Welcome to the Best of Birthful. Creator and host Adriana Lozada curated and edited each selection in this playlist of the show’s most popular episodes. It’s a tailored introduction to the expansive catalog she amassed over the first five years of Birthful’s 300+ shows.
Somatic practitioner and author Kimberly Johnson shares the lessons she learned while writing about “the fourth trimester” and what it takes to fully recover—physically and mentally—after giving birth, including paying attention to what you eat, who supports you, and more.
What we talked about:
- What does “restoring your vitality” even mean?
- Un-shaming the body
- How long will this take?
- How postpartum takes the lid off your unresolved issues
- The five universal needs during postpartum
- Setting up your support
- Creating a postpartum plan and having a code word for mental health
- The connection between your mental health and your pelvic floor (and vice versa)
- When to book your pelvic PT appointment
- The need for gathering
- Preparing for a profound experience of codependence
- Learn to truly rest
Mentioned resources and additional links*:
- The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality, by Kimberly Ann Johnson
- The Fourth Trimester Journal: Practice and Reflections to Honor Your Journey Into Motherhood, by Kimberly Ann Johnson
- The Fourth Trimester Cards: Daily Support, Inspiration, and Wisdom for New Mothers, by Kimberly Ann Johnson
- Natural Health after Birth: The Complete Guide to Postpartum Wellness, by Aviva J. Romm
- After the Baby’s Birth: A Complete Guide for Postpartum Women, by Robin Lim
- The First Forty Days: The Essential Art of Nourishing the New Mother, by Heng Ou, with Marisa Belger and Amely Greeven
- Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation 1st Edition, by Pam England
- Ancient Map for Modern Birth, by Pam England
- Seven Sisters for Seven Days: A Mothers’ Manual for Community-Based Postpartum Care, book by Michelle Peterson
- #metoo movement (metoomvmt.org)
- Bringing Baby Home, articles from the Gottman Institute
- The seven BEBA principles developed by Ray Castellino
- Meal Train and Take Them a Meal, meal delivery coordination services
- International Pelvic Pain Society (IPPS)’s provider directory
- The Wood Cutter Stories, on “sharpening your axe”
Related Birthful episodes:
- Setting Up Your Postpartum Support, with Michelle Peterson
- Will You Shower During Postpartum?, with Lisa Chin
- Hormones After Birth, with Dr. Jolene Brighten
- Postpartum Doulas, with Jackie Kelleher
- Taking Care of You, with Mar Oscategui
- Healing Your Birth Story, with Pam England
Get access to my Postpartum Vacation Plan worksheet to help you prepare for life with a newborn.
[Best of Birthful] Restoring Your Vitality After Birth
Adriana Lozada: Hey mighty one. With nearly 300 Birthful episodes in over five years, it may be hard to know where to begin listening to the show. To make it easier, we’ve put together the Best of Birthful series, which showcases some of our favorite or most relevant episodes. This is one of those. If you enjoy what you hear, make sure you subscribe. It’s free and that way you won’t miss a thing and joy.
Lozada: Hello, mighty parents, and parents to be. My guest today is Kimberly Johnson, who came out with a book called, The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions and Restoring Your Vitality. Kimberly, welcome to the show.
Lozada: Yay. So I am very excited to be talking with you about restoring vitality after birth. And so give us a little bit of background for the listeners who are not familiar with you. How did you get to the place where you’re writing a book on the fourth trimester?
Johnson: Well, I, like a lot of women, was really prepared for birth and had a birth plan and made a lot of adjustments in my life so that I could have the birth that I really wanted to have. And then, like many women, also I just was completely surprised by how difficult the postpartum period was for me. And I had no idea that the potential physical ramifications would be. So I ended up with chronic lower back and side pain, hemorrhoids, fecal incontinence, just all of these super unpleasant symptoms that I had never experienced before and had not even conceived of experiencing. So I was told that I needed a full pelvic floor surgical reconstruction. I knew that there was no way that I wanted that and I doubted that, that would even help me. I started just doing everything that I could to understand what was happening with me, because I really knew that it wasn’t just, number one, a personal problem.
Johnson: I knew, number two, it wasn’t a women’s health problem. And then thirdly, I recognized there’s something archetypal about this. There’s something bigger than me that’s happening right now that I am trying to figure out. And so I started traveling and going to other cultures and mostly in Asia where there’s very specific care for women postpartum. And I started to see that there was similarities among them. And then when I found sexological bodywork and somatic experiencing trauma resolution work, that’s where I got the most healing and very significant, profound and efficient results. And I just started realizing that when I searched holistic postpartum care online, all I found was, I think 500,000 entries on postpartum depression and that postpartum depression is real and that it exists. And I know about the history of women’s health and how quick we are to call things hysteria or to assign them this ment… It’s easier to say it’s a mental health problem than it is to address the underlying societal cultural framework, that places women in a position where they’re more predisposed to have difficulty.
Johnson: Even now, when I tell people, people say, “What’s your book about?” And I say… I’ve learned to say it in many different ways, because if I say it’s about the postpartum period, people automatically assume that it’s about depression instead of recognizing it as a period of time that any woman goes through, if she’s had a baby or a miscarriage or a loss or an abortion. And so the book is the synopsis of my personal experience with all of these things, including prolapse, and then the case studies of the women that I worked within… Those are called community stories in the book. So it’s like, it’s the book that I wish that I would’ve had putting together the physical, the emotional, the spiritual, the sexual, the archetypal parts of all the changes we can go through becoming mothers.
Lozada: So focusing on restoring our vitality after birth and our topic today, I think we need to define a bit what that means, because there’s this great misconception that it’s about getting your body back, getting back to where how things were before baby, which is not even possible. But, there’s, culturally, we’ve got these representations that, that is a possibility. So I think part of our, even this conversation of restoring the vitality after birth is defining a bit of, what does that even mean?
Johnson: So interesting because in English, we say, “Life force. Vitality or life force.” But that’s usually just being used as a translation for prana or chi, or these concepts of our vital energy. Our essence are the thing that makes us, us, that are very obvious to anywhere where Chinese medicine is the foundation of life understanding. Because just like in India, ayurveda, it’s not medicine separate from spirituality, separate from human development. And so, restoring vitality, it doesn’t necessarily look like becoming the person you were. But for me, my postpartum period lasted six and a half years in the way that I demarcate that is because that’s when I felt like I had full access to my life force again. And that my physical body was repaired to the extent that I could use it, how I wanted to use it. And then I felt available to life in the same way that I had felt previously.
Lozada: What does restoring your vitality look like? And you mentioned six and a half years, what do you think is realistic in terms of expectations for a person to, approach how long feeling restored my take?
Johnson: I think that it really… The postpartum period kind of takes the lid off of everything that’s not resolved. And then there’s also some very concrete things that contribute to postpartum healing. So there is an element that one can control and prepare for it. And then there’s, elements that one cannot control and perhaps can’t anticipate ahead of time. But if we are doing our part to do the preparation, then those things that are out of our control won’t create so much difficulties. And so, there’s so many variations on what is creating the most challenge or the biggest growth opportunity postpartum.
Johnson: And people are for sure, their eyes bulge out of their heads, when I say six and a half years, I think it’s divided. Some people are incredibly relieved because they’re like, “Well, that’s kind of, like, that’s the first sound thing I’ve heard because it’s certainly not six weeks.” But, I think every woman who’s been through it is like, “How long is this going to be?” And that could be when they’re three weeks postpartum or that could be when they’re 10 years postpartum. And they’re admitting, “You know what, this really started after I had a baby, but I never took care of it.”
Lozada: But in terms of things that are helpful for restoring that vitality and how do you even prepare for that? Let’s go for a switch with restoring the vitality. What are some things people should look out for and sort of support?
Johnson: So in the book I talk about the five universal needs and those are what I had identified across cultures, where that these are things that every woman needs, no matter where she lives and how old she is in, when she gives birth, it’s just what women need after they have a baby. And the first one is an extended rest period. So that’s 30 to 45 days to 60 days where a woman doesn’t really leave the house and she’s mostly resting and still, and I really can’t emphasize that enough because most of the time, there are some people who come through birth with birth injuries. But a lot of times what has happened is that a person has not rested adequately enough. And then the symptoms ensue. So slowing down, resting. The second one is, nourishing food, and that means warming foods, foods that are collagen dense and mineral rich and high in saturated fat.
Johnson: Every culture has specific foods that women are given after they have a baby. In Korea, it’s a lot of seaweed soups. In Hong Kong, it’s black chicken soup. All over the world, there’s very specific things that women are given postpartum and that’s to help the tissues rebuild, it’s to help the ligaments, the 16 ligaments that hold the uterus in places. The third thing is nourishing touch. So, loving touch. Every culture has a bodywork practice that goes together with the postpartum period. And then the next is, the company of wise women. So women are surprised to hear, everywhere I go, I tell people, new moms with babies, shouldn’t be alone with babies for more than two or three hours at a time. To be alone with a baby all day, anyone is going to end up depressed and low energy with the diminished vitality, because we’re not meant to be alone in that period of time.
Johnson: This is where the village comes in and people kind of look at me like, “Well, this is all just impossible.” Or either, “This is expensive.” Or, “This is impossible.” And we just have to get creative about it. It is possible. And even if you can only do 25% of what I’m saying, it will make an exponential difference because even if you can only afford to hire a postpartum doula to come one day a week for three hours, knowing that that person is going to come every Friday and that person is going to come to take care of you.
Johnson: Most people’s postpartum plan is like, “My husband’s got two weeks off of work.” And I just am like, “Okay. And what’s your postpartum plan? Because two weeks is a flash and a partner is not a postpartum plan because they don’t know the specific needs that women have postpartum and they’re not equipped to fulfill all those needs.” So it requires really making ourselves a protagonist of the experience and setting ourselves up for success, believing that our health and our body matters just as much as the baby’s does. And that it’s a way of preserving relationship and preserving intimacy.
Lozada: Yeah. And, I know that for anybody who’s hearing this, and hasn’t had a baby that this sounds like, and you’ve had the same experience that it sounds like, “Wait a second. How am I not even going to get out of my house in 60 days?” But, is the trying to rest the most important of the five? Are they exponential and built on each other?
Johnson: So in Chinese medicine, the essence is talked about in two different ways. And essentially if we are yin deficient, which often happens in the postpartum period, then there’s no life force to draw from. So the only way to replenish that is through resting and good food, but if you’re eating good food and you’re not really resting. So either that means you don’t have the… You’re not taking the time to rest or that when you do have the time to rest, that your body’s actually not able to down-regulate itself, which is where the foods and the touch come in and relating comes in, to help your system downshift. Then you can eat all the good foods and do all the rest of the things, but you don’t really have that essential life force essence to pull to the surface, to give you what you need for the healing process.
Johnson: And how you do it, is just like people are now knowing about meal trains, you put together a meal train and you put together a friend train and you ask people to come and visit you and stay with you. And you realize that this is not an individual experience. That even if you have only a so-so relationship with your mom or your mother-in-law, as long as it’s good enough that, you are going to need more help than you think that you will. New mothers need to be mothered. Everything that they’re giving to the baby, the loving touch, the eye contact, the vocal intonations, a new mother also needs that. So where is that mother getting it from?
Lozada: And I really appreciate that analogy of whatever you’re giving, it needs to come back. Somebody you needs to give you some of that back to you.
Johnson: Right. And we make a mistake because we think that because, where we are in our culture is like, “Genders are equal.” And all genders, not just the binary gender, so genders are equal. And so everyone should be able to do an equal amount of things. But anyone whose birthed the baby and been in any kind of remote partnership or even not in partnership, knows that it’s not equal. And so rather than trying to turn the other parent into an equal parent, it would be better that, that other parent protects the birth space, protects the mother. And makes sure that the mother has what she needs so that she can attune to the baby.
Lozada: So, in the concept of restoring, right, the more you can show up ahead of time, the less that goes away, kind of like, the less you have to restore. So what are some of the things that can be done during pregnancy to support that transition and help set the stage for this nurturing during the fourth trimester?
Johnson: Yeah. So I do recommend doing a postpartum plan. And what that entails, is just kind of number one, before you have the baby having a couple of conversations with your partner, just talking about, what do you think is going to be different? How do you both usually deal with stress? What expectations do you have of each other? What’s your realistic? What’s your not realistic? In the book, there’s even some conversation starters and ways to have that conversation. It’s great to research in your area, who are the pelvic floor PTs, get a pelvic floor physical therapy session scheduled. Because everybody thinks, “Oh, that my muscles are just too loose.” But is that true? And, is there scar tissue and do you need some rehabilitative work on your pelvic floor? Because essentially what’s going on in our pelvis affects our mental health, affects how we’re feeling about engaging with our partner, affects how we’re feeling about if it would be possible for us to exercise and what would be healthy exercise.
Lozada: When’s the good time to schedule that visit? I know the six week is when you usually see your primary care, but for a PT, should you wait until then or do it earlier? What do you think?
Johnson: I usually don’t see people till six weeks, just because I feel like that’s safer. If people really are having huge problems. Then I will make a house call, but I don’t really want women even leaving their house before six weeks. So I don’t want them to come to an appointment with me before then. And I just recommend that women, that you ask your practitioner for that referral because many doctors actually, it’s the confounding and it seems impossible. But a lot of doctors don’t really know about physical, pelvic floor, physical therapies.
Lozada: So you do the postpartum plan. You get your resources for pelvic floor PT. And once you have the baby, have somebody figure out how to schedule a visit, what other things can you do?
Johnson: Well, you can have a postpartum doula. You can save resources or ask family members rather than giving you baby clothes to contribute to your postpartum care, so that you can have somebody come to your house. Eventually, right now we’re trying to recreate something. We knew how to do this, we used to live in community and a hundred years ago, this was obvious. A woman had a baby and neighbors are just bringing over food because that’s what you do. But now we’re trying to restore these traditions. And so those of us who are at the forefront of it, we have to do a lot of educating.
Johnson: That’s why the book is helpful because instead of our moms feeling like, “Why are you… What’s wrong with you that you can’t take care of yourself? I didn’t get help, why do you need so much help?” It’s just, you can give the book and it’s a common resource that you can refer to. That gives the background on why this isn’t luxurious. Plus, we live in a culture that is so hyper self-sufficient, that asking for help is seen as vulnerability or weakness. And so we really have to practice doing that. It’s not comfortable at first.
Lozada: Yeah. And, I think giving yourself that permission to receive the help is a huge shift. I have a postpartum plan worksheet that I give my clients and it’s on the website too. And I actually call it, “A Postpartum Vacation Plan.” For as much as we’re hyper self-sufficient and go, go, go, go, and have to do everything stronger, longer, better. One of the things we do, kind of know how to do culturally is take vacations. And that’s the sort of mental space where we give ourselves permission to actually do nothing, to sleep in. So I find it’s helpful to reframe it as that, as like, “You’re going on a very weird vacation.” So I find that helpful, but we need a cultural shift. We, definitely figure out how to get people to be okay with doing this.
Johnson: Yeah. I think it’s such a huge conversation and there’s so many ways that we could be practicing it. If we were really resting one day of our cycle or on the new moon, and that really meant, going inside and communing inside, then we would have a little bit of practice at it, because it’s one thing to say, “I’m going to rest.” And it’s another thing to actually know how to rest. And most people are operating in a very high level of sympathetic arousal most of the time. And so to be able to downshift and surrender to that rhythm where you’re not being productive and you don’t have a, to do list, that’s getting checked off. And a lot of people have unknowingly connected their self-worth to those things. And so, it’s a radical shift for everyone and there are ways to practice this.
Johnson: I mentioned resting when you have your period, there’s also just slow exploratory sex, doing sex differently. Not having the kind of sex that’s about 20 minutes and you do me, I do you and you get off and I get off and we call it good. It’s, setting aside hours at a time because female arousal takes 45 minutes. We shouldn’t even be penetrated until we’re fully aroused. And a lot of women have never even experienced that. So allowing for that time of connection and embodiment and breathing and rhythmic cycles is another way to practice the downshift and the relaxation, the loose… I call it in the book, loosening your grip, loosening the grip of this solid identity. So again, we’re in the stage of reinvention. And I think a lot of people are realizing that we’ve moved, many people have moved away from formal religion and there’s a lot of attempts at sort of feeling what formal religion does for people, which is create a weekly ritual of community, of some kind of devotion to a higher power.
Johnson: And, we’re struggling as a culture to try to figure out how to fill that gap in and what goes there. So, it’s meaningful for people to get together, but what women really need is to hear each other’s stories. Women need to hear from each other, like, “What is it that you wish you would’ve known?” Or, “What is the message that you… When you went to the dark depths, what did you learn there? And what are you coming back with? And what can the community gain from that?” So, the last phase of a rite of passage is integration. And integration means that the person comes back from the proverbial mountain top, which in this case is the birth scenario. And you tell your community, “This is what happened there. This is what I learned. This is the animal I saw. This is the symbolism for me of what this meant.”
Johnson: And in Indigenous cultures, they consider that if you don’t have that integration phase, that, that person will be lost and that person perhaps will have psychosis because they won’t have any landing place for that new person, the new identity, it’s not the same person that comes back. So, that new person needs a home inside community. And that’s where we’re failing people. And what we see right now is the outcome of, a few generations of people not being recognized that this is a rite of passage, whether or not you want it to be. It is, and you can try to push it away and ignore it. But life is both generous and cruel in that way. I think of it as a revolving door, that door is going to come back and hit you in the back again, if you didn’t get it the first time. Women are doing more than ever, but haven’t given up any of their roles. And, many women are finding, they’re like, “Okay, so I got everything I thought I wanted. Why do I still not feel that great?” So this is, this amazing opportunity to repair those things
Lozada: And so much so, right. And that starts with giving yourself the permission to create that space of resting and introspection and of sharing. And, back to the five universal needs that you mentioned, with nourishing food and loving touch. So, is there something that we relating to restoring your vitality after birth that we haven’t mentioned yet? That is important for us to say?
Johnson: It’s a radical act as a woman to put our pleasure and our pelvis high on our priority list. And there’s a lot that stands in our way of doing that. And we come up with a lot of excuses not to do it. And when we talk about patriarchy and we talk about all of the things that need to change, we can change that as we center our own experience in this transition. And it’s not about being entitled, it’s not about being a princess, it’s not about being high maintenance. It’s about being real, about the gravity of the transition and its harder than ever before for women to have babies. Our birth practices in this country are not conducive to women having uninterrupted, physiological births. And so that adds to the difficulty in recovery.
Lozada: Absolutely. And, it is a radical act and it’s the first… As caregivers, your first charge of care should be yourself. Because otherwise the whole system breaks.
Lozada: In order to be able to continue to taking care of people around you, you need to be taken care of. And so thank you so much for being on the show today. It was lots of fun.
Johnson: Thank you. Thanks, Adriana.
Lozada: You’ve been listening to a Best of Birthful episode, and there are many more where this came from. Look for episodes with the words, Best of Birthful in the title, to continue your deep dive, to inform your intuition. You can find that in the show notes for this episode at Birthful.com. And you can also connect with us directly on Instagram, we’re @birthfulpodcast. Birthful was created by me, Adriana Lozada and is a production of LWC Studios. The show senior producer is Paulina Velasco. Jen Chen is executive editor. Cedric Wilson is our lead producer. Kojin Tashiro is our associate sound designer. Alie Kilts contributed to the Best of Birthful series. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Good Pods, Amazon Music, Spotify, and everywhere you listen and come back for more ways to inform your intuition.
Lozada, Adriana, host. “Best of Birthful: Restoring Your Vitality After Birth.” Birthful, LWC Studios, November 24, 2021. Birthful.com.
About Kimberly Ann Johnson
Kimberly Ann Johnson is a Sexological Bodyworker, Somatic Experiencing trauma resolution practitioner, birth doula, and single mom. She specialized in helping women prepare for birth, recover from birth injuries and birth trauma, and heal from sexual trauma. She is the founder of Magamama.com, an international holistic women’s health care resource for expectant and new mothers. She is the co-founder of the STREAM School for Postpartum Care, where she trains birth professionals, yoga teachers, somatic therapists, and bodyworkers to help women prepare for birth and recover from birth. She is the author of The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions and Restoring Your Vitality, which is out now on Shambhala Press.
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