The Fifth Trimester :: Navigating Anxiety Four Months Postpartum


post partum anxietyThe Trimesters of Motherhood.

Each one comes with its challenges and joys. Every woman who has been fortunate enough to carry and birth a child has a different experience with how they navigated each of those three month marks. After the first 9 months are up, you come face to face with the new little life you have housed and grown. This is when you enter into yet another trimester, one filled with all of the postpartum healing and the newness that comes with having a newborn.

You might have never heard of the 4th trimester, but it is a period of time that every mother and baby will experience together. Personally, this fourth trimester was my favorite stage of pregnancy/postpartum. Our baby was here, we were home from the hospital, I was on a 10 week maternity leave, a meal train had been set up, and our family and friends joined forces to make sure we were taken care of. For an extroverted woman like myself, this fourth trimester was a dream.

Yes, it came with its challenges of sleepless nights, breastfeeding trials and errors, and maternal healing; however, it was the period of time when I felt most at peace with where I stood as a mother. It was a time when I could give myself grace for not keeping the house spotless, and one where there was little to no guilt for sitting on the couch all day snuggling my newborn.

Ode to the Fourth Trimester

As the end of my maternity leave neared, I tried to stay present and savor the time I had left at home with my babies, but it was much harder than anticipated. I found myself on edge and surprisingly anxious thinking about how we were going to navigate life after I went back to work. I tried to remind myself that women do this all the time, and I knew they did, but that didn’t make the transition any easier for me. With my first son, that 3 month postpartum mark was seemingly more difficult than with my second.

Being a new mom and leaving your newborn in the hands of someone else for 8 hours of the day, 5 days per week comes with a wave of emotions and mom guilt like no other. Not only was that difficult, but trying to navigate how to pump at work was one of the hardest things I’ve ever done!

With my second, I knew that going back to work was just like riding a bike—or getting back on the horse—it was second nature, if you will. It was something that I had to do whether I dreaded it or not, so with the help of lots of positive self talk, I made the choice to jump right back in to working life and embraced the transition with ease. (Or so I thought. Now, when I look back on that time, I realize how much my brain and my body were running on automatic in an attempt to protect themselves from this big transitional moment.)

The Wake-up Call

I remember the day very clearly. It was New Years Eve. I woke up that morning feeling slightly off but I chalked it up to the 4 month sleep regression, the fact that I had returned to work earlier that month, we had just celebrated my oldest son’s 3rd birthday, and we had just put our house on the market to sell. After a morning spent at the park, I started to not feel well.

My heart started to race, I became dizzy, and my vision started to blur. In a state of panic, I managed to get my oldest down for a nap and my youngest in the bouncy seat. While sitting on the couch I tried to use all of the self-taught coping mechanisms for anxiety, but this time nothing was working. I started to shake uncontrollably, my hands and feet went numb, and if I am being completely honest, I felt like I was dying. Had it not happened during the year of heightened COVID cases, I would have gone to the emergency room immediately. Thankfully, after a few hours of agony and a looming feeling that a heart attack was surely insight, I was able to calm down and rest with the help of my mom and husband.

Fast forward to a month later, after a visit with my primary care doctor and several normal lab results, it was confirmed that what I had was a panic attack. These attacks are not foreign to me. I’ve suffered from anxiety since I was in elementary school, but never had one hit me this hard. This episode shook me so much that I knew I had to really take my mental health seriously.

The Fifth Trimester

So, what now? After talking with several friends who are also mothers, it turns out that I was not alone in my struggles with anxiety at the 4 month postpartum mark. One of my good friends actually referred to this time filled with hormonal shifts, changes in your baby’s sleep patterns, and a return to work for some as the fifth trimester. I can honestly say that it took the full trimester for me to start to feel like myself again. It was so comforting to hear from mothers with similar experiences, but I was still left with the question of “what now?” My body and mind had gotten my attention loud and clear, but I didn’t know what further steps needed taken for my mental and emotional health to be stable enough for me to be the best mother I could be.

I’ll be really honest here—I was so adamant about preventing another paralyzing panic attack that I looked for a quick fix first, one that ended up truly saving my mental health at that time. Yet, starting an SSRI came with its own waves of guilt and shame for having to depend on a medication to help me get through the day stably. Once I started taking it, though, I remember feeling like a thick fog had been lifted from my eyes. It was like I was finally skimming the surface of life with a little ease rather than just barely keeping my head above the water.

Prioritizing My Health

With fresh eyes I was able to see the need for other outlets to keep my mental health in check. I found that for me, being outside in the sunshine and doing physical activity worked wonders for my anxiety. I also decided to give therapy a shot, but to be completely honest, it wasn’t something that I could afford financially or time-wise in the long term. (This might lead to another blog post about the sad reality of the lack of funding for affordable mental health therapy and the financial burden that taking time off work to seek these services brings with it.)

Medication and physical activity, paired with rest and my brief time in therapy—that I’m hoping to start back again—were the perfect recipe for a thriving, not just surviving, mama. If you find yourself in a similar situation feeling on edge, out of touch with your emotions, and like you are just trying to get through the day without breaking down, you are not alone. I encourage you to dig deep and prioritize YOU. A good friend once told me that we can’t pour from an empty cup, and I still cling to that truth daily when I notice that my full mug has dwindled down to just a few drops.


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Hannah Trammell
Meet Hannah Trammell! She was born and raised in Birmingham, and while college took her away to Kentucky, she eventually found her way back home to the magic city after graduating. She and her husband currently reside in Roebuck springs with their two wild and crazy boys Franklin (4yrs) and Amos Jon (17mo), and their sweet German shorthaired pointer Leita. They’re an outdoor loving family and some of their favorite memories together have been made hiking, camping(both of their boys went on their first overnight camping trip at 3 months old) taking cross country road trips out west, exploring national parks, and riding bikes. During the week Hannah is a Spanish interpreter at Children’s hospital. This month will mark 8 years since she started working at Children’s, and while this occupation has proven to be extremely mentally and emotionally challenging at times, especially once she became a mother herself, she states that, “it has been an honor to use my language skills to directly serve our Spanish speaking families who walk through our hospital doors.” Her childhood was filled with Latin influence thanks to her precious Puerto Rican abuela, but her love for the Spanish language really flourished in college. Now, 8 years later, she is a Nationally board certified medical interpreter. Her husband Taylor is also in the medical field and owns a small independent retail pharmacy in Crestwood (Crestwood pharmacy and soda fountain) where he operates as the best community pharmacist she knows! When she’s not spending time with her family or working, she finds joy in thrifting and making old treasures new, running, reading, dancing, and in savoring a cup of super hot and creamy coffee at home. She has always enjoyed writing and feels that she expresses herself best when she can get her racing thoughts written down on paper. Hannah is so excited and thankful to be a part of this group of diverse Birmingham mamas and she looks forward to sharing her words with other moms in Birmingham