Motherly Collective

When you want an amazing vacation, you research the best views and strategically pack your suitcase. When you want a date night, you arrange for a sitter, make reservations and you may even put on attractive underwear. When you are about to have a baby, there are plans for a shower and a “birth plan”, too—but planning for your fourth trimester seems commonly forgotten. Why do we neglect the fourth trimester when it’s such a crucial time for recovery, rest and bonding with our new little ones? By and large the fourth trimester, which is marked by women all around the world as a well-deserved, pivotal milestone, is neglected in Western culture. In general, we have atrocious rates of postpartum mood disorders, pelvic floor problems and exhausted mothers trying to do it all. This provides a compelling reason to delve deeper into the importance of rest and recovery during this crucial period.

I’d say most people don’t understand the concept of a “fourth trimester,” or the first twelve weeks postpartum. Yes, we know in a general sense there will be a short-lived season of wearing adult diapers and ice packs. But the pace of life seems to go on, adult diapers or not. 

The new American mother makes an appearance as soon as she can in the main living room, wearing her makeup and visiting with outside friends and family as they eagerly pop in to meet the fresh baby. This mom begins hosting visitors as the laundry piles up beside her. The baby is passed amongst friends and family and eventually, this mama finds herself cleaning up after meals, taking care of older children and ultimately, resuming normal life and productivity. How come this has been determined as normal postpartum in America? How come no one told me that resting and bonding with my baby for multiple weeks was important enough to plan for?

The rest of the world’s women seem to be doing something entirely different in their fourth trimesters. Malaysian women practice confinement after childbirth, where she is discharged from household chores, commanded to rest in bed, only eating nourishing foods that have been prepared by others for her, practicing specific hygiene practices, and learning to care for her newborn. Chinese and Indian women are encouraged to rest for 30 days and are discharged from normal tasks and responsibilities (Raven, et all. 2007) . Many Thai women practice childbirth confinement and are cared for intentionally by family members for 30 days postpartum. In China, most women utilize a Pei yue or an experienced woman who accompanies the new mother for a month after her child is born. The Pei Yue is responsible for cooking and physically caring for the mother and other children during the confinement period. Zuo Yue (or to-yueh-tzu in Taiwan), commonly referred to as ‘doing the month,’ is a month-long period of rest during which extended family assists mothers to promote recovery and allow ‘loose’ bones to return to their previous positions. Among Mexican women, there is a 40-day rest period known as la cuarentena that promotes newborn bonding and focuses attention on lactation. There is similar data found for intentional postpartum rest among Amish, Japanese, Hmong, Malay, Eastern Indian, and South African women. You get it, right? Most Americans don’t prioritize rest postpartum.

By stark contrast in America, the postpartum period is often considered a time of rapid return to normal function pre-baby. During this time, medical attention rapidly shifts from the woman’s care to a focus on infant feeding and care. What happens to the mother? Many times, maternal symptoms during postpartum recovery are under-recognized and overlooked. 

Why does rest matter? After a baby is born, the placenta, or life organ for the baby, detaches from the inside of the uterus. What’s left is a large, open, placenta-sized wound on the inside of the uterus. Had a cesarean? Now we’re talking about abdominal surgery, separating six layers of the abdominal and uterine wall. Rest is required? Oh, indeed.

I’ve welcomed five babies over the years—-one through foster care, two through adoption, and two through childbirth. Each season of welcoming our newborn into the family was different but sacred. Viewing the fourth trimester season as sacred implies a deserved veneration or a significant pause for weight and recognition. The fourth trimester deserves this kind of emotional and physical pause from the daily rhythms experienced in normalcy. 

I have a toddler who is obsessed with animals. Let’s play his favorite game. Can you picture a mother mammal? Lion, tiger, or bear (oh my). What are they doing with their new baby? They are nourishing and spending time with it. Undisturbed. Many attachment theories promote the concept of “nesting” where parents create a hedge of felt safety around their new child by slowing the pace of life, protecting the focus and promoting the connection between main caregivers and their children. 

Before my last childbirth, my midwife intentionally made me plan for postpartum rest. I looked at her like she had a third eyeball because I have three other children. How in the world will I rest? And yet, she persisted. She made me sit down with my husband and specifically plan for my fourth trimester. In the end, my husband took seven days off of work to be home with the “big three.” And me? I laid in bed. Took sitz baths. Nursed on demand. Stared at my baby. Ate nourishing meals made by incredible family and friends. Made space for peace so that I could get to know my new baby and how to care for him. Guess what? My postpartum bleeding was finished in only one week. I recently talked with a mom of three in her late fifties. She told me that she bled until her daughter was over six months old. She was responsible for resuming life as quickly as possible. My heart broke for her.

Not everyone has a partner to help with household responsibilities and caring for older children. And without family or friend’s willingness to step in and help the new mother get to know her baby and rest, there may be an equally alternative option of hiring a postpartum doula for a short season. Ultimately, noting the birth of a child is a whole lot more than just taking two days in a hospital bed. It is creating space postpartum for tending to the condition of a woman’s soul to allow healing and intentional focus on the mother and child bond. Now, plan for it.


Fadzil, F., Shamsuddin, K., & Wan Puteh, S. E. (2016). Traditional postpartum practices among Malaysian mothers: a review. The Journal of Alternative and Complementary Medicine, 22(7), 503-508.

Maloni, J. A., & Park, S. (2005). Postpartum symptoms after antepartum bed rest. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34(2), 163-171.

Albers, 2000; Brown & Lumley, 1998; Glazener et al., 1995; Thompson, Roberts, Currie, & Ellwood, 2002). Maloni, J. A., & Park, S. (2005).

Raven, J. H., Chen, Q., Tolhurst, R. J., & Garner, P. (2007). Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study. BMC pregnancy and childbirth, 7, 8.

Kaewsarn, P., Moyle, W., & Creedy, D. (2003). Traditional postpartum practices among Thai women. Journal of advanced nursing, 41(4), 358–366.
Karimi, F. Z., Abdollahi, M., Khadivzadeh, T., & Yas, A. (2024). Investigating the Effect of Kangaroo Mother Care on Maternal-Infant Attachment: A Systematic Review and Meta-Analysis Study. Current Women’s Health Reviews, 20(2), 50-60.

This story is a part of The Motherly Collective contributor network where we showcase the stories, experiences and advice from brands, writers and experts who want to share their perspective with our community. We believe that there is no single story of motherhood, and that every mother's journey is unique. By amplifying each mother's experience and offering expert-driven content, we can support, inform and inspire each other on this incredible journey. If you're interested in contributing to The Motherly Collective please click here.