The fourth trimester is the first three months of baby’s life after they are born. These first 12 weeks look very different across cultures, but I can only speak to my own experience as a working mom in America. The US is one of the only countries in the world that does not require a paid maternity leave. Jokes on me though, because I own my own business and decided what my maternity leave would look like. Originally, I decided on a 3 week leave and then to bring Hazel to work with me for as long as I could. After my unplanned C-section, I had no choice but to take off 6 weeks. My coverage doctor, Tiffany Halm, graciously agreed to extend her coverage at my office. I don’t know what I would have done without her, or my staff who really kept things afloat while I was gone! I did return after 3 weeks to see new patients and be in the office, but I did not adjust anyone until my 6 weeks had passed. I have been incredibly lucky to still have Hazel in the office with me. Some days are definitely easier than others, but she has lots of people willing to play with her and keep her entertained while I am seeing patients. (Shout out to Christina, Paxton, Rebecca and the BenchMark PT staff next door.) 

My first few weeks postpartum:

I’m not sure that I suffered from postpartum depression, per se, but I was definitely depressed. If you read my birth story, it’s not hard to see why. In those early days after we got home, I was just plain upset. I was mad at so many things and so many people, including myself. My mother and sister came to help Jonathan and me after my surgery. When I look back on those first few precious weeks, I feel so much sadness for how I acted and how I did not bond with my baby. If she would cry, I would look at someone else to help her. If she needed a diaper change, I would look at someone else to do it. If she was hungry, I got frustrated that breastfeeding was so much harder than I ever imagined it would be. The physical pain I experienced was awful. I could barely get up and down, I couldn’t get into my own bed for weeks, I had horrible pain around my incision, and I could not even bring myself to look at my scar without wanting to throw up. For the first two months, I went through the motions of having a new baby. I did not feel excited or in love with her at all. In those beginning days, Hazel didn’t even feel like she was mine. She was just this strange baby living with us that I was responsible for. Since I never saw her actually be born, I questioned all the time if she was really our baby. It made me wish I knew that all along we were having a girl because then at least I would feel a little better knowing we left with the right baby. Crazy, right? It didn’t matter that she looked just like us, I questioned for months if this was really my baby. I realize now that these irrational thoughts and actions are quite common for new moms. Why is no one talking about this? I would mention it to people and they would say, “of course that’s your baby, stop acting crazy.” Ah, this is why no one is talking about this! No one wants to be called crazy when they are already feeling crazy. We’re looking for validation as new moms that we are doing a good job, that the feelings we have are normal and common, that everything is going to be ok. 

The rest of my fourth trimester looked much like the first few weeks. I briefly sought help from a professional counselor to work through my feelings, but I didn’t feel like she understood me or why my birth story was important to me. I went to three sessions and decided that it was not for me. Every day, I woke up at 4:45 am to pump, get ready for work, get Hazel ready, and then we went about our day together at the office. 

 My breastfeeding journey:

I don’t remember the details of why the hospital gave formula to Hazel, but it was completely against what I had desired for her. I tried for months to breastfeed this child, but my supply was never adequate. I sought the help of lactation consultants, google, Facebook groups, friends that tried breastfeeding and stopped, friends that breastfed for two years, and anyone I could think of that might help me figure this out. Nothing worked. My supply was never adequate. I was embarrassed yet again. Why is my body literally failing at everything? I pumped every few hours for the first 3 months, for mere drops and ounces. My husband told me our baby was happy and healthy and to stop being so hard on myself. I couldn’t accept that I failed yet again at something I was supposed to be able to do. For 6 long months, I breastfed, pumped and supplemented with formula. I hid the fact that Hazel was supplemented to nearly EVERYONE. If we were going to be around friends, I said “don’t let them see the formula” to Jonathan. Why was I like this? Why did I feel so guilty about feeding my baby? I went to a seminar last September in Atlanta and it was really hard to sit through. The instructor didn’t “believe” that you couldn’t produce milk for your baby. I had to hold back tears for two whole days listening to how some people viewed C-sections and bottle feeding. This is exactly why I was embarrassed and tried to hide my story. Other moms are doing this! If you are doing this, please stop. We are all trying to do the best we can, and no one is better than anyone else.  What you choose may not be what I choose, and vice versa, but I do promise to listen to you without judgment and support you whole-heartedly. At the end of September 2019, I hosted a birth trauma workshop at my office. The lactation Consultant Scotty, from the baby café in Fairhope, AL was in attendance. I spoke to her about my hardships with breastfeeding and she looked at me and told me my body had been through an enormous amount of trauma. I had two major surgeries within 24 hours of each other. Of course my body was not going to produce enough milk, it was focused on survival. Just like that, I was no longer embarrassed. She was right! It took validation from someone else to tell me I tried my best and some things you cannot control, for me to finally accept that I really did try my best. It is my hope that someday we do not need validation from others to know that we are doing our best. 

 Motherhood during the first few months feels a lot like the movie Groundhog Day. Every day is pretty much the same. There are a lot of sleepless nights, a lot of crying from both you and baby, a lot of frustration, but there’s also a new awakening of a new person, a mother. What did your fourth trimester look like? When did you go back to work? What is one piece of advice you would love to give to a new mom? 

In my next post I will discuss my physical pain post-surgery and my experience with a pelvic floor PT. If you aren’t already, would you please follow me on Instagram @drnikkicottis!