2ND TRI POST

2nd Trimester Post Partum

13th - 29th weeks

Keeping this information in all trimesters as a reminder because as one client eloquently put it, “this [caregiving] thing is not for wimps”.

For the record, you are doing great.

Mind Lethargy + Slow Reaction

Several studies have found that reduced sleep duration + sleep quality have an impact on gray matter volume + functional connectivity at rest - your thinking may feel slower or forgetful. We bedshare + I breastsleep (nurse son throught the night on our bed): my lexicon went out the window.

Also, it should be noted that another study discovered that the reaction time of sleep deprived individuals was worse than individuals who consumed alcohol. while leaving my RMT’s parking lot, I hit a telephone pole at 10 weeks PP + I knew that i was not okay to drive.

Amygdala + OFC Function

Experiences of caregiving alter the brain. First time caregivers have greater neural responses in the amygdala + OFC of the brain to infant specific cues than that of caregivers with more than 1 child or a child over 14 months. According to studies this will shift as your child ages.

You are not crazy.

Your brain has changed by birthing + by raising a child.

Your body is still healing, especially if you had a caesarean, vaginal/pelvic floor tearing, PSD +/or diastasis recti.

Hair

Your hair will start to shed like crazy. Expect crazy *ss baby hairs to emerge as well :).

Transverse Abdominals

Your back may be sore from holding your babe - forward flexion. Engage those transverse abdominals literally like a corset.

Relaxin

The hormone that makes your ligaments more flexible around all of your joints, will still be in your body if you are breastfeeding. PSD may still be mildly present. Be mindful of lunging, squatting, turning on a dime, etc.

REST

When you can with 0 guilt. The sleep deprivation is real. If you are able to sleep when the baby sleeps, do it. Or at least lie down + meditate/relax if your body will not allow you to sleep.

Trigger Warning :

Disordered Body Image

My TCM Body Practitioner shared with me that the caregiver's body after childbirth is akin to Mother Earth - soft + round. And as long as mothering/caregiving is required of her/him/they, the body will respond with a soft roundness. Use that info how you wish.

Putting this information in every trimester because it is important to speak about. Plus, Intrusive Thoughts can present at any time post partum.

1 out of 5 birthers experience a form of Post Partum Depression. So common to have one or a mix of many.

Intrusive Thoughts, Post Partum Anxiety, Post Partum OCD, Post Partum Psychosis, Post Partum Depression +/or Post Partum Rage.

Intrusive Thoughts

They arrive out of the blue + may be ideas of harming your baby that horrify you, but they never bring you joy nor would you act on them. This is considered 'normal behaviour'.

Post Partum Depression

signs + symptoms may include:

Depressed mood or severe mood swings

Excessive crying

Difficulty bonding with your baby

Withdrawing from family and friends

Loss of appetite or eating much more than usual

Inability to sleep (insomnia) or sleeping too much

Overwhelming fatigue or loss of energy

Reduced interest and pleasure in activities you used to enjoy

Intense irritability and anger

Fear that you're not a good mother

Hopelessness

Feelings of worthlessness, shame, guilt or inadequacy

Diminished ability to think clearly, concentrate or make decisions

Restlessness

Severe anxiety and panic attacks

Thoughts of harming yourself or your baby

Recurrent thoughts of death or suicide

Post Partum Obsessive Compulsive Disorder (OCD)

The OCD symptoms that are new, rarely occur in the postpartum period (about 1%-3% of women). The obsessions are usually related to concerns about the baby's health or irrational fears of harming the baby. Panic disorder may also happen. You can have these conditions + depression at the same time.

Post Partum Psychosis

Occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1 -.2% of births. The onset is usually sudden, most often within the first 2 weeks postpartum.

Symptoms can include:

Delusions or strange beliefs

Hallucinations (seeing or hearing things that aren’t there)

Feeling very irritated

Hyperactivity

Decreased need for or inability to sleep

Paranoia and suspiciousness

Rapid mood swings

Difficulty communicating at times

Post Partum Rage

Some new moms/caregivers feel mad more often than they feel sad, lethargic, or anxious. For these caregivers, postpartum rage may be the cause of intense anger, outbursts + shame in the first year of their baby’s life.

Wonderful podcast interview with clinical psychologist Dr. Catherine Schmidt gives multiple examples + coping strategies.

It is necessary to access support if you feel any of the above. Be that talk therapy or whatever works for you. Many licensed psychologists have sliding pay rates along with virtual therapy sessions, which I myself have accessed both.

Follow your intuition regarding still eating warm easily digestible foods.

If you have had 3 periods, consider incorporating the Cycle Sync Nutrition - childrearing with much dissipated pms has been a winner for me.

Hydrate

Keep it coming. The more fluids you consume, the faster your body can continue to rebuild + to regenerate. For breastfeeding birthers, at least 10 to 15 glasses of water a day. My fave diy electrolyte mix.

Eat whatever you wish of nutrient dense anti-inflammatory foods. The below is the grocery list of foods that will help to replenish your body by Integrative + Functional Medicine Physician, Alejandra Carrasco.

For nutrient reasoning, refer to 1ST TRI POST Nutrition.

Grocery List

Vegetables: leafy greens, bell peppers, bok choy, broccoli, broccolini, carrots, spinach, swiss chard, snow peas, potatoes, parsnips, beets, carrots, kale, sweet potatoes, squash, tomatoes, celery + cabbages

Fruits: berries, citrus, cranberries, goji, papaya, pineapple, guava, mangos, melons, banana, apricot, avocado, apples + pears

Whole grains: oats, quinoa, millet brown rice + sprouted whole grain bread

Lean or low-fat protein: including fish (WILD SALMON, Albacore Tuna, Mackerel, Sardines), poultry on the bone, lamb, beef liver, tofu, beans, legumes, seeds (pumpkin+), seed butter, nuts, nut butter, lentils, edamame, bison, grass-fed lean beef + plant based protein powders

Nuts + Seeds: Almonds, Brazil nuts, Chia seeds, Flaxseeds, Macadamia nuts, Pistachios, Pumpkin seeds, Sunflower seeds + Walnuts

'Dairy' : Coconut Fortified Yogurt, Fortified Plant Milk - Pea is super high in Calcium

Healthy fats: Avocados/avocado oil, Coconut oil, Extra-virgin olive oil, Flax Seed Oil (do not heat)

Miscellaneous healing foods: Bone broth, Cocoa, Cultured foods such as yogurt, kefir, kimchi, sauerkraut, Dark chocolate, Hydrolyzed collagen, Sea vegetables, Herbs + spices

Ginger Tea - in moderation

Holy Basil Tea - awesome for entire pregnancy, breastfeeding + post partum as it is an adaptogen

Herbal Fruit Tea - read the label well if buying conventional tea

Mint Tea - only if not breastfeeding as it will dry up your milk supply

If Breastfeeding, these foods are known to cause painful gas + colic:

anything Bovine includes Dairy + collagen, eggs, fish, seafood, nuts, soy, onions, garlic, beans, legumes, cruciferous family + Brassica Family

If Breastfeeding, these foods are known to cause diaper rash:

citrus, tomatoes, strawberries, pineapple

Trigger Warning:

Disordered Eating

If you are breastfeeding your body needs around 500 calories extra/day. You will be hungrier.

Exactly the same as 1st Tri Post

Prenatal Multi-Vitamin: besides ensuring your healing body is receiving nutrients, this also aids Post Partum Depression. When a body is lacking nutrients, it cannot function properly, which affects hormonal chemical balancing in the brain. I still take this 11pp + will continue after learning what I have with the infradian rhythm.

Omega 3 DHA 400mg: this will help your muscles, ligaments + brain heal/function well to ward off PPD. Plus, if you are breastfeeding, this will aid your baby’s cognition development.

Epsom Salts (unscented): ENJOY THAT HOT BATH FINALLY after your obstetrician’s clearance. This is a gentle way to absorb magnesium into your body to aid sleep.

This STILL is up to YOU.

Your body has gone through trauma + is still healing. Every birther + every post partum is different.

I chose to have sex with my partner during this trimester as I wanted to connect physically + I wanted to know where my vagina was at pain-wise due to my history.

If you have pain or discomfort when doing normal tasks or exercise, consult with your healthcare provider before attempting intercourse.

You Time

Awesome sexual focus meditation for womxn by Dr. Lori Brotto.

LUBE

If you are breastfeeding, know that your vaginal secretions will be next to nil due to prolactin + oxytocin. Use lube. DIY that i prefer/USE as it does not disrupt my hormones.

Intimacy Dates

Taking a bath together or sipping a glass of wine/tea with your partner, after the baby nods off can help you rekindle your relationship. Not going to lie, raising a newborn was tough on our relationship. Communication was key for us when we had baths together after our babe was asleep.

Touch

You might not be in the mood to have sex, but you can still be physically intimate. Kiss, cuddle, hold hands, give each other back rubs — whatever feels right.

Positions Post Partum

By Sex Educator, Bethany Ricciardi

Choosing any woman-on-top position — including the cowgirl, the seated scissors or reverse missionary: means that you can control insertion, depth, speed + clitoral stimulation. By taking control, you can ease yourself into intercourse in a way that literally makes you the most comfortable.

Doggy-style, the happy scissors, bent over a counter, the frisky flip: any from-behind, rear-entry sex position will do. Fatigue may plague the new mom, so rear-entry positions may work nicely. However, if you have had any perineum tearing, this position may not be comfortable.

Spooning: is intimate + not very deep-penetrating, so there is less chance for a sensitive cervix to be touched.

Missionary position: is a popular choice due to the intimate face-to-face positioning, clitoral rubbing, which can aid in orgasm + normal penetration depth.

If you are physically in the clear per your doctor’s advice + you want sex: go for it. Remember you can still be fertile even if you have not had a period yet.

On the other side, your sex drive may not return for months — even a year or longer, particularly if you are breastfeeding. There is even evidence to suggest that it can take 18 months or longer before many birthers find sex pleasurable again.

Still be gentle AF with yourself. Physically + Mentally.

Honour Where You Are.

Mindful movement is still the key. If you set up a good base in your 1st tri Post by focusing on rehabilitation, you should feel confident to increase your intensity physically by exploring your full range of movement carefully.

Move Every Day

Even if it's 5 shoulder rolls. Fresh blood + fresh oxygen supply aid healing muscles, ligaments, tendons as well as brain function.

If you have access to a partner or other caregiver, book time to yourself - you deserve this + it is not selfish. In all honesty, sometimes all I get is 10 minutes, but I take the time when I can to keep my QI moving/fresh blood to my brain + my muscles. If you can manage 30min, that is the sweet spot to gain biological + physiological positive effects, but all moving is good for you irregardless of the time allotted.

PS stroller walk outside is movement by the way :).

Full ROM + Strength

Now is the time to mindfully reintroduce yourself to all facets of your range of movement including building strength. Strength with flexibility, in every direction, aids your body to be less prone to repetitive movement injury - picking up a growing moving baby 20x/day :). Plus, moving without pain as one ages is a goal for myself as a body worker.

Download a free monthly Post Partum plan for Beginner, Intermediate or Advanced movers to learn how to schedule your own movement.

101s

Revisit all the 101 videos to relearn proper alignment as your body is still readjusting to your internal organs re-establishing their positions - namely, your decreasing uterus, diaphragm, intercostals, all abdominals, pelvic floor + hip ligaments.

NB Headstands are still amazing for asisting the uterus, ligaments + internal organs back into position post partum. There is an 101 on how to do headstands safely.

Mirror + Alignment Adjustments

Continue to work with a mirror to keep an eye on your placement, especially your thoracic spine (360 degree of chest area) + pelvis. With breastfeeding + carrying a babe, all birthers/caregivers tend to collapse anteriorly (front body). And, as I learned, sometimes a posterior pelvic tilt emerges due to holding a babe + counterbalancing that weight with your hips - I was shocked to learn from my PFPT that I had this.

Now that you know, look at yourself sideways in the mirror + adjust. Your feet should align parallel under your hips, pelvis neutral, ribcage directly stacked above, open chest, parallel chin to floor. If this is too much, focus on your feet + slowly add in the rest with time. But honestly, there is no point to moving out of alignment so work in baby steps to ensure your body’s proper form.

Slow Squats

Squeezing a yoga block, a sm pilates stability ball or a pillow between your adductors (inner thighs), execute a slow squat. This will help the psoas, glutes + hamstring group to activate - aids with healing PSD, sitting, going to loo, etc. Try not to bear down. Brain goes up the back side of your body.

Moving in this way while holding a baby is paramount for injury-free repetitive movement. Depending on your pelvic floor requirements, your PFPT may ask you to engage your PF on the standing section when executing slow squats.

Transverse Abdominals

Practice the Clock, sahrmann, Trans Ab Osteo Exercise + Bird Dog daily. Be sure to engage corset of abdominals in every day life, especially while holding your baby.

Move however you desire with caveats, of course.

1. Unless you are working with a pelvic floor physiotherapist closely, I still do not recommend high impact movement - this is to avoid pelvic floor strain/pressure.

2. Diastasis Recti: 0 flexion of the rectus abdominals - this is to lessen diastasis rectus separation.

3. 0 ankle or wrist weights + heaviest weight is a maximum of 5lbs in each hand - this is to avoid excess internal abdominal pressure on a healing body. Feel free to go weightless now as you are still renegotiating how to move your entire body post partum.

4. PSD is still healing, especially if you are breast feeding: lower all arabesques, developpés, bâttements, attitudes, side line, side series, leg lifts + lessen depth of squats/lunges. BE MINDFUL. Move slow + with precision as you can easily hurt yourself now due to the relaxin still in your body.

5. Diastasis Recti: do not engage rectus abdominals (six pack/forward flexion movers). Never roll down on your back: turn to your side, use your arms to lower yourself + then transfer your weight from your shoulder onto your back. Reverse goes for sitting up - getting out of bed.

6. There is no prize for finishing a video - move at your own pace, stop the video, do a longer video over 3 sessions. Whatever works. BUT you can begin to challenge yourself a for you.

7. Breastfeeding: drink water every 15min no matter what. My fave Electrolyte DIY recipe.

8. No pouching, tenting or pushing out of abdominals: always focus on pulling your abdominals towards your skeleton 360 degrees.

9. Breathe with your movement. Holding your breath will cause aggravating pressure on your abdominals + your pelvic floor.

10. Hydrate often: 4oz for every 15min of movement, at least. Even more if you breastfeed.

IN 10 core is set up to do sequentially.

Start at 1 + work your way through following your Pelvic Floor Physiotherapist suggestions.

Please do not move on until you master each video.

NB I am not an obstetrician nor a nutritionist nor a psychologist, I am a nerd. Please use the above info at your own discretion.

Never disregard seeking professional medical advice or delay in seeking it because of something you have read or seen here.