foreword

Get your body back after baby. Right? That’s what we hear from other moms, that what we see in the media—perfect images of stunning pregnant celebrities who, mere weeks after delivery, somehow seem to have returned to their impossible prepregnancy bodies. We even tell ourselves, in our confusion about what we should expect postpartum, something along the lines of, “if I could just get myself back to what I was before, then everything will be okay.” The social pressure to get back to the hot, sexy, non-mom self is enormous. The turbulence caused by the transition into motherhood is real, and yet, we are left totally without any guidance as to how we are to restore ourselves after such a tremendous body and life altering experience.

When you think about what you learned about preparing your body to recover postpartum, what were you told? Is this something your doctor brought up with you? Did your mother, sisters, aunts, or girlfriends share their stories with you in a helpful and positive way that showed you what your game plan should look like? Did anyone help give you perspective on what you should expect for the period of time immediately following the birth around your body, your hormones, your sex life, and your relationship? If any discussion was there, it likely mirrored the conversation around your first period: expect and accept an unavoidable and unchangeable negative physical experience.

So much of the time we use during pregnancy is dedicated to preparing the nursery, planning the baby shower, trying to find clothes that fit your changing body, and dealing with all of the unexpected things that can happen with our bodies, health, and moods during pregnancy, all while making sure you are doing your very best to eat and take care of yourself for the benefit of your baby. It is presented to us as a finite adventure (filled with shopping), which after the birth is then complete. We’re encouraged to put so much careful thought and planning into the shower, the nursery, the birth plan. We don’t get any guidance on the planning we should be doing to care for the body of the mother who just completed the herculean task of 3-D printing a tiny human for nine months!

We go through the intense, physical experience of delivering that tiny human out into the world safely. We then continue to nourish from our own bodies and nurture that new person with so much intensity and focus. All of this is incredibly depleting of micronutrient stores, and has real impact on the organs, tissues, and fascia of the abdomen, back, and urogenital system. And yet we are left surprised and vulnerable when our health and bodies start to suffer.

This missing conversation not only downplays the largesse of this experience as women, but also undermines our chances of proper recovery. Motherhood is a process of becoming, transforming, and responding, which develops over time and begins in pregnancy. The birth moment is one part of the transformation, but it continues in the fourth trimester and beyond. Yet the support, access to information, and expectations around what is actually needed postpartum leaves much to be desired. What if you were told instead that your pregnancy time is already preparing you emotionally, spiritually, and physically for your transformation into motherhood, and that specific care in the days immediately following the birth are required for your hormonal recovery, your emotional and physical wellbeing both short and long term, and for your ability to be fully present and enjoy the gift of motherhood?

As a functional nutritionist and hormone expert, I’ve spent the past seventeen years helping women balance their hormones with food, recover from frustrating and debilitating menstrual disturbances like PCOS, fibroids, endometriosis, PMS, and improve their fertility to become the mothers they want to be. Every woman I’ve ever spoken with, who has long suffered with symptoms and the conventional failed approaches of medication, surgeries, and synthetic hormone replacement, wishes she had been taught how her body worked and how to deal with her inevitable hormonal fluctuations naturally. As someone who has suffered personally with a hormonal imbalance, I know how reclaiming hormonal health totally transforms every aspect of one’s life. That is why I wrote WomanCode. I wanted there to be a guide for women to navigate the inevitable hormonal turbulence that comes with puberty, periods, pregnancy, postpartum, and peri-menopause, so women everywhere could know what I discovered in my research, that foods, not pharmaceuticals, are the way to restore balance and reclaim your vitality, and that an ongoing relationship with your body and organizing your self-care around the innate cyclical patterns of your biochemistry is the only way for women to live their healthiest, happiest lives.

Kimberly Johnson leveraged the protocol in WomanCode to help regain her hormonal balance during her own postpartum healing process. In her book, she is now sharing all of her vast knowledge as a doula and pelvic floor expert to help women understand how to use this postpartum period as a time to partner deeply with our bodies to reclaim our health and set ourselves up for lifelong wellness as mothers. She will encourage you to listen to your intuition that you do in fact need more support and your own body deserves attention after baby because a healthy mother is best for baby.

When I was preparing to go through my own pregnancy and postpartum, because of my professional training, I knew I needed to assemble a team of support, stock my freezer and pantry, create space in my career for rest, and monitor myself and symptoms closely. I spent the majority of the third trimester putting this together and preparing myself emotionally and physically for the epic journey ahead. This is not a standard way to think of the process, simply because from the earliest moments we are handed a set of beliefs about our bodies; rather, we believe that we are victims to them, that nothing can be done when things go wrong, that suffering is part of our destiny as women. These beliefs stifle our natural instinct to take action and keep us in a passive relationship with our bodies where we feel like victims and not like the leaders we are meant to be.

The Fourth Trimester is an important book and contribution to the women’s health collective library. It is a critical read for every woman planning to become a mother. We don’t have adequate terminology to describe the things that happen to us. Even in writing this, the autocorrect doesn’t recognize the phrase “postpartum”—everywhere I’ve typed it, it has the red squiggly line under it! Kimberly makes official this conversation about the existence of the term fourth trimester, one that has remained somewhat on the fringes of alternative medicine. It’s almost incredulous that it isn’t part of our normal lexicon. Think of this book as “What to Expect, after You’ve Finished Expecting.” It will help you deal with the real physical impact that birth can cause, as well as provide you with resources to guide recovery. It’s now much more common to hear women expressing desire to have more natural birthing experiences, and it’s only logical that we would want to bring that same self-awareness and wellness-based approach to the period right after the birth. This book will help you do that.

Kimberly knows first-hand what happens when we don’t have access to this conversation, this perspective, and this practical game plan. Kimberly, after the birth of her own daughter, struggled in many aspects of her health and life, and she suffered alone and found it difficult to find resources to support her. Her arduous journey of physical recovery, however, opened her eyes to the struggle we all have as women to make sense of confusing symptoms from our bodies, to navigate through specialists to find the right care, to even know in the first place to seek care out, and of course to actually recover. Kimberly bravely tells her story of how the fourth trimester opened her eyes to all of this, remade her totally not only as a woman, wife, and mother, but also as patient, student, and guide for other women—she is a midwife for the emergent mother during the fourth trimester.

In very practical and approachable ways, you will be guided on all the things to consider after birth, with the express design of reducing any and all sense of overwhelm and stress. There are charts, lists, and exercises to help you organize everything from food and chores, to your desires and ideas on what you want your experience to be at home, with your partner, and as a mother. Kimberly will guide you expertly to make your optimal post-birth plan. She brings real talk around what to expect in healing physically from pregnancy and birth, and this candor extends to preparing for the impact of the birth on your emotions, sex life, and relationship, as well as giving guidance on how to navigate those waters successfully. The more you read this book, the more you will feel encouraged that you are capable of leading yourself and your family through this transition. This is truly what motherhood requires of you: to emerge as a leader.

Kimberly is committed to your well-being as a woman and as a mother. This book is the result of that devotion and love. It emerged from her own commitment to loving herself enough to take care of herself properly and daring to want more for her own health and life. She has laid the trail clear for you, lit the torches, and left you snacks along the way to help you continue the journey, not back to your old self, but out beyond who you’ve ever known yourself to be before, into the field of motherhood, centered in your own body and with a new and increased confidence in yourself and your strength as a woman.

We all take for granted now that every woman should prepare a birth plan. I believe you should also prepare your post-birth plan for the precious and foundational early days of motherhood. With this book, Kimberly has created a guide that will help you restore your body and expand yourself into the role of a lifetime.

—ALISA VITTI, HHC, author of WomanCode, founder

The FLO LivingHormone Center, creator of The MyFLO App