The Fourth Trimester

A Gift to Christian on the Birth of his Daughter

Thank you God.

It's the only thing in my brain. There is not a single other thought. There is no room for love, exhaustion, or amazement. There is only tremendous, humbling gratitude.

Ten minutes ago: I sit in the operating room holding the hand of my wife. The OR is walk-in-freezer cold. It's a giant tiled bathtub designed for the single purpose of being easy to clean. Easy to get blood off the floor. My wife looks at me, petrified, as the near-silent, mechanical physicians pull my son from her tired body with great heaves and violent tugs. I have no enmity towards these doctors and nurses. At this moment -- this exact, narrow, electrically thin moment in time -- I want the humans on the other side of the light-blue paper screen to forget their biological heritage and be nothing but automatons. I want them hardened and finely honed. I would not care what injustice, insensitivity or crime-against-humanity they commit, as long as my wife and my son survive.

I close my eyes. I hold back tears. She needs me to be strong, to be present more than I have ever been before. I pray. From a place inside I did not know held much belief, I pray with truth and honesty. I beg and I promise and I bargain and I plead.

After the wet and pain and cold subside, I am a dad for the second time and my wife breathes in and out with peace. Thank you God.

It was hard. Both births compressed a lifetime of energy, angst, and focus packed into a combined 60 hours of labor and one to-close-for-comfort trip to the the sterile room. An outlier birth story to help the bubble in the the bell curve for the rest of the world's women.

Looking back, I should have saved the depth of my prayer for the 90 days after the event. Human children require a full year of gestation; the last 3 months just happen to be outside the womb. Babies are simply not done yet. They are tomatoes: apparently complete on the outside, but just a nasty mess of confusion below the surface. It may be less intense, but that fourth trimester as a new parent can be more stressful than the intensity of the miracle itself. I don't honestly know where I found the strength to do it that first time. Perhaps deep inside all of us there are parenting ready-reserves called up for the task -- a remnant from our days as cavemen, where intensity-on-demand meant survival in the face of an angry wildebeest.

7 years later, I hardly feel the expert. No Dean of Parenting has lowered a doctoral hood onto my shoulders. There are fathers who have more calm, more cool, more sense of "getting it" than I ever will. But I am where I am. I am unabashedly proud of my kids and my wife, and I believe I have had more good days than bad, and that's all I can hope for.

Since then, I've seen dozens of friends, many much younger, face the wall of the fourth trimester. Last night, another friend, a young mid-20s man of faith and intellect, nervously sired a baby girl. Christian, here's all I can think to give you of any worth -- the one liners and mantras that have guided me through the darker moments. Perhaps one -- just one -- will ring true and help someday. Then I will consider this a worthy gift.

Care and Feeding: You

-- You do not need the advice of every relative and friend. Never listen to anyone unless you want to. They are not "your kids" in the way that that Toyota Prius is "your car." They are your uniquely sacred trust, and to hell with anyone who thinks they can walk a mile in your shoes. Default to ignoring everyone, including me. Extract what wisdom you can, and leave rest in the dustbin where it belongs.

-- You do not need endless reserves. You need to breathe. That's what the well-meaning hippie woman told you in the birth class, but she got the target wrong. Your wife remembered how to breathe, I'm quite sure. You're the one who needs to remember, every moment of every day.

-- You do not need to know what to do. You only ever have to figure this out a single day ahead of your kid. The day you get home, the only thing you need to know is how to protect her, feed her, clean her, clothe her and love her. College and boys (and firearms) are years off. You can figure it out then.

-- You do not need anything you buy from Walmart or Babycenter or anywhere else. You do not need a butt-wipe-warmer. You do not need a swing, a sling, a high chair, a diaper changing table, a fuzzy floor mat, hundreds of cute little pink outfits, a crib, a mobile, a baby bathtub or a night light. You need love and food. Everything else can be improvised, and is often better. By all means, use what works, just don't pretend you need it.

-- You do not need a sense of self. Just this once, subvert your ego. It's all too easy, as a dad with strong will and a quick mind, to build resentment in your heart -- to wish that things could be the way they were. Let it go. Embrace no-mind. You have become a Buddhist, in addition to whatever you were before: Christian, a Jew, an Atheist, or a worshiper of the FSM. Embrace it. Cherish it. Grok the lack-of-self in fullness.

-- You do not need to be "on" all the time. Create time: time for yourself, time to be with your wife, time to play games and sing and dance and pray. Your mother, mother-in-law, best friend -- they are all wired with protective genes. If you love them and trust them, let them be with your child while you remember why you had kids in the first place. Do this from the very first day you get home, every once in a while.

-- You do not need pink, yellow, baby blue or lavender anything. Eschew color. Every child I know that is surrounded by clean white blankets, clean white towels, clean white clothes and leftover shirts from dad's old-clothes pile is a happier baby. Plus, they look better in pictures.

-- You do not need all those toys. If it's plastic, and it takes batteries, throw it away.

-- Embrace pornography.

-- Only one of you has to be the man in the yellow hat at a time. The other one can be the monkey. Takes turns.

-- Go into the corner, alone, and just cry sometimes.

-- Only play games when your wife is asleep. Of course you should be sleeping too.

-- You can play a game with a child on your lap, or even better, strapped into a chest pack. This is a good time not to play Gears of War and Counter-Strike, but perhaps something tamer with pretty colors. Like Magic or Brettspielwelt.

-- Your in laws are now your very best friends in the world. Your daughter has given you phenomenal leverage with them for these 90 days. Use it.

-- If you're not careful, you will throw your back out getting the infant car seat in and out of the back seat. This will happen precisely between 4 and 6 months from now. Your wife will have built up her back-strength doing this movement many times a day. Help her out, start progressive weight training (babies get bigger!) keep yourself healthy.

-- If it all gets too much -- if there are no words that matter, no prayers that bring the peace with passes understanding, nothing that will make the tension ease -- just walk away. Give everyone a breather. Put her in the crib, send your wife to the basement and you go sit in the attic. There's rarely a reason to panic, and the panic will only make bad things happen.

Care and Feeding: Momma

-- If Momma's happy, everyone's happy.

-- Breast feeding is hard. Very hard. One bottle a night, so that Mom can sleep, will not do any harm, and it will do a lot of good for your wife.

-- If breast feeding is not to be, by choice or biology, understand that there will be guilt, acknowledged or not. Let it go. What works for you and your family is what is right. Period. End of story. There will be others out there who feel it's their duty to berate her for this choice. She is entitled by law, and required in some states, to punch them in the side of the head. Repeatedly.

-- Post partum depression is very real. She is not crazy. This is especially true if she's not breast feeding, as the intimacy that comes with breast feeding every 11 minutes is missing. I've never figured out anything you can actually do about it other than be on your toes and love the crap out of her and the baby. See note about becoming a Buddhist.

-- As soon as possible, encourage her to join the cult of new moms. My wife established a rotation of having coffee, knitting circles, play groups, grocery shopping with friends, etc. This is doubly important if this is the first time shes taken a bunch of time off work. If she has no friends with babies, find some. Long distance runners got nothin' on new moms when it comes to feeling lonely.

Care and Feeding: Baby

-- Like dogs and horses, babies smell fear.

-- She doesn't know what to do with her body. When you strap her into a chest carrier, or a sling, or an improvised bed-sheet-salvaged child-holding toga, you are bringing her close and holding her the way she remembers being held for 9 months. When you wrap her tightly like a psychiatric patient in swaddling clothes, you are quieting these spastic-flesh-puppets called limbs that she doesn't understand, and allowing her to simply be. This is not cruel. It is a gift.

-- Stimulation is a fickle beast. Her little neural network just doesn't know how to process the data yet. A little stimulation -- one sense at a time, is a good thing. Lots of stimulation can be a convenient overload-and-shutdown mechanism. In the middle lies madness.

-- Start her musical education today. My children think that the Clash and the Sleater-Kinney are lullabies. I don't know a single adult that actually enjoys those "nap time CDs."

-- Listen to Elysium for he is wise. Babies cannot be reasoned with. They are selfish. And attempting to save your back by transferring your sleeping child into her crib is like "rubbing your body in bacon grease and playing with feral wolves."

-- The umbilical cord stump and the first 5 diapers are the most disgusting part of being a parent.

-- The next 90 days are not the time to become an environmentalist. is much more important than

In Xanadu did Kubla Kahn his Stately Pleasure Dome Decree: (aka Sleep)

-- Your child will sleep. They will stop crying. But very often there is nothing you can do to make them stop. That's OK. Crying is exercise for babies. Invest in extremely good earplugs, then put headphones over them. Then love your child. Exodus contains no commandment that "thou shalt make the baby stop crying." Just stare at them from your induced cone of silence and ooze love into her little heart. It's all you can ever really do.

-- Do not drive your child around at night to get them to sleep. You will join the ranks of dads who crashed their cars at 3AM.

-- Babies, and really children of all ages, thrive on structure and routine. From the very first night, we established a simple bedtime ritual, and the idea that the darkness was the safe place in which you slept. It may take some time before these routines and structures seem to matter, but they will.

-- Babies have no circadian rhythm. They do not know that night is night and day is day. While your child may not care to sleep, establishing a pattern where it is dark and quiet from 7PM-7AM sets you up for success.

-- If you wait until she makes two little snuffling noises on your shoulder, she's down for two hours. Drop the tike on the carpet and rejoice (quietly).

-- There is no perfect solution to getting your baby to sleep through the night. That said, letting the kid spend 7 hours trying is not necessarily a bad thing. Eventually they figure it out. She will not suffer a life of expensive therapy bills because you let her learn how to go to sleep without a hand on their back for 5 hours a night. See note about earplugs and headphones.

-- There's rarely a need for both parents to be on call at night. Make a simple schedule: one of you gets earplugs and possibly a bed on a separate floor. The other one takes the duty. There should be no guilt in this for either party.

That's it. That's all I know about this 3 month window. It's not much of a gift, but it's the best I can do. Nobody can teach you how to be a dad. There's no manual. There's no degree. There's not even an Indian company you can outsource it to. But it will all be OK. In two years, you will have forgotten the stress and anxiety, and you will revel in the miracle that is your child. You will know the unquestioning love that only a child can give. You will be the single most important person in another human's life, and no matter what you think, this is true of nobody but you kids.

It's a cliche to say it's all worth it. When I was in that fourth trimester for the first time, people told me and I didn't believe them. It was plain God-damned hard. I had moments of resentment and anger and anxiety and bile and despair. More than once, in the endless night, I felt I could not go on.

But I did. And you will too.

P.S. - Don't forget the earplugs and headphones.



I vividly recall thinking that raising an infant was the hardest thing I'd ever done, and yet it didn't seem to be much trouble to many not super impressive people. It was a very humbling thought.

We're about two months out from starting round two here. I'm hoping experience really helps.

Starting round two meaning wifey is due soon? That's great news.

He's 8 weeks old at the moment and we've started teaching him to get to sleep on his own. Late afternoon / early evening is sometimes a 4 hour long howling session. Physically and emotionally draining.

I made a little progress yesterday. When he wouldn't stop crying and nothing would soothe him I just lay him down on the bed and lay down next to him making soothing sounds and let him get on with it. I figured if I'd checked everything and didn't know what the cause was then I needn't feel guilty about it and might as well be comfortable and just present. Made things a little easier.

Swaddling is a life saver, sometimes.

jonnypolite wrote:

Swaddling is a life saver, sometimes.

Swaddling was great for our little guy but now that we need to stop swaddling (16 weeks and he is supper close to rolling over) it has been hard to stop the swaddling, he doesn't like it and tends to hit himself in the face and wake himself up. I can also strongly recommend the Halo swaddle sleep sac it has been great.

My wife keeps reminding me to soak this period of his life up as much as I can. He will not be this little for long and for the other kids to come we will not be able to focus as much on the baby because the older children will need attention too.

My son is just starting to show his discontent with just cuddling and sleeping in my arms I know I will miss him sleeping on my chest while I lay in the recliner...

Stellan hates being swaddled. He's also rolling over now and putting his hand in his mouth so we're unlikely to convince him of its benefits now.

We're getting there. Building a sleeping ritual and determining the bare minimum amount of intervention we need to soothe him at any given point.

A friend wrote this the other day about the birth of their first child.

Babby #2 is 15 weeks today. We should have exited the 4th trimester, but I'm not sure it feels like it. Starting teething probably isn't helping matters.

TheWanderer wrote:

Starting round two meaning wifey is due soon? That's great news.

Yes, we're expecting a boy around late February.

And stay strong, nivek! I've seen friends of mine demonstrate strength I never knew they had through similar situations. And seem to grow stronger in their marriage at the same time.

There is no magic bullet on sleeping. My daughter (12) still has issues. my son, 8, is a rock.

But it seems like your on the path. A lot of parenting is just showing up, being present, oozing love, and making it up. Earplugs, or earbuds with heavy metal on.

Fedaykin98 wrote:

We're about two months out from starting round two here. I'm hoping experience really helps.

It sure does. While we were convinced that we'd somehow kill #1 through negligence or ignorance, #2 suffers from a lack of doting since we've learned that he can survive falling on his bum while learning to walk or even a bonk on the coffee table. He's made it to 2.

nivek wrote:

I searched for this article back in August before our daughter was born and tried to keep it in mind since then.

We're just past the 4 month mark at our house - about 4 and a half months. At two and a half months, our baby girl had to have open heart surgery for a VSD, an ASD and a PDA. For those of you that haven't had the pleasure of spending time with a pediatric heart surgeon, that's a hole between the left & right ventricles, a hole between the left & right atria, and a leftover connection between the aorta and the pulmonary artery that didn't close up after birth.

She was born with Down Syndrome and heart defects are very common among babies with Down's.

People say the damnedest things when they learn that your baby girl has Down's.

"Didn't your wife get the test?"
"She doesn't look like she has Down's."
"I couldn't handle that, I would have terminated."

Thankfully, most folks have tact filters installed and there have been a handful of people that have helped me understand that it's not as bad as most people think. She is actually far more agreeable than my son ever was at her age, and much more likely to fall asleep on dad's shoulder.

I think of her as our little good luck charm. She got through with no complications and came home eight days after surgery. Her heart defects prevented her from crying before the surgery, and I've only heard her cry a handful of times since; when the nurse would stick the tube down her nose to clear her congestion, and bathtime. Her mother and I have cried far more in the past four months than she ever has.

I want to get her a t-shirt that says "Heart surgery? B*tch, please."

I think I've only managed to get to this point because I tend to live largely in the present. I don't remember much from the week in the hospital (which was an amazing place full of amazingly talented people) except for these things:

  • Swallowing hard after seeing baby girl for the first time after the surgery, with no less than 17 tubes and wires attaching her to three large machines silently ticking away beside her.
  • Each time one of those connections got removed. It became a very helpful countdown to the trip home.
  • When Momma went home to be with our son and I spent the night alone (well, you're never REALLY alone in PICU) with her and baby girl learned how to hold on to dad's finger.
  • "There is only tremendous, humbling gratitude." When the surgeon, Dr S., would come in and visit her, he would stand there silently looking at her for minutes at a time, holding her foot. I've never seen anyone look so intently at anything before. I've met people before who gave me the distinct feeling that their silence indicated their brain was moving much faster and more accurately than I could ever comprehend. He was one of those people.
  • The asiago cheese breadsticks and the clam chowder at the Au Bon Pain in the hospital. Damn. I gained about ten pounds that week.

Thanks again for this article, Julian.

Oh, and thank you Elysium for this post. I read this shortly before the surgery. A lot of the info there is relevant, no matter what age the patient is.

So hang in there, new dads. Julian is right.

Topic, post, link. This is the epicenter of dustiness.

Point taken, Ghostship, thanks

Moving my post to a new thread...

Our little girl is almost 20 weeks old now. We have had major issues with reflux and constipation when she was 2-3 months old, where she was in extreme discomfort and would cry for hours on end. During that time, one thing that would soothe her was sleeping in her (moving) swing. We've turned the corner on the reflux and feel that issue is well resolved with medicine.

However, we had developed some poor sleeping habits during that time, as we were doing about anything we could to get her comfortable and sleeping. As of a few weeks ago, she was sleeping only a few hours during the night, waking up to eat 3-4 times, and sometimes even refusing to sleep in the swing, which had worked well before. She was very fussy and irritable, and a lot of that was due to being tired, some was due to reflux, and we're suspecting maybe an allergy to something in breastmilk (we are currently using a hypo-allergenic formula, but hoping to switch back to breast feeding soon). My wife was exhausted, and getting quite frustrated.

We asked friends and family for advice, and also read several books. Unfortunately, we heard something different from everyone we asked. Opinions ranged from crying it out, to adding cereal to her bottles, to inclining her mattress and so forth. Some of the books directly contradict each other, so it's hard to know what the right things to do are.

We finally decided to enlist the help of a professional nanny, as nothing we were doing was working, and had her in our home for several days two weeks ago. The nanny helped us break the dependence on the swing, and helped to get us started on a schedule of napping, and develop a bedtime routine. The first few nights of that were rough, but for the past week our baby has been sleeping two ~6 hour stretches at night in her crib. We still are having to swaddle her to keep her asleep (she goes to sleep fine without the swaddle, but won't stay asleep for more than a few minutes), but we're hoping to break her out of the swaddle once we're well established on the routine.

Anyway, now we have a happier baby, who is sleeping for 14-18 hours a day (versus maybe 6 before) and a much happier momma who is able to get some sleep of her own. There's still work to do, but we're on a much better trajectory than we were a few weeks ago.

Great update, Ben! I wonder if one of the things that nannies have over first-time parents is just the ability to be unfazed by crying, screaming, etc. We had friends over last night who have two kids now, and they confirmed my suspicion that a big part of the second child being easier is just that you don't stress as much since you've been there before.

I told my daughter today not to stand up in her chair because she might fall and really hurt herself (she's 2 yrs and 4 months).

She said "It's okay, I have a good doctor."

So after a weekend of him not going down to sleep for hours at a time that left me incoherent with frustration it looks like he's actually ill and in a lot of pain. The whiplash of emotions that hit me with is almost impossible to describe.

After spending hours waiting at the hospital and cuddling him to my chest for hours so he could eke out some sleep I have now crossed a threshold from objectively understanding the depth of my responsibility to this little guy to Grokking it in Fullness. Nothing else has ever needed my everything so much.

Yep. That's what this is. Strength, brother.

Maq wrote:

So after a weekend of him not going down to sleep for hours at a time that left me incoherent with frustration it looks like he's actually ill and in a lot of pain. The whiplash of emotions that hit me with is almost impossible to describe.

One thing to be aware of is that small children generally have problems identifying the source of distress. Our daughter who's 3 1/2 now still feels earaches in her tummy rather than her ear, so when she says her tummy hurts it might actually mean an ear infection. One of our other kids (21 months) is just stoic--she's has a full-blown double ear infection and didn't complain about pain at all, though she was grumpier than usual. So a lot here comes down to learning how your kid reacts to stimuli and finding ways to suss out what's actually going on. Sometimes questions work but they have to be worded extremely carefully or the kid will generally just agree with you on impulse.

Wow. When they start smiling at you it really changes huh? That's a barrier I didn't know existed. Until now it's been all negative or neutral feedback - now he actually smiles back we're getting positive feedback as well. Amazing feeling. Tears of gratitude and relief.

So true!

I find that the more I read the more I fight spiraling into freak-out town, so that's good.

Maq wrote:

Wow. When they start smiling at you it really changes huh? That's a barrier I didn't know existed. Until now it's been all negative or neutral feedback - now he actually smiles back we're getting positive feedback as well. Amazing feeling. Tears of gratitude and relief.

Wait until they start laughing!

Wait until puberty!

rabbit wrote:

Wait until puberty!


We find out their sexes on the 17th. Part of me is hoping for girls but another part of me (the part that read that post) is really not =)

Maq wrote:

Wow. When they start smiling at you it really changes huh? That's a barrier I didn't know existed. Until now it's been all negative or neutral feedback - now he actually smiles back we're getting positive feedback as well. Amazing feeling. Tears of gratitude and relief.

We went though this just a couple months ago, went from thinking we had the most serous thinking baby to now he smiles *most* every time I start talking to him. The other first that was amazing was the first belly laugh that was a few weeks ago for us and my wife couldn't get the video camera going fast enough

oilypenguin wrote:


We find out their sexes on the 17th. Part of me is hoping for girls but another part of me (the part that read that post) is really not =)

Brian, Congrats I missed the news (having a kid seem to reduce the amount of time I spend on the internet...) about the work in progress, and not just one

When is the Gamers with Kids spinoff set to launch?

I have a 19-month-old, and gaming has been a forbidden pleasure for some time now. It's not so much lack of time as just plain guilt. I'll play games that are inconspicuous to my wife. But I just feel guilty if I'm spending time on something that's not work or family related. (Games with Kids AND Jobs?) It doesn't help that our in-laws are far away or absent, and so we're a bit stranded in our own little nuclear family.

That said, I recently re-fired up Dance Central for the first time a year on the justification that I'm getting FAT (winter putting a crimp on the stroller-jogging). I've put in a lot of hours into GOG games that I can run on my underpowered laptop (that is, inconspicuous games). And I'm ashamed to admit that I've even been playing Facebook games.

What I would give to have 20 uninterrupted hours in Skyrim!

Well, I wouldn't give up the time I do spend with my son.


For me, having an established bedtime for my daughter is key. It's good for everyone. Afterwards, my wife and I have a couple hours to spend time together or separately, doing whatever we like. That's when I fit in 2-3 hours of gaming.

I double-post for regular bedtimes!