The Fourth Trimester - A [Must Read] Book Review

Is there something you wish you could go back and do all over again in an attempt to "get it right," or at the very least, do it a little better than you did the first time around? 

That's exactly how I feel about my postpartum experiences (x3) after reading Kimberly Ann Johnson's The Fourth Trimester, a book about the importance of healing, resting, and reframing the days, weeks, and months after having a baby. It's not that I had harrowing or even particularly difficult postpartum experiences. But I imagine now what could have been back then -- more rest, support, physical strength, emotional balance -- and what could be right now. In some ways, I'm still dealing with the lingering physical affects of doing too much too soon after birth, and at the same time, not doing enough soon enough. 

In a culture that places 99.9% of its focus on pregnancy and babies, The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions & Restoring Your Vitality brings a welcome, critical, and long overdue focus on the mother/parent after giving birth. The book shines a light on the glaring deficiencies in support, physical repair, emotional processing, and relationship nurturing that exist in the Western culture both within family units and medical professionals.

Though we are slowly beginning to change the conversation around postpartum care, many obstetricians and even midwives do not know enough to appropriately assess, diagnose, or refer out people who are in need of pelvic healing/therapy (hint: most people who have gone through pregnancy and birth require or could greatly benefit from some kind of bodywork that addresses healing the pelvic floor and core, even if your pregnancy and birth were fairly "routine").  

The Fourth Trimester quickly became my new all-parents-must-read book. No matter where you are in your journey (expectant parent, new parent, several years post-birth parent), you should read this book. I'm seven years out from my last birth, and after reading this book, I can see several practices that are still relevant and useful today! The Fourth Trimester offers poignant bits of wisdom that any parent can take, apply, and benefit from. But enough of my praise -- let's get down to specific content and you'll see what I mean.  

The Fourth Trimester - A Book Review

Who should read it: Mothers, fathers, parents, families, health practitioners working with parents and mothers. This could mean pregnant parents, new parents, or parents who had a baby 10 years ago. There is something here for almost everyone. People who practice the more Westernized approach to postpartum care (ie, American) will likely benefit most from the information in this book, as our culture seems to overlook this area significantly more than some others. 

When should you read it: Ideally, you're reading this book in the middle part of your pregnancy. Don't worry if you don't pick it up until after you've had your baby though -- you'll be able to find lots of helpful tips and strategies for healing and strengthening at any point after the birth of your child. 

What will you get from the book: Where to start. Overall, you will understand (if you didn't before) the very real needs (physical, emotional, social, psychological) a person has after giving birth, how they are not currently being addressed or supported by community and professionals alike, what good support and repair look like, and what you stand to gain from having those needs met.

More specifically, you will get tools you can use immediately, like:

• Mindfulness practices to help with any kind of stress
• Exercises to prepare your body for birth and ease pregnancy pain
• Steps and outline for developing a "postpartum sanctuary plan" for protecting your at-home environment after birth to promote optimal healing and rest
• Practices for exploring your sexuality in a way that feels right for you
• Simple, doable communication and connection exercises for you and your partner
• Different ways/exercises to use to process your birth 
• Suggestions and definitions for the best kinds of postpartum care practitioners 
• Exercises to help restore your core and pelvic floor after birth

What I learned that surprised me in this book: That the postpartum period can be considered up to 10 years after giving birth, especially when you consider long-term healing. That exploring your sexuality can help prepare you for giving birth. That so few parents are referred out to pelvic floor physical therapy when it is needed and helpful for most people in order to heal properly after birth. That births that resulted in tears are not seen as or treated with the same level of care as other bodily injuries. That it's best to wait at least six months after birth before you engage in activities that involve running and jumping. 

What I love about the book: I love the multitude of community stories sprinkled throughout the book. They give you a sense of how people are exhibiting and dealing with these issues in real life, and are a testament to the author's range of experience. I also love how at the end of each chapter, there is a bulleted summary along with questions for reflections (perfect for journaling and therapy sessions) and a list of the practices provided in that chapter.  

What I wish was different about the book: This comment has more to do with the way I navigate the world, but I do wish there was more of a "do this exercise three times a day for six days to see optimum results" kind of instruction with each of the exercises. Ultimately, I feel that the author may have omitted this information because in order to truly understand how much/how often you need to do which kinds of exercises, you need to be evaluated by a practitioner who specializes in postpartum health, like a pelvic floor physical therapist. Otherwise, there is nothing I would change about the book! 

Where you can find the book: Amazon, of course! You can also get it at Barnes & Noble, Powel's City of Books, and Shambhala Publications. 

More about the author: Kimberly Ann Johnson works at the intersection of sex, birth, motherhood, and trauma. She's a birth doula, a certified sexological bodyworker, and a somatic experiencing practitioner. She calls herself a "vaginapractor" and sees herself as "spearheading a radical embodied movement for sexual and pelvic health." (source) She began in bodywork as a yoga instructor, and after a difficult experience with healing from her own birth, she began the journey to become the kind of professional expert and support person she so desperately needed. Johnson teaches in person and online classes and sees clients one-on-one for bodywork. Learn more on her website, Magamama.