Beyond Baby Proofing

00:00 | Introduction and Welcome

Thank you again for coming, everyone. I’ll start by introducing myself. I’m Rachel Goldstein, a perinatal mental health therapist who works with individuals and couples through pregnancy, postpartum, and early parenthood.

I want to start by saying that if you are feeling nervous, excited, overwhelmed, or all of the above, you are in the right place. Before we begin, I’d love to know what has been on your mind when it comes to the fourth trimester. Is it your relationship with your partner? Feeding? Sleep deprivation? The unknowns of what is coming next?

It sounds like many of you are on the later end of pregnancy, and there are a lot of resources out there for you. I really appreciate you being here.

Today we are going to talk about staying resilient in the fourth trimester, which is technically the first 12 weeks after birth. But let’s be real: the psychological and physical changes often last much longer than that. For today, we will treat the fourth trimester as a longer transition than the narrow 12-week definition, and my hope is that what we discuss will help you far beyond those first three months.

This is a time of incredible change for your baby, but also for you as parents. What I want to offer today are tools, mindset shifts, and strategies for building resilience both as individuals and as a team with your partners.

I also want to commend you for being here and making this investment in yourself and your family. Research has shown that higher maternal resilience during the perinatal period, meaning pregnancy through postpartum, is associated with lower incidence of mental health concerns such as depression and anxiety. Your future self may thank you for being here, even if today simply gives you the knowledge and confidence to ask for help when you need it.

A few housekeeping notes: today’s session is being recorded, and it will be available to rewatch through the end of the year. You are also welcome to use any available accessibility features if they are helpful. Here is what we will cover: what the fourth trimester can look like, what resilience looks like postpartum, how to build that resilience, when to seek help, and then closing reflections and questions.

03:24 | what does the fourth trimester look like?

There is no single fourth trimester experience that every birthing person has. It looks different for everyone. As a therapist, I often tell clients that the fourth trimester is real, and it is intense. You are recovering physically and emotionally from birth. We sometimes talk about birth as if it is just the thing that happens after pregnancy, but birth is a major experience. It can be deeply impactful for women and birthing people in general.

You may be feeding a newborn every two to three hours, or even more often. You may be sleeping much less than you normally do. Your identity, your relationship, and your sense of self may all be changing. While that can feel disorienting, all of it can be normal. Nothing is wrong with you if it feels hard. The goal is not to bounce back. The goal is to adapt, get support, and grow.

Some of the things you may experience include hormonal and emotional changes, which can affect birthing people in different ways. Some may weather those changes more easily, while others experience them more intensely or feel surprised by what comes up.

You may also feel stress about your baby’s developmental needs. Are they progressing as quickly as they should? Are they meeting milestones? And while you are worrying about the baby, you are also trying to care for yourself. It can become a constant back and forth.

You may experience an identity shift or role change. You are now caring for another human being, and you are not totally independent in the same way anymore. That comes with a lot of change and adaptability. You may even feel grief for some of those changes. Even though many communities do not talk about this openly, it is okay to feel sad that you no longer have the same independence, freedom, or intimacy with your partner that you used to have. That does not mean you love your baby any less.

You may also feel isolation or pressure to do this “right.” I want you to hear me when I say that there is no one right way to do this. However it works for you and your family is the way it should work. I like to reframe this period not as a crisis, but as a transition that requires adjustment and intentional support.

06:38 | Defining Postpartum Resilience

So what does resilience look like postpartum? At its core, resilience is the ability to adapt and recover from a stressful event.

When we talk about resilience in therapy, we are not talking about being stoic or simply powering through. We are talking about naming your emotions instead of ignoring them. Time and time again, research and clinical work show us that naming our emotions is the first step toward processing them.

Resilience also looks like reaching out for help when you are drowning. So many people have trouble asking for help. It is incredibly common, incredibly difficult, and often necessary when you are in the trenches and feeling very overwhelmed.

It looks like staying connected to your partner even when you are exhausted. These things are hard, but they are possible with practice and introspection.

It also looks like practicing self-compassion instead of self-criticism. I do not know many people who naturally extend more compassion to themselves than they do to others. Most of us are wired the other way. But you deserve as much compassion as the next person, even when it is hard to remind yourself of that.

Resilience includes acknowledging your limits. That can be hard because many of us want to prove that we are capable and can do it ourselves. But acknowledging your limits is a sign of strength. It signals to the people around you that you can recognize when things are getting overwhelming and ask for help so things can continue moving as smoothly as possible.

It also means honoring your own pace of recovery and growth. Your recovery will not look like anyone else’s. It is personal to you and your journey. If you have ever heard the phrase “bouncing back,” I do not subscribe to that. Whatever pace you are moving at is the right pace for you. I know that can be frustrating, especially when recovery is slower than you hoped. Still, it is okay to honor that journey.

09:26 | What Resilience is not

Now let’s talk about what resilience is not. These are things I often see in the therapy room.

Resilience does not look like pretending everything is fine when you feel overwhelmed, anxious, or sad. It does not look like silencing your emotions out of fear, guilt, or pressure to be grateful. We hear things like, “At least the baby is healthy,” all the time in our culture. But that often fails to acknowledge the experience you went through. Your experience matters, and the lack of acknowledgement can affect you.

Resilience is not doing everything on your own to prove you are capable or strong enough. Asking for help does not say anything negative about your strength or worth, even if we sometimes internally believe that it does. Acknowledging limits is a strength.

It also does not look like dismissing your mental health needs because the baby comes first. That “at least the baby is healthy” message can be harmful because it invalidates the birthing person’s experience and places it secondary to everything else. I want you to hear this clearly: your mental health needs matter.

Resilience also does not mean constant positivity. Sometimes we put a mask of positivity over everything. We say the sleep deprivation is not that bad, or feeding does not hurt, or everything is wonderful and there is no downside. That ignores the reality that sleep deprivation is hard. It is really hard. There is no other way to put it.

11:39 | Building Resilience: Expectations, Support, and Connection

So how do we build resilience for the fourth trimester? Many of us enter parenthood with unrealistic expectations of ourselves, each other, or the experience of parenting. It will look different for everyone. In fact, your experience may feel wildly different from your partner’s, let alone another family’s.

The best way to manage expectations is to acknowledge that a lot will change, and that you will cross each bridge as you come to it together. When possible, let go of perfect parenting and social media comparisons. If something is working for your family, then it is working. Full stop. Just because something does not work for another family does not mean it cannot work for yours.

The next piece is creating a support network. One of the biggest predictors of postpartum mental health is social support, yet many parents feel they need to do it alone, or they do not know where to seek help. It is important to identify the people in your life who can support you practically and emotionally.

That does not only mean someone who comes over to clean bottles or hold the baby. It might be someone who lives far away, like a parent or best friend, who can respond to a text about how you are feeling and offer encouragement.

A lot of people have trouble accepting help, and I want you to know that it is okay to accept help even when it is imperfect. I do not mean help that does not work for your family. I mean help that might not be exactly the way you would do it. Maybe a friend wants to drop off a meal or organize a meal train. That may not be your ideal way to stay fed, but it is practical, and it keeps your family nourished during a vulnerable time.

It also helps to know your resources. If you do not have family nearby or a strong support network, there are still resources available, such as postpartum doulas and support groups. There is help out there, even if you do not have a natural network.

14:09 | Communication and Emotional Regulation Skills

Postpartum stress often brings out our rawest selves, which is why communication matters more than ever. Practice regular check-ins now. That is how these skills get stronger. You can ask your partner, “What do you need today?” “How can I help you?” or “Is there something on your mind?”

It also helps to talk to other parents, friends, and family members and normalize the many different experiences of new parenthood. Part of the reason you are here is that not enough people talk openly about the fourth trimester. It is a raw and vulnerable time, and when you talk about it more openly, you open the door for others to do the same.

If you are talking to your partner, or to anyone you are struggling with in the moment, use non-blaming language. It is much easier for others to hear us when we say “I feel” instead of “you never.”

Keep tiny rituals alive. I know that may seem small in the grand scheme of things, but those small rituals are part of what keep communication and connection alive. If one of you makes coffee every morning, or if you trade off, keep doing that. Keep something that helps you stay connected and moving together.

Another resilience skill is working on your own emotional regulation. We often talk about emotional regulation in relation to toddlers, but these skills will matter for you in the next few months and beyond. Learn coping skills now, or at least experiment with them. That might include breathing, grounding, stretching, going for a walk, or doing something physical with your body. What matters is that it works for you.

If it is not something you already do regularly, start practicing it now. When you are heightened later, those skills will be more likely to kick in automatically. And no matter how well you use your regulation tools, you will still benefit from breaks. Everyone needs a reset sometimes. Even a few minutes in a dark room can help.

16:51 | Approach Parenthood as a team

Another way to build resilience is to approach the struggles of early parenthood with a team mentality. This is tough, and it is also part of the foundation of couples work. Parenthood can strain a relationship, but it can also deepen it.

We can come at things as “you versus me,” or we can come at them as “us versus the problem.” Instead of becoming caught in “we are both exhausted and now we are at each other’s throats,” we can name the shared struggle: “We are both exhausted because sleep deprivation is awful. This is hard. What can we do together to make this better?”

17: 39 | Conversations to Have Before Baby Arrives

One of the most important things you can do ahead of time is talk openly with your partner. I know these conversations can be hard to have. We tend to talk about the nursery, the stroller, and names, and we do not always talk about these other pieces.

One important question is: “How will you know if my mental health has started to take a turn, and what is the best way to talk to me about it?” This topic carries a lot of stigma, but perinatal mood and anxiety disorders are real, and we need to take identifying and treating them seriously. It is important for both partners, and any other caregivers, to talk about this from their own perspectives. PMADs can affect birthing people, partners, adoptive parents, and other primary caregivers because this is a vulnerable period for everyone involved.

Talk with your partner about what might look different if your mental health starts to change, and how they can approach you in a way you will be able to hear so you can get the help you need.

Another important conversation is: “What roles do we want to set for grandparents, family, friends, and visitors? What boundaries are important to us, and how will we set them?” This can be sticky for a lot of people because expectations may differ between partners, grandparents, and extended family.

For example, is it okay for one parent’s mother to stay for the first six weeks? Is it okay for visitors to wake a sleeping baby because they want to hold the baby? Is it okay for a family member to offer unsolicited advice about sleep training when you would prefer to have that conversation only with your partner? You do not have to solve every possible situation in advance, but it is important to discuss what boundaries may look like, how you will set them, and who will have those conversations.

Another question is: “How will we cope with night wakings and sleep deprivation?” Many people go into this without a plan and make it through, but it can be more difficult than it has to be. I am not pretending it will not be hard, but suffering does not have to be the goal. Talk about what each of you will need to keep going each day. Will you offer bottles at night? Can you share responsibility for night wakings? Once feeding is done, can the other partner change or rock the baby back to sleep? There are many ways to approach night wakings, and the arrangement does not have to look one specific way.

You may also want to ask: “What do we think about co-sleeping and sleep training?” When choosing a partner, people often talk about whether they want children, but once you are actually having children, these more specific conversations matter. Are you okay with co-sleeping? Do you plan to sleep train? Do you need to do more research to get on the same page? Having this conversation while you are still getting some sleep is likely to be easier than having it after several nights of being woken up every hour.

Another question is: “How can we support the birthing person’s postpartum body?” A lot of people feel insecure about their postpartum body. Society often glorifies the pregnant body, but treats the postpartum body differently. Whether or not you personally agree with that message, it can still influence how you feel about yourself.

It is important to let your partner know how they can support you. Is body neutrality helpful? Is body positivity helpful? Do you want reminders that your body grew and birthed a human being? What will help you feel cared for and noticed?

Finally, and I cannot emphasize this enough, ask: “How do we make this an ongoing conversation that we regularly revisit?” You may go into parenthood with a clear plan, and I am glad if you have one. But plans can change. It is important to be open with your partner when things start changing and to know that these conversations can be revisited. None of this has to be final.

22:52 | When to seek help

Now let’s talk about when to seek help. I am not bringing this up just because I am a mental health therapist. I am bringing it up because perinatal mood and anxiety disorders are common, and the statistics only reflect people who are actually identified and reported.

Across studies, perinatal mood and anxiety disorders affect roughly one in five birthing people worldwide. Postpartum depression affects around one in six, and anxiety disorders can range as high as one in five. You do not need to be clinically diagnosed with any of these conditions to need support, reach out, and find help beneficial.

Signs to watch for include constant worry or dread. It is common to worry that something might be wrong with the baby, but if that worry becomes so intense that you cannot sleep even when the baby is sleeping, it is time to seek help.

Rage or irritability that feels out of control is another sign. Some people refer to this as “mom rage.” Many women do not feel like themselves and do not recognize their reactions. They may then feel guilt or shame. The reality is that your hormones are in flux, your body and life are changing, and it is okay to feel many things. But if the feelings become more than you can handle or control, seek support.

Sadness that does not ease, or feeling numb, can also be a sign of depression in the perinatal period. Feelings of hopelessness, guilt, or shame that become intense enough to interfere with daily life are also signs to reach out.

If you are avoiding friends, family, or baby-related activities you previously wanted to participate in, that loss of interest may be connected to depression. And this goes without saying, but if you have any thoughts of harm to yourself or your baby, please reach out. These thoughts can happen with PMADs. No one wants you to feel that way, and no one wants you to feel ashamed for feeling that way.

25:40 | Professional & Community Support for Postpartum Families

So who can you reach out to?

Peer support groups and parent support groups can be very helpful. There are groups for moms, lactation, and many other specific needs. Some are tied to particular communities, birth centers, churches, synagogues, or neighborhoods, and others are open to everyone. Some are virtual. Many are free. These groups can create a community of people going through the same thing at the same time, which can be incredibly meaningful.

Medication may also be appropriate. If you are experiencing symptoms that feel overwhelming, medication might help you get through that period more quickly than you otherwise would. It is not always the answer, and I know it can feel taboo, but it can help. Perinatal psychiatrists are the professionals to contact if you need medication or think you might. They may also provide therapy, but they are the ones who can prescribe medication in this context.

Perinatal mental health therapists can help you transition through pregnancy, postpartum, early parenthood, and everything that comes with it. Couples therapists can help you and your partner move into this new phase where your roles, intimacy, and commitments may look different. It is a challenge. The largest drop in marital satisfaction often happens after the birth of the first baby. That is not a guarantee, but it does happen for many couples.

Doulas can also be incredibly helpful. Prenatal doulas, birth doulas, postpartum doulas, and night doulas all support different parts of the experience. If doula support is in your budget, covered by insurance, or offered through an employer benefit, take advantage of it. Doulas are an incredible source of information because this period is their specialty.

IBCLCs, or International Board Certified Lactation Consultants, are also valuable. Very few birthing people have what they would describe as an easy breastfeeding journey. Feeding does not always come as naturally as people expect, and it can look different from birth to birth. Lactation consultants specialize in this work and are extremely knowledgeable. Many insurance plans cover prenatal visits, so you can build that connection before the baby arrives and have someone in your back pocket when you need support.

Pelvic floor therapists are another important resource. If you identify names and set up appointments preemptively, you are already in their system and can access them more easily later. Prenatally, pelvic floor therapy can help prepare your body for the birthing process and support postpartum recovery. Postpartum, it can be incredibly helpful as well.

30:26 | Key Takeaway

To wrap up, I want you to remember that you do not need to be perfect parents. Striving for perfection will only leave you feeling defeated. Do your best, and seek help when you feel yourself heading toward the deep end without enough support.

The fourth trimester is hard, and you are not alone. You are going through this at the same time as many other people, and there are people who want to support you if you are able to welcome or accept that help.

Resilience is built in small, everyday moments: making coffee, keeping a routine, or holding onto the small things that help you feel grounded when you cannot remember whether it is Monday, Friday, Wednesday, or Saturday.

Honest and open communication with your partner can strengthen your relationship during what may be one of the most stressful times you experience together. Keep that in mind, and let it be part of how you move through this season.

It is okay to ask for help. Hear me when I say: you are worth the support. You are worth asking for help. You are worth not doing this alone.

Before you leave, I would love for you to think of one intention or strategy you will carry with you into the fourth trimester. It might be a daily check-in with your partner, your mom, or a friend who had a baby two years ago. It might be setting an appointment with an IBCLC now so you can build that support and knowledge before you need it. Or it might simply be giving yourself grace. Many of us have trouble doing that for ourselves, so reminding yourself can be helpful.