in fetal position incapacitated for months by the return of my postpartum depression. I decided that instead of our home life being made worse by this, I’d plan around it so they would be ok

Creating the Plan

My “list of dreams” included a lot of the basics you’d find on any old list written by a privileged, white lady (let’s be honest shall we)? The no brainers: I wanted a cleaning service to come in. I wanted meals delivered. I wanted family support. I knew which timesaving, on-demand apps to enlist and resource. This all felt like a good start.

But the book encouraged me to think a little more deeply about all of these things plus more.

The first decision I made was to hire postpartum support. While I didn’t want a labor doula, as I had during the birth of my first son, I felt strongly that a nighttime doula would carry us. This had me thinking about the daytime and I began wondering: if restorative sleep would make the following day livable, I might have the opportunity to make it even more productive.

But what else would a daytime doula add to my life? Picturing someone competently loving on my newborn while I rested and recovered, who could also help keep life going in my absence (if things came to that) sounded reassuring. We began interviewing, bringing in four different birth and baby support companies. By August, we contracted with Birthways, who agreed to support us after his arrival for the first three months of our baby’s life. I was due in early November.

With this task complete, I built my plan around those doulas. I outlined the ways I’d enlist their support. But just as importantly, I considered what wasn’t appropriate to ask them to do, which created our child care plan for my first son. While I was so grateful for the school he was already attending by that time (to provide him with some sense of consistency and routine), I considered how he’d get home from it, who’d give him 100% of their focus before and after school, and help him into his evening routine… if it couldn’t be me. Seven months pregnant by that time, I started interviewing babysitting agencies that wouldn’t constrict us to a set schedule but would provide a team of sitters to support us as we needed them. By September, I hired K Grace Childcare who began working with my first son a few weeks later.

To give you a picture of where I was mentally at that point, my anxiety was getting more uncontrollable. I saw things falling into place but privately was preparing for my suicidal thoughts to return postpartum. 

When I was ok enough to face those, I’d tell myself, “Just get him here. Bring him into the world, get him in safe arms, and then decide what you’ll do with yourself.” It was around that time I began planning how my family could live without me.

What did they need to have in place to get them through? Food, I thought.

No one had offered to organize our meal train yet, so I did it myself. I injected some honesty and humor in their needs. I set the dates through the first three months of our newborn’s life on a delivery schedule that worked well with our family’s weekly rhythm. While some people (surprisingly) pushed back on my boundaries, most respected my wishes. 

Clicking around the site after that step was done, I discovered if I paid a small fee, I’d have access to a few other capabilities. So I paid and started messing around with it. What if I added other requests that might be helpful to all of us? The Fourth Trimester had me thinking about my support system, who I’d call on, and where to enlist those people. I added “visitation hours” for folks interested in coming by to meet the baby. I dropped in playdates for my first son so he’d have some hang time with friends. I even scheduled Friday night brewery visits… I figured it might be nice for friends to pull my husband and I out of the house with the kids for a beer. 

And last but not least: the coffee dates.

These coffee dates were more life-giving to me than any delivered meal. They were scheduled weekly, at 7am, and they asked anyone interested to bring me a latte. During these visits, I had a chance to honestly check in with someone. Not surprisingly, my mom friends quickly filled these spots, and then showed up like clockwork. They left their kids at home, brought me coffee, and just hung on the couch, holding my baby while they listened to me. They made sure I was ok, emotionally and mentally. As bold as it was to ask for all of this, my girlfriends signed up. To this day, these girlfriends continue to show up in other ways and have become my village.

Meal train in place, I wrote our baby announcement (yes before he was born). Fortune telling, I drafted the update before it happened, adding in red X’s for the info I’d only find out after he got here. And in that message, I dropped the link for people to sign up, saving the draft in my email account so it could easily be sent out following the birth.

Doulas, childcare, meals, connection to the outside world = check. And he wasn’t even here yet.

Empowered Anxiety

With these tasks complete, I was left with what I’ll call, “Empowered Anxiety.” I was starting to see dim light at the end of the tunnel with all the planning I was doing. I even began to realize that I might be setting myself up to be better than just non-suicidal. Ignoring how strange this was to acknowledge, it was motivational, so I ran with it.

Resourcing my (again, very privileged) list of dreams for life following bonus babe, the Empowered Anxiety encouraged me to set up a Google calendar I called, “Self Care.” I began adding recurring appointments to it, and set reminders to “Book a 30-minute facial,” and “Schedule a 60-minute massage.” I found an app that I liked for in-home massages and hit up a local small business in the neighborhood for those facials. 

The Empowered Anxiety encouraged me to enroll in a parent-baby class at my older son’s school. I figured it would force me to commit to showing up to something that would get him and me out together week after week for quality time. I later discovered it was so much more than that… the class was run by the most loving woman who prepared a warm lunch (with freshly baked bread!) week after week. She always welcomed us as we were and took the babe from me so I could just relax and have a break with other new moms who felt similarly to me.

Last but certainly not least, I wrote the “VanderRohan’s Household Guidebook”, which is my Empowered Anxiety’s pride and joy. “A manual never hurt anyone, why not write one for our family?” was the thinking. Seventeen pages later, every detail you could possibly consider important to us was added. Then printed. Then placed inside plastic sheets and organized inside a goddamn fuchsia binder. And more than once since, I thought to myself, “Well if you do end up fetal position, at least it will be business as usual at home.” Flash-forward to present day and this handbook has been used minimally five out of every seven days since my second son’s birth a year ago.

Fourth Trimester Reflections

My plan worked. While I anticipated I’d stick to it daily, after baby came in reality I stuck to it loosely but the structure was in place to support everyone in my home and it truly did.

The proof is in my writing this to you today. Remember, all I wanted was to have a few things in place if I couldn’t pull myself out of bed, but what ended up happening was I not only pulled myself out of bed, but I actively found my way through one of the most challenging times of my life.

A disclaimer: I hadn’t planned ahead of time to add Zoloft to my daily rituals, but my doctor prescribed something that assisted in greater ways than I ever anticipated. One day I’ll write just on this.

Here’s what I learned this last year:

  1. Every day that you’re able to get through another day proves how incredibly strong you are.
  2. You’re doing good. They’ll be fine. Most moms have no idea what we’re doing. And that’s ok.
  3. It’s ok to be honest when you hate parenthood, especially early on. Just tell someone so they can help.
  4. It’s worth learning to love the new version of you in whatever way you can get there.
  5. Asking for help doesn’t mean you’re weak or incapable of being a mother. It means you’re wanting the best for yourself and your family.

Just as childbirth class has become the norm for most women or couples to participate in as part of their pregnancy, postpartum support needs to be normalized for all parents. That six week check-up after baby is born is kind of a joke, and we need to watch out for one another. We need to check in on our new mama friends.

If you feel you may benefit from Thanks, Julia’s maternity or paternity support offering, I’m here to help. I can design a fourth (or fifth!) trimester plan for you that answers all of your anxieties and concerns and would be honored to help you through this challenging time. And I can connect you to invaluable resources to provide additional support in every possible way.

To learn more, contact me.

If you’ve survived this unique time of life for yourself, I would love to hear from you.

  • What’s the biggest insight you’re taking away from this conversation? 
  • What’s your best advice for new mamas trying to figure it out? 

Please leave a comment below and let us know. Share as much detail as you can. Your story may be just what someone needs to see things from a fresh perspective.

Never forget, you are strong and capable and worthy of happiness. No matter what you’re facing, you have what it takes to figure anything out.

With SO much love,

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Hi, I'm Julia

Founder of Thanks, Julia​

I’m here to assure you that when you invest in your own support system, you add priceless value to your family life, your career, your social time, your passion projects, and your overall quality of life.


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