The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality

by Kimberly Ann Johnson

A guide to help support women through post-partum healing on the physical, emotional, relational, and spiritual levels.This holistic guide offers practical advice to support women through postpartum healing on the physical, emotional, relational, and spiritual levels—and provides women with a roadmap to this very important transition that can last from a few months to a few years.Kimberly Ann Johnson draws from her vast professional experience as a doula, postpartum consultant, yoga teacher, body worker, and women’s health care advocate, and from the healing traditions of Ayurveda, traditional Chinese medicine, and herbalism—as well as her own personal experience—to cover   • how you can prepare your body for birth;    • how you can organize yourself and your household for the best possible transition to motherhood;    • simple practices and home remedies to facilitate healing and restore energy;    • how to strengthen relationships and aid the return to sex;    • learning to exercise safely postpartum;    • carrying your baby with comfort;    • exploring the complex and often conflicting emotions that arise postpartum;    • and much more.

Genres: Parenting, Nonfiction, Health, Audiobook, Self Help, Unfinished, Family

358 pages, Kindle Edition

Published December 26, 2017

About the author

Kimberly Ann Johnson is the author of the early mothering classic The Fourth Trimester: Healing Your Body, Balancing Your Emotions, and Restoring Your Vitality, published in seven languages around the world. A sought-after practitioner and lead authority in postpartum health, Johnson has been working hands-n in integrative women's health and trauma recovery for more than a decade. Her work has been featured in the New York Times, Forbes, Vogue, New York magazine's The Cut, Harper's Bazaar, Today.com, and many more outlets.

Her latest book Call of The Wild: How We Heal Trauma, Awaken Our Power, And Use It for Good will be available April 13th, 2021. This is part science, part medicine, part cultural-political work leaves readers feeling seen, inspired and empowered to live their most embodied lives by heeding THE CALL OF THE WILD.

Trauma educator and somatic guide Kimberly Ann Johnson has worked with women to understand their nervous system through somatic practices in sessions and through her online platform. The Call of The Wild is based off of her signature course Activate Your Inner Jaguar which has helped thousands of women explore embodied consent, healthy boundaries, and gain a real world understanding of the nervous system.

Reviews

[A. · Rating 1 out of 5]

A bizarre mix of Western entitlement, Eastern pseudoscience, and anecdotal postpartum fearmongering. This is truly the Goop jade vagina egg of pregnancy books.

[Private Account · Rating 3 out of 5]

If Johnson just told her story from beginning to end, and thoroughly explained her healing, this would be an amazing book. No need to tell me what I should do - I can make my own conclusions from hearing your story.

If you are going to tell me what I should do, I would appreciate more organization - to-do lists, time tables. This book does not provide any structure like that.

The exercises in this book, sadly, did not work for me. They just made my back hurt. That was a huge disappointment.

Fascinating that the author simultaneously says that being a vegetarian is a leading cause of getting yourself a massive birth injury and that's great if you're a vegetarian! Don't worry about it, if that's what works for you! Yay!

This lack of any real opinion, totally normal today, was disgusting throughout the book. Today's "mental health" advocates just tell everyone it's okay to be lazy and fail at everything. Fail at having an unmedicated birth? It's not failure! Don't worry! C-section births are just as ideal as natural births. Decide to abandon your kids? If that is what you feel you have to do, that's great! Don't judge yourself! Life is so hard! Don't worry if you fail at breastfeeding! Breastfeeding is so hard. It just doesn't work for some people. Formula is just as ideal if formula is what makes you happy (who cares about your kid). If breastfeeding doesn't make you just giddy with joy, then forget it!

No one tells the truth anymore. No one is capable of saying, "Breastfeeding IS the ideal for your baby, your relationship with your baby, and your own body. You CAN prioritize something above those things and use formula - it's not the end of the world, but I'm not going to tell you that it's great that you're too tired/lazy/selfish to learn how to breastfeed. I'm not going to tell you that formula is AS IDEAL as breastfeeding. It's not.” As a doula, Johnson sees it as her job, not to advocate for the child, not to know what is actually ideal and tell you to buck up and that it's not all about you anymore, but rather to ... tell you that it's okay to fail. It's okay to suck. You're still awesome. Vomit!

[Rebecca · Rating 2 out of 5]

I would not recommend this book for everyone. It may be worth reading so as to prepare for all the "what ifs" you may ask yourself about birth and healing (emotionally and physically). The book is meant to be read both during pregnancy as well as during the fourth trimester as a guide for the transition into the post partum trimester and new motherhood. Personally, I found the author's tone to be one of a glass half empty. I read this during my third trimester and I was left feeling like something, if not many things will inevitably go wrong during birth and the post-partum phases. At many times I found the author's approach to be discouraging and I had to stop reading for a few days to regain perspective and trust in my body's vitality and health. I don't believe it was the author's intention to discourage women but alas her book did a good job of making me feel like I WILL end up broken, either emotionally, physically, or both in not one but in many ways. I would have benefited from a more empowering tone. Yes, birth is a very physically intense process and healing is inevitable. Although, I would have liked this guide-book better if the author had centered on the theme that women are strong and resilient and then backed out into what ways one can heal from the multitude of traumas she explains.
I would recommend this book to anyone in the healing phases of birth and new motherhood and I would HIGHLY recommend it to those who feel isolated in their unique and particular healing process. In conclusion, for those new mamas still pregnant that may want to read or have just read this book; you and your body are not destined to fail or wind up broken, trust your body in this process and learn from what it teaches you after birth!

[Jessica · Rating 2 out of 5]

I didn't finish the whole thing because it drove me too crazy. There's maybe ten or twenty pages of good advice in here buried among all the woo woo stuff, but my patience for finding it ran out. TLDR: allow yourself to rest and accept help.

[Nicole · Rating 2 out of 5]

I read maybe 1/2 of this book pretty closely and then skimmed the rest. I'm bummed, because it's such an important topic--postpartum care is important and worth thinking about, and that's why it gets two stars instead of one.

The main thing that puts me off is that she gives a lot of specific medical advice, but the book's bibliography doesn't cite a single peer-reviewed source (except maybe one University of Chicago book published in 1960). I get that she is interested in alternatives to the medical establishment, but I was uneasy with how she was drawing from non-Western practices, too--I didn't feel I had any clarity about her method. The beginning of the end for me was a reference to a pretty famous John Gottman study about partners' relational satisfaction in the three years after having a baby. What she says: "Dr. John Gottman, a seminal researcher on parenting and relationships, found that on average there is a 67 percent decline in marital satisfaction in the first three years after having a baby." What the APA says in a report on the research: "After having a baby, 67 percent of couples see their marital satisfaction plummet, according to research presented at APA's 2011 Annual Convention by John Gottman, PhD, and published in the Journal of Family Psychology (Vol. 14, No. 1)." Those are very different things, and although the general point might be sort of similar, the sloppiness makes me worry about what might happen to me if I, for instance, followed her detailed exercise regimen.

Anyway, I had a hard time seeing most of the claims made in this book as credible, which is a shame, because, as many other reviewers have noted, if it were presented as more of a memoir with a collection of resources she's gathered, I think it would actually be more effective.

[Sarah · Rating 2 out of 5]

I love the premise, but the execution fell short. The book begins with a long story about the author's postpartum experience, which felt unnecessary. It goes on to include practical tips to care for yourself, reflection questions, and community stories about other's postpartum periods. It would best be read at the end of your pregnancy as there are tips to make birth easier, and that way you can start preparing for the postpartum period before it begins. I liked all of this. There was some New Age theories and verbage that is not my area of interest, but I was able to look beyond. I abandoned the book when the author, who says she was trained in "Sexological Bodywork," delved deeply into how to have sex.

I received an ARC from NetGalley.

[Jackie · Rating 5 out of 5]

I ended up loving this book, and I DEFINITELY didn’t think I would. I thought it would be all “earth mother” bullshit and would annoy me, but while it was a lot of earth mother, it wasn’t bullshit. Throughout my pregnancy and since my baby has been born, everything I’ve read has been about the baby; it was nice to read something that was strictly for MY health and MY relationships. You can’t take the best care of your baby if your own self isn’t taken care of. This book is going to be my new go-to gift for pregnant friends.

[Morgan Kahler · Rating 1 out of 5]

New age garbage.

[Laura Ilkiw · Rating 2 out of 5]

There were some minimally helpful chapters, but overall I found this book to be anxiety inducing for an expectant mother. There is so much emphasis on what can go wrong in a birth, and the suggested approaches for combating these issues do not seem to be rooted in science. A little too far out there for me.

[Veronika S · Rating 4 out of 5]

I wish I read this book BEFORE having the baby - not after. Some of the things suggested by the author are a bit too hippie/mother earth for me but overall it sends a powerful message and has a lot of useful tips.

[Mike & Brittni Holverson · Rating 4 out of 5]

Exhaustive to all topics postpartum, inclusive of most experiences birth and postpartum, and thorough to anything you could need to know.
Personally I did not enjoy this book. The author is more spiritually inclined to new age practices and mindsets that made me take most information with a grain of salt so to speak. That being said, Johnson has a vast knowledge of postpartum and I appreciated the exhausting of each topic. The subjects that I needed help with she did an excellent job on and I was able to walk away from this book with some nuggets of wisdom. Would I recommend it to every pregnant or postpartum mother? Probably not. If you have the ability to eat the meat and spit out the bones however then I have no doubt you’ll gain wisdom from something in this book.

[Emily · Rating 1 out of 5]

DNF 40%

I think this book would have been better for someone else more into holistic medicine/ birthing techniques. I am not that person, respectfully, give me all the drugs.

I wish it was more clear from the title that this is a crunchy moms guide to giving birth, not your typical every day moms guide to surviving birth and after, which is really disappointing because as someone currently in the third trimester, I really needed this info.

Also I can't respect any author that makes a woman feel bad for needing a C-section. The author wrote something along the lines of "Babies need to pass through the birthing canal to complete birth, or else their bodies cannot be equipped for the real world" and then to also say that mother's who get C-sections don't complete necessary birth acts and that's why they "struggle" post birth?? No. Respectfully, go f yourself. What a horrible thing to say to mothers who may already be struggling with the fact that they didn't get the birthing experience they wanted.

[Meredith · Rating 2 out of 5]

This book was a bit all over the place for me. I went to it for ideas on how to approach the fourth trimester but ended up feeling bombarded with a lot of content around pregnancy and birth that was random and unsettling.

I struggled to figure out where the book would go next - it jumped around from after-birth to birth to parenthood with pregnancy scattered throughout. I wanted a more cohesive structure.

I was drawn in at the start by the author’s story about having traveled the world and learned about the fourth trimester in different cultures. I would have loved a more on this.

I would also have loved more community stories and less of the author’s birth story which was honestly pretty traumatic. I thought by sharing it at the start she wouldn’t keep revisiting it but it kept coming back up. Given just how unique it was, it was hard to relate to.

I also found the discussion of c-sections felt like afterthoughts or inevitably negative experiences.

[Louise · Rating 2 out of 5]

Although some of the tips and recommendations in this book were useful, I was relieved to finish it, and I hope my mush brain will forget most of it soon. I understand that I need to be aware of the possible difficulties I will encounter during birth, and prepare myself mentally for the life-altering task that lies ahead, but I felt as though this book left me convinced that I will be left broken, with a failed relationship, and that I will need A LOT of money and specialists to help me recover. Perhaps this would have been better as an autobiography, at least to understand that much of what is written here is from the perspective of someone who suffered extreme trauma during and after birth. This is not to discount her in any way, but I wouldn't call this a guide to healing. It is rather a story of a person's journey, and you should take from it what is meaningful to you.

[Tiffany · Rating 3 out of 5]

I actually didn’t finish this, but I want it off my “currently reading” list. I forget what made me put it down and never pick it up again, but I think it had something to do with support systems I don’t have (but the book seemed to reference as vital to my healing, recovery, and integration) and an undertone of spiritual beliefs I don’t believe in. So I think it just wasn’t a good fit for where I was at with a newborn. There’s a lot of value in acknowledging the “fourth trimester” though, and a lot of folks I know found this very helpful. It seems to be standard reading for mamas who go the doula/midwife route?

[Liz De Coster · Rating 1 out of 5]

Yikes.

[Sierra · Rating 3 out of 5]

I'm conflicted. On the one hand, this is the most candid and "practical" book I have found so far about post-partum issues ranging from physical damage to one's relationship to femininity, perhaps due to the fact that very few books actually take on those topics. Before proceeding, I want to specify what I mean by practical: the book does have many actionable pieces of advice to help a woman heal. Whether you find this advice relevant or not is another issue, but the author makes a significant effort to lay out exercises that can be done alone or with a partner in order to recover and to ensure that the post-partum period is as smooth and perhaps even as enjoyable as possible. Now, it is true that the advice will be most relevant if you are economically and socially privileged. If you are a socially isolated mom who works two low-paid jobs in order to make ends meet, the majority of the advice may not be that "practical" due to many issues that the author points out, and laments, and that I won't discuss here.
Aside from the problem that the book may have a limited audience, I have to agree with several other readers that the content can be extremely new-agey and grants some eye-rolling with pseudo-science meeting science in a sometimes confusing way. Therefore, if you like evidence-based recommendations, this is definitely not for you. However, if 1) you agree that the US approach to childbirth may have its own defects from a public and personal health perspective, 2) you are interested in learning how non-US societies have traditionally approached the subject, perhaps to the benefit of mothers, children, and society in general, and 3) you are willing to explore which options can actually work for you in a more systematic/scientific way, I think you can enjoy this book.

[Marissa Perkins · Rating 1 out of 5]

DNF…I tried to finish, but it was too unscientific and new age/“woo woo” for me. There were a couple of good holistic viewpoints but would not recommend

[Lucia Calvo]

Although this book is highly informative about the biological process and recovery postpartum (which I think many women might just accept and take it as their new normal without trying to find help), I found it very stressful and negative. I was listening to the audio version and there was this constant urgency about all the possible ways the female body gets damaged during labour and the long lasting consequences requiring what seemed like a lot of work and professional help. Instead of finding it helpful, it made me paralyzed and feeling that without all that extra effort and persistent practice described I was going to be forever disabled in some ways. I'm not sure if this is a good book to read for a new mom to be who is already scared and really needs some soothing encouragement and grace. If you find yourself experiencing any problems after you deliver, you might want to look them up in this book and see the suggestions.

[Alison · Rating 5 out of 5]

What's not to love about a book that treads the complicated waters at the intersection of sex, trauma, and birth?

My body knows things that my mind has forgotten. Or worked hard to block out. Or reappropriated through narrative. Or tried to overcome through healthy relationships. Or never even was able to articulate in the first place. Or or or or ad infinitam. So now it's time to go back to the body and lovingly prepare it for the singular rite of passage that is giving birth. I have a lot of work today.

I will probably buy this book for a lot of people.

[Jerard Fagerberg · Rating 3 out of 5]

Definitely and important counter to the traditional thinking around the postpartum period. There is a lot of good wisdom in here, and it has the potential to realign crucial thinking in Western medicine. But it also falters in the way that so many other texts in the new age tradition does. The ideologies are inconsistent, and there is a near aversion to anything evidence-based. Johnson is not prescriptive, though, and throughout the book, the mentality of "you may want to apply this to your experience, you may not" prevails. For that, it is worth a read.

[Kate M. Colby · Rating 3 out of 5]

There are definitely some helpful aspects to this book, and overall, I’m glad I read it. I appreciate the reminder that pregnancy and the postpartum period are a short, transformative time in my life. And there were several useful exercises that I plan to use in my post-birth recovery.

That being said, I think this book does do some unnecessary fearmongering, and I don’t agree with the author’s blatant mistrust of doctors. I would say, as with all nonfiction books, take what is useful for you and leave what doesn’t sound good or helpful.

[Allison · Rating 5 out of 5]

Incredible resource. Johnson is tremendously smart, enlightened, empathetic. Not just a guide for the new mom, but for all of motherhood.

[Marian Kvamme · Rating 1 out of 5]

A super new age perspective on postpartum hyperfocused on feminist ideology and sexuality. Skimmed a lot of it because of the lack of useful content. My major takeaway is that the more complicated your past sexual history, the more rough your postpartum healing could be. Interesting how morality and general well-being are so often intertwined. 🤔

[Megan · Rating 3 out of 5]

2.5 stars... While there was a TON of great info in this book, there was also a lot that was a bit too woo-woo for me. It could have used stricter editing as well; it was disorganized and in some places Johnson repeated earlier parts of the book almost (if not) word for word, which came off as confusing to me.

[Blair · Rating 2 out of 5]

I liked the premise of this book which discusses getting mentally prepared for the challenges postpartum but I found too much of the information that was presented as 'fact' was really just anecdotal. Overall the book was just too disorganized for me to enjoy.

[Cappa Fogarty · Rating 3 out of 5]

I read the first 100 pages and then skimmed. This book is all over the place. The most helpful parts for me were the sections about maintaining closeness with your partner after giving birth.

[Marlee]

DNF - One too many mentions of cosmic energies. tapped out when it instructed to “lodge a divine prayer in your womb space”.

[Lelde Kaše · Rating 5 out of 5]

Lasot ienāca prata salīdzinājums ar peldēšanas metodi, kur nemākuli vienkārši iemet ūdenī spirinaties.
Deviņus mēnešus jaunā mamma lasa, domās gatavojas “peldēšanai”, dzemdības pielīdzināmas iemešanai ūdenī un 4.trimestris tad būtu tā spirināšanās. Rietumu sabiedrība, veselības aprūpe un arī pati mamma šajā periodā koncentrējas uz mazuli. Viss, ko mēs dzirdam par mammas stāvokļiem, ir noreducēts uz “pēcdzemdību depresija”, bet patiesībā sievietes ir neinformētas un neatbalstītas šajā “peldēšanas” procesā. Neviena no mums nezina kas ir sagaidāms mammai ne fiziski, ne emocionāli, reti kurai ir resurss tam vispār pievērst uzmanību, vēl retāka saņem reālu atbalstu. Šajā grāmatā fakti mijas ar dīvainām cilšu un austrumu gudrībām. Un tomēr šis ir plašākais avots, kur esmu jutusies saprasta un kaut caur grāmatu atbalstīta.

[Suzanne De · Rating 3 out of 5]

2,5 ster. Deels hele nuttige informatie. Deels erg zweverig. En had de helft korter gekund.