47. Postpartum Support & the Fourth Trimester

In this episode of Nourished with Dr. Anikó, Dr. Anikó Gréger opens a deeply important conversation as she begins a special series on perinatal and postpartum health.

Drawing from both her professional expertise and personal experience, she explores the emotional, physical, and logistical realities of the postpartum period, often called the “fourth trimester.”

If you are preparing for motherhood, supporting someone who is, or reflecting on your own experience, this episode offers a grounded and compassionate look at what true postpartum support really looks like.

Dr. Anikó shares why this time is meant to be supported, not experienced in isolation, and how thoughtful preparation during pregnancy can transform your postpartum experience.

EPISODE HIGHLIGHTS

02:00 Why postpartum is often experienced in isolation
05:00 The role of a postpartum consultant and why support matters
12:00 The 5 universal postpartum needs, rest, nourishment, touch, support, nature
14:00 Planning for food, rest, and real-life logistics before baby arrives
18:00 How relationships shift after baby and why preparation matters
22:00 Building your postpartum support team
25:00 Redefining intimacy and connection after childbirth
29:00 Why outside support helps you see what you can’t

This episode is just the beginning of a powerful series on perinatal and postpartum health, where you’ll hear from experts and explore the support, care, and conversations every birthing parent deserves.

Be sure to follow Nourished with Dr. Anikó so you don’t miss the upcoming episodes in this series.

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Website: https://www.draniko.com/

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Disclaimer:
The content of this podcast is for informational and entertainment purposes only and does not constitute medical advice, diagnosis, or treatment. The views expressed are those of the host and guests and do not substitute for professional medical advice. Always seek the guidance of your physician or other qualified healthcare provider with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay seeking it because of something you heard on this podcast.

Transcript

Dr. Anikó: [00:00:00] Hi, you are listening to Nourish with Dr. Ani Kreer. This podcast is all about the many, many ways you can support your health and your family's health. I'm an integrative physician and I am so passionate about helping people find their pathway to their very best life. I hope you enjoy.

Hello. Hello y'all, and welcome back to Nourished with Dr. Aniko. This is the first episode in a special perinatal health and perinatal mental health series I'm doing on nourished. So for the next few weeks, you're going to hear information from several different experts in the world of perinatal health and perinatal mental health.

And I'm hoping that it not just opens the conversation around this. [00:01:00] But really provides y'all with some helpful and important information about a time in life that is deeply sacred, but often happening in isolation. So one of the things that we are often missing in our experiences, postpartum, meaning after we have the baby.

Sometimes we start experiencing this before we have our babies. 

But really that experience of trence or becoming a mother. 

Dr. Anikó: so many of us experience it in isolation, and that really was never how it was meant to be experienced. And we know that we need lots of community support Exactly. During that time.

So I thought I would kick off this series by sharing. My work in this field, so I've shared my personal story about my postpartum experience and then my experience in [00:02:00] pregnancies and basically my 

 trence 

Dr. Anikó: experience to try to capture it under a single title. My experience of the transformation of becoming a mother and that experience.

Obviously very much motivated me to move into the perinatal mental health space. It inspired me to get trained in perinatal mental health to talk about these topics and to work with people in this area. So although I'm an integrative pediatrician in the perinatal mental health world, I function as a postpartum consultant.

So that is really more of a coach and I call it coaching to be. Pretty clear about what it is that I'm offering in that space. So I'm not prescribing any medications. I'm not functioning as your physician, although I am a physician. So obviously my medical knowledge is that of a physician. But I'm really there to [00:03:00] be your support person, your wing person, your sounding board, and then often what I have found is to be.

A set of eyes that is also looking in at your experience, but from a different vantage point. Because one of the things that I experienced when I was postpartum, and I don't just mean when I was having postpartum depression, but I mean just literally being postpartum, your sleep deprived and also your lens is so different.

You're not necessarily thinking super logically. And I don't mean that as a knock, I actually mean that as a. Kind of a compliment to be honest, because. Motherhood, and especially early motherhood isn't about using your logical brain. It is about feeling into this relationship with your child, with yourself, with the world you're connecting with your baby.

That's not a cerebral thing that's happening. We really step into this very [00:04:00] embodied and also very emotionally connected place in ourselves. But that means. That sometimes we aren't able to problem solve or even notice things in the ways that other people might. So sometimes another set of eyes looking at the same situation might be able to offer a potential solution or even maybe name something that's not working out well or that could be improved on, that could really improve your quality of life.

So I thought it might be helpful just to kind of go through what I do as a postpartum consultant that could get y'all thinking about. Even if you don't hire somebody to be a postpartum consultant or coach or anything like that, but just start to think about. What life looks like after you have a baby to help you prepare for it and hopefully help you have a supported and hopefully very sacred transition period into motherhood, [00:05:00] birth parenthood as well.

So when I meet a client, ideally I would meet them in the third trimester. Of course, we would talk about things like medical history and any pregnancy history and anything like that within medical history. I always ask about social history, histories of trauma. You'd be surprised how many people just don't ask about that.

But it is really important to ask just in general, in medicine, and then certainly when you're having a transformative experience. Through your body like childbirth. It's really important to ask about traumatic history, whether that's emotional trauma, sexual trauma obviously is very relevant. And then things like mental health history, eating disorders, anything that.

Could kind of be kicked up a little bit by both pregnancy, being postpartum, just doing a really thorough history is incredibly important. Obviously, because I'm an integrative doctor, we talk [00:06:00] about lifestyle, getting out in nature, activities, food. We talk very, very specifically about food when we're eating what we're eating.

How we're feeling, movement, all of those things, right? So really getting into lifestyle. Obviously we're gonna talk about sleep. We're gonna be talking about how your body is feeling. Are we having any pain? How our movement is changing, right? Because a lot of times people will. Often kind of being one of two camps.

One camp is I'm going to keep doing all the same movement that I have been doing no matter what, and they really hold themselves to, I kept running throughout my entire pregnancy, or I kept weightlifting, or whatever it is that they do. And then there's another camp that sort of stops everything. And these can both be reasonable approaches for certain people, but what I find works a [00:07:00] lot better for most people is to develop a relationship of curiosity with your body.

What feels good? 'cause things change. I know that sounds a little bit obvious, but your body changes, your weight, distribution changes, you know. Beyond the things of not really being able to lie on your stomach or anything like that, your back feels different, your pelvis feels different. So really listening to your body and being open to different ways of moving because movement that is nourishing is actually a really important, supportive part of pregnancy and even postpartum.

But again. Our bodies are changing, so we need to be responsive to that instead of prescriptive, right? We don't need to say, Hey, I've always run, so I'm gonna keep running. I will tell you that I ran throughout my entire first pregnancy. By the time I had my youngest child running was not my friend. I eventually got back to running, but there was [00:08:00] a lot of pelvic work that needed to be done before I could run again.

And we need to just. Honor that, right? We don't need to beat ourselves up about that. We can be upset about it, but we don't need to have shame or blame or anything like that. We just say, okay, I can't do this right now. Let me pivot to what does feel good, and if we frame it as kind of like a exciting journey.

What cool movement would feel good. Now, it's a much more enjoyable experience. I do find that many people reconnect or connect for the first time with dance. It's just that rhythmic movement to music. Whatever feels good to you, it can be as gentle or as exciting as feels good to you. But remember, you're always listening.

Responding to your body, you're not telling your body what to do. You're listening to what your body wants to do and what feels good for your body. And so part of social history is your social connections. So we do take a look at [00:09:00] who is nourishing and supportive when we think about who might you want in the delivery room.

Who do you want around you in the weeks and early months after having a baby? Because there are people who we love so much that aren't the right fit, right? We have energy takers. We have energy givers. We have people that like to call the shots and run the show. Those aren't the people that are often going to be the best fit, both in the delivery room and in the early months and weeks of postpartum.

Again, you need people who are going to be responsive to you and what you need, and also people who you feel comfortable enough around to be honest with around that. And I will say that it is. So much easier oftentimes to set the stage for these expectations in pregnancy versus trying to establish it after you've had the baby because you are just in a state of [00:10:00] fatigue and just, again, you're not in the most logical place in your life for good reason, right?

You're very embodied. You need to be connected to emotions and your baby. So it can sometimes be challenging to navigate all that if it's only coming up for the first time after you've had the baby. But if that's when it's coming up and it hasn't come up before, then we deal with it. When it comes up. 

And in my case, since people are talking about it with me and I am not a member of their family.

Dr. Anikó: I'm not sort of in their inner social circle. They can share with me the things that they're worried about. If you think about somebody and you're like, oh, they smoke. I don't want them around after I have the baby or around me at all, period right now, that's a great thing to know. Sometimes the only time that we can sort of allow ourselves to see that is in the company of somebody who's not already in that circle.

Again, that's a really important thing to establish from the get go, and also [00:11:00] establish in your mind who you might have a hard time talking about that with, and maybe having a supportive partner or friend have that conversation with that person. If you feel like you are not gonna be able to have it.

'cause we can also honor our limits and boundaries, particularly in this postpartum fourth trimester where it can be especially challenging for some people. Other people seem to find their voice in this time, so it's definitely not prescriptive, it's not one size fits all, but if you can sort of allow yourself to start seeing these things and start having these conversations before baby is here.

Usually sets you up even more for success, and so we talk about the five universal postpartum needs. Kimberly and Johnson wrote really beautifully about these in her book, the fourth Trimester. And in the perinatal health and perinatal mental health world, we talk a lot about how [00:12:00] mom or birthing, parent and baby need these same things, right?

So we need rest. We need nourishing foods, we need loving touch, we need emotional support and companionship. We need contact with nature. And in my experience, that last one is so underestimated and yet so nourishing and can make such a huge difference as we enter this very special time postpartum. We're in such a different state of mind than we typically are in.

Nature is so restorative and regulating and I know that I felt. Even more deeply connected to nature and even more a part of nature. 'cause I had just had this very primal, natural experience of birthing another [00:13:00] human into this world. So a lot of my work in the perinatal space is holding the sacred. Like reminding people that this is sacred work, this is sacred time.

And then also the practicalities of what are nourishing foods to eat, especially early. Right. We don't wanna have heavy foods in the early period. Warming, nourishing warming spices. I wrote an article for Hello Postpartum about what to eat after giving birth, but it's really simple, nourishing, healing foods, right?

Soups, stews. As we get more advanced, there's a great first days Ayurvedic rice pudding that I loved after I gave birth. You can also look into your own familial traditions. You may find some sweet surprises or sweet practices that maybe people in your family do for [00:14:00] one another, but thinking through the practicalities of how are you going to get fed?

How are you going to get rest? How are you going to have companionship? How are you going to experience loving touch? How are you going to get out into Nature Savor this time of bonding with your baby and transforming into a mother? For maybe the first or maybe not the first time, transforming into a mother again, but for the first time to this child, ideally, we're able to look at your space at home.

So I've done visits in the home before where we look at the room you're going to be spending time with. You can think through, do I want a rocking chair? Is this a good place to sit in the sun? Do I want blackout curtains? Do I want a little fridge upstairs? And then think through. And again, you can always change this, right?

There's plenty of people [00:15:00] that think, I want all this company after I give birth, and then they really don't. So thinking through the food options, do you wanna start a meal train? Do you wanna ask people to drop food off in a cooler? Are you a chef and you wanna cook a bunch of stuff and put it in the freezer?

Are your friends chefs and they wanna contribute in some way? There's so many ways that people can contribute and it's great to think it out because then people are actually supporting you in ways that are supportive. So thinking through food is a really big one. And then also. Thinking through the necessities of everyday living.

So obviously if you have other children who's going to take care of those children? Do you have pets? Do you have plants? This isn't the time to worry about messes or how clean things are gonna be, but if you really don't have a tolerance for that, then that's an area that you're going to wanna put some thought into.

Can friends come over and help? Can you hire a [00:16:00] housekeeper for a little while? But so many of us, when we become parents, especially when we give birth and our body is, are in a completely different state than before, realize that we are used to kind of taking care of everything in our lives. And even if it's not just us, a lot of times it's a very nuclear family approach to living.

And so this time before you have a baby can be this really beautiful experience of recognizing I have a larger community than I realize and. I can reach out to them. And again, not everybody can help in every way, but there are always going to be people who have space in their lives, desire, who are willing to help.

You might have a neighbor down the street whose kids are in college, who might want to spend time with your kids, pick them up from school. So really think a little bit out of the box beyond just, you know, if your parents are. Alive and able to [00:17:00] help. You know, a lot of times our parents are older and so they might not help exactly in the ways that we need or want.

Sometimes they do and that's beautiful, but sometimes we need support from other places. And so this can be a really beautiful time to realize that we have so much more than we thought. Another area where we need to do a lot of real talk is in the area of that. Primary relationship, right? So if you are having a baby with your partner, especially if it's a heterosexual relationship and it the woman is giving birth, that can be a really big change.

And I say that because a lot of times in heterosexual relationships, the woman is that. Not just the primary, but the only intimate friend of the male partner. So that is where he shares his feelings and that's the only place he [00:18:00] shares his feelings. She is his only sounding board. She's the only person that is holding him emotionally, and so he needs to do some work to figure out.

Who he's going to turn to and who he has emotional connections with who can support him while her attention is appropriately turned to the baby. And I usually use this little very rudimentary diagram where I draw two circles and. The two circles are next to each other, and you draw an arrow from one circle to the other circle, and then a corresponding arrow back from that circle to the other circle, indicating that this is a bidirectional relationship after baby is born for a time, not forever, but the birthing parent's attention is appropriately diverted to the baby.

The partner's attention needs to continue to, so the partner's arrow keeps pointing towards the birthing parent or the mother. But the mother's arrow in attention is now pointing towards the baby and naming [00:19:00] that that is going to shift. Naming that that is temporary and also naming that like you gotta have a plan can be immensely helpful in starting the conversation around.

What is this going to look like? Where can I turn so that you're not caught off guard and kind of empty handed when you realize that your relationship has changed, especially in those early weeks and months of having a new baby. But it is a true honeymoon period because then you start in on the sleep deprivation and then you start in on the, well, we had a lot of.

Support in the beginning, but we don't have as much now. So also thinking through, you're not just gonna need support for a couple days, at least get a food plan out for a few weeks and have a social connections plan as well. And again, this can be evolving. It doesn't have to be set in stone if you think somebody's gonna be a really good fit for coming over.

And keeping you company after you have the baby and then it turns [00:20:00] out maybe that isn't the best fit, that's okay. There's always room to change that. But not thinking through that at all is where we often run into problems. Making sure that you are resting and healing and having that be a really, really high priority.

Naming that early on, not just to yourself, but to your family. Can be really helpful. So there is a whole different attitude towards mom's sleeping right now. She's resting, she needs to rebuild, to heal again In Ayurveda and traditional Chinese medicine, the belief is that how you are taken care of after you have a baby determines your vitality and health for the rest of your life.

So it deserves to be taken seriously. But that also might mean some changes. Like I said, you might need a blackout curtain. You might need a sleep mask. You might need a sound machine. You might need earplugs. There are all these. Little tweaks that we can [00:21:00] make that aren't a huge deal. That can make an enormous, an enormous difference in our lives.

And perhaps, obviously I could talk about this all day long, but one of the other areas that can be very, very helpful is to start to talk to your friends and family and practitioners about different. Professional support folks that you could reach out to should you need that kind of support. Now, this doesn't mean that you will, it's just great to have it already there lined up in a list that you can call rather than scrambling to find the right person.

Should you. Have a need for it. So pelvic floor therapist, I mean everybody who has a baby. I think there's this misconception that it's only if you deliver vaginally. No, your C-section also absolutely impacts your musculature and your pelvic floor. You've carried the baby [00:22:00] on your pelvic floor. Even if you didn't birth the baby through the vagina, it absolutely affects things.

So I do think that having an assessment before delivery and during pregnancy and then aft following up with a pelvic floor therapist, I think should be sort of compulsory. Um. And provided and supported for everybody. So figuring out who are the pelvic floor therapists in your area. Certainly figuring out who are the therapists, especially if there's reproductive psychiatrists, perinatal psychiatrist, perinatal therapists in your area.

Just to get a sense of. Who those people are. You might have friends who have sought out that kind of support. That can be a great conversation starter too, so that you know which friends you can reach out to, should you find yourself in a space where you need some mental health support. Certainly lactation consultants, postpartum doulas, night nurses.

Again, you might not need it, but boy is [00:23:00] it nice to just have that person be a phone call away rather than, you know, uh. Internet search and a friend search, but I do find that the best ways to find these folks is to talk to your friends and family, and it can also be a great connecting conversation so that you know where to turn in your support system should you find yourself needing to have these conversations and needing a little more help than you anticipated.

Postpartum support, international and other really amazing organization, they have a wonderful helpline. They have online support groups. They can connect you with practitioners should you need support. So these are mental health practitioners. And then also if there's any moms groups or any parent groups locally, these can be such a lifeline in those early days postpartum where you feel like you're just the only.

Lonely mom out there. It can be so wonderful to connect with other people that are also going through [00:24:00] it. And I know so many people who have made lifelong friends through connecting in an early parenting group, and I would add to that list. Massage therapists that may specialize in perinatal massage. If there is some kind of body work that you really enjoy or some kind of therapy that you have found nourishing in the past, just include that on your list.

If you've moved to a new place, find a practitioner before you have the baby so that you have. A resource to provide you with touch that you have found nourishing in the past. But also, it's okay if after you have the baby you realize, Hmm, I'm not really enjoying this. There are other modalities that might feel more supportive when you're in the postpartum period.

But I think just having the understanding that touch, loving touch is really important. Can. [00:25:00] To shift our mindset a little bit to prioritize this more than maybe we do in other phases of our lives. And on the topic of loving touch, I also think it can be really wonderful to start opening up the lines of communication around sexual intimacy and sexual touch with our partners.

Because often it looks really, really different after. Childbirth and what feels very intimate can change as well. So people might not want penetrative sex. That might not be a thing that they want for a while, but maybe they are more connected to massage or holding hands or even. Deep conversations with lots of eye contact.

So again, this is all about being expansive. Expanding your idea of what intimacy and physical intimacy is can only serve you both in the short and long term because who doesn't want more? Avenues for intimacy, right? But when [00:26:00] we stay really prescriptive about it, this is what we do. This is how often we do it.

We can often find ourselves in conflict and feeling really disappointed after childbirth because we have not prepared ourselves for the fact. That intimacy can change and it doesn't necessarily change forever. And even if it does, it can change for the better, right? It can expand our concept and our experience of intimacy.

So again, approaching all of this with a sense of. Wonder, adventure, curiosity, instead of trying to force ourselves into some box that doesn't really fit us anymore. And so these are the kinds of things that we talk about and explore both in the third trimester before baby arrives and then in regular visits.

After baby arrives. And those can be home visits, those can be visits in the office. Those can even be virtual visits if people prefer. But it can be really nice [00:27:00] to actually be with somebody in real life and sharing your experience. And the point of all this is to provide support to the mother. Birthing parent so that there is a practitioner that is focused on her and what's going on in the family.

And again, just sort of these. They seem like boring logistics sometimes, but they can be absolutely life altering, life enhancing changes that are happening on a more practical, logistical level. And then of course we talk about everything that's going on so that spiritual companionship is a big part of it.

And then also having somebody. Who's outside of the situation, who's trained in perinatal mental health. Looking in from the outside saying, you know, it sounds like you might need the support of a therapist or a lactation consultant or the [00:28:00] housekeeper, or, it sounds like we could tweak the food situation a little bit, or it sounds like this person that you thought would be very supportive for you in your family is maybe.

Not that way. So how can we make changes right now to invite them back at a different date? We talk a lot about scheduling, about making sure there's time for movement as we move forward into the postpartum period. So again, it's this person that's sort of. In your corner and accompanying you through all this, but isn't in the thick of it with you and with the experience and the training to know when they are seeing red flags, because sometimes it can be hard to tell for ourselves the areas where we might need support because we're just kind of trying to get through every day and we're not pausing and saying.

Hey, maybe this is too much. Maybe I'm carrying too much. Maybe this part of it shouldn't be as [00:29:00] hard as it is, and maybe I could find some support that would help me. That can be really, really hard to do when you're in it. So it can be really helpful to have somebody on the outside come in and offer guidance offer.

Support, offer expertise. Obviously, I'm an integrative pediatrician, so sometimes we'll have situations where the person will say, you know, I talked to my pediatrician and they said it was fine, and I genuinely have the expertise to say, yeah, that is really, really normal. It's normal, not only to worry about it, but it's also genuinely a normal baby behavior, for example.

And so these visits, like I said, ideally start in the third trimester and then they can go all the way out through the first year and beyond if people would like that support. But I do recommend having this kind of support, at least through that first. Three months. So that fourth trimester, [00:30:00] again, as this support person, as this person accompanying you through this experience of resin, whether it's your first time tressing, or your 10th time, each time is different and you are transforming every single time.

And the goal and the hope is that you are able to experience it as a sacred transformation rather than an experience that's just draining, decimating, where you feel isolated and alone, which we know going back to those five universal needs postpartum. The last thing you want when you are in your fourth trimester is to be alone.

You need community. You need love, you need touch, you need support. And so my postpartum consulting work. Is an effort to provide that for folks. So I hope this helps y'all. I've seen it be so supportive and transformative for people in their journey through postpartum in this sacred window of the [00:31:00] fourth trimester and.

I'm really looking forward to sharing even more information and resources about perinatal mental health and perinatal health with y'all over the course of the next few weeks. So take good care, y'all, and I'll see y'all next week.

Thank you so. So much for listening to Nourish Today. Your presence is truly felt and so deeply appreciated. I hope today's episode brought you some insight and also some inspiration to create an even better life and world for yourself and for your community. If you enjoyed this episode, please don't forget to follow the podcast and leave a review and please share Nourish with a friend.

It helps more people discover the power of true nourishment. Until next time, take good care of [00:32:00] yourself and your people and stay nourished.