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OUR THIRD ‘FOURTH TRIMESTER’

Writer's picture: Julia IddirJulia Iddir

Updated: Aug 18, 2022

Our three ‘fourth trimesters’ were so vastly different… one birth went ‘to plan’, the next ended in a haemorrhage, and the third was fairly medicalised (26% of births are induced at the ERI) and also saw our daughter spending 6 weeks in hospital, so the time leading on from each birth played out differently.

I can’t say I ever really got to have my golden hour with any of my children. Leila was taken away within 10 minutes, and was gone for about half an hour because of concerns that needed to be seen to. I was then allowed to give her a quick hug before she was taken off to the NICU. Although none of this was forced on me, it can certainly feel that way when you don’t know any better and can be a terrible and upsetting shock.

Although premature due to early rupture of the membranes, my daughter was the only one of my children who latched on with no help (before she was taken to NICU), but as it turned out her latch was ineffective and she couldn’t extract milk because of her cleft palate (1 in 700 babies in the UK are born with a cleft lip and / or palate, 45% with CP, 24% with CL and 31% with CLP, Clapa.com), so I spent 6 weeks struggling to painfully express pitiful amounts of breast milk (which occasionally the nurses forgot about, and later discarded) while also trying to get to grips with using a haberman bottle (one of a range of feeding bottles that cleft palate babies usually require), and learning how to place and replace an NP airway tube on a daily basis.

I was desperate to give my daughter whatever I could to help her through this hard time, only to give up in total exhaustion when she finally came home, in the realisation that I simply couldn’t express, feed, and care for her, while also being a mother to two young boys.

It’s now totally obvious to me why expressing was so ineffective. That all important fourth trimester was burried under hospital routine, tubes and monitors. Initially I was barely allowed to hold Leila, let alone have skin to skin time with her (nobody mentioned kangaroo care to me, I didn’t even know about the concept until after we had got her home), so at the time that my milk should have been coming in, my body had no idea there was a baby out there that needed it. I had two kids in part time child care too so I could barely spend a couple of hours with her each day, and the guilt of leaving my frail little baby alone in a big hospital was (still is) soul destroying.

When I look at the information thats out there about the 4th trimester, and the things that make that transition so much easier for baby… warmth, closeness, skin to skin, co-sleeping, quiet, dim lighting, fresh air, on demand feeding, swaddling, baby wearing, movement…. Leila had none of these, instead she was in a loud, brightly lit room all day, in a different person’s arms for every feed, and straight back into bed once she’d been fed and changed. It must have been the biggest shock to her system. I remember being told by the nurses that she was such a dream baby through the night… she’d just feed and go back to sleep, and I’d think how horribly sad that was and then cry in bed at night thinking how lonely she must be.

Likewise, all the things that mums are supposed to do during the 4th trimester – taking it easy, giving yourself a break, enjoying time with your baby, not putting too much pressure on yourself…none of that really applies when your every moment is filled with thoughts about your absent newborn, or plans of how and when you’ll next get to see them. Although never diagnosed, I’m certain I suffered from post natal depression (PND) after Leila was born – in fact mums of premature babies in NICU are 40% more likely to suffer from PND.

I can see in hindsight, the incredible value that a gentle 4th trimester can have on both mother and baby, and even partner. Understanding this process is becoming increasingly salient. Everything else in life these days comes instantly – we order on amazon one-click, we have the world in our smart phones, we pay someone to pick up our favourite meal and bring it to us… but for this we need patience. And harder still, there is no instant pay off for it – we don’t see after one month, that we have helped to create a secure, confident, well attached little person, and they’ll never sit down as an adult and thank us for having made those first weeks of life a little less overwhelming. We just have to believe in the process. We have to trust that we’re doing the right thing because the difference it can make can have lasting effects, practically and emotionally, and on the whole family.




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