Surviving the fourth trimester

The Bible in Ecclesiastes says there is nothing new under the Sun. So yes, I know that since the year 0000 BC women have been giving birth and even in 5000 AC (After Covid-19) they will still be doing the same and therefore postpartum issues are not new or unique to me. However, I am not those women and therefore, I will tell my tale just because.  

If I only knew 

For most of my pregnancy, I walked around in a daze and I swear I was not high on Wajackoyah treasure. Physically, I was well but psychologically it felt like I had accidentally walked onto the set of the Walking Dead and had been forced to join in as an extra. 

Comprehensively processing everything was impossible and yet being the African I am, taking a break to feel my feelings was not an option. One of the things that kept me going was the knowledge that after nine months, it would be over. 

“The baby will be born and it will be hugs, kisses, cuddles and goat intestines for breakfast,” I told myself. If only.

The fourth trimester

The fourth trimester if you do not already know is the first 12 weeks after delivery. People never really talk about it. I think for some its taboo or maybe it is just swept under the carpet in the name of kugumaring (being strong) or maybe we prefer to go through it in silence in the name of being heroes (eye roll). 

Corinth Rebecca Nabukenya, the founder of Nakaweere Wange, a small startup that provides care services to new mothers says society tends to compare women today to our mothers and grandmothers. 

“Just because someone’s mother gave birth to 10 children and in two or even less days postpartum they were in the garden digging, they expect mothers today to do the same,” she says. 

Lilian Nuwabaine Luyima, a nurse, midwife and women’s health specialist, says: “Women are taught that putting their own needs last on the list is preferred. And yet since the mother is vulnerable during this period, it is ideally expected that her spouse, family and community support her in fulfilling self-care.” 

To say the least, the fourth trimester is a trying time both physically and mentally. 

Constipation tales

Even as I write this, I am in the loo not talking to the moon but to myself, pledging that tomorrow, I will drink six litres of water and not just the three I drunk today. The constipation that ties itself to your life in the fourth semester is horrible. Imagine a dry maize cob trying to make its way down your 12cm rectum. Now break that cob into 20 small pellets and colour them green. I know; it is gross but yeah, postpartum does serve a full course meal of constipation. 

Health workers advise mothers to drink a lot of water and fluids and add fibre to one’s diet. They forget to mention that buying nice soft tissue is an added advantage. This is not the time to experiment with old newspapers or leaves.  Because by the time you have successfully emptied your bowels, the exit is so tender and ooh, it burns not to mention bleeds. This happens almost every time you go, so much so that you develop a phobia for the restroom.

Overwhelmed

Because during pregnancy most women change in appearance and become difficult to look at without wincing, after delivery, they hope for respite. Unfortunately, the body does not snap back immediately. So, there you are looking pregnant, with a size XXL nose, and if you are like me, matte black in skin colour. Then of course there is the bleeding and for the first few days, the cakes of blood and then the night sweats that leave your bed drenched. Then the feet that are still swollen like balloons filled with water and the tears and stitches wherever it is that the bundle of joy exited your body from. 

 It leaves you feeling like an old, torn, oversized company t-shirt. You know, the one that usually ends up as a rug. Then there is the numerous people telling you to do this and that.  And the baby who needs you when sometimes, you cannot even carry them, let alone feed them because you are sore all over and hardly aware of where you are.  Is it surprising then, that some mothers slowly but steadily slip into depression?

Postpartum baby blues and depression

Nuwabaine emphasises the fact that the birth of a baby can trigger a lot of powerful emotions, from excitement and joy to fear and anxiety and can also result into postpartum depression.

“Most new mothers experience baby blues after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. The baby blues typically begin within the first two to three days after delivery and may last for up to two weeks, but, some mothers experience a more severe, long-lasting form of depression known as postpartum depression,” she says.

Quality care

In their recommendations on maternal and newborn care for a positive postnatal experience, the World Health Organisation  points out that  in line with the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health, and in accordance with a human rights-based approach, postnatal care efforts must expand beyond coverage and survival alone to include quality of care.

Support system

I am lucky to have devoted caretakers, who have been where I am and know exactly what I am going through, and what is to come. 

“A new mother’s greatest need is someone they are comfortable with, someone who will understand; a supportive person. Support does not only mean money, support is understanding that she is asking for this because she really needs it,” Nabukenya says.

So there you have it, fourth trimester sucks, but it helps when you have support and know what to expect. To all my 4th trimester-mates and those to come, you are not alone. Kisoboka (in 2021 presidential candidate Willy Mayambala’s voice).