An Interview with the Author of The Fourth Trimester: A Postpartum Guide

For new or expectant mothers, there are a vast number of resources available that offer guidance, information, and support throughout the three trimesters of pregnancy.


But what about the fourth trimester?

If you’re scratching your head, thinking, “There’s a fourth trimester??” – you’re not alone!

Before reading Kimberly Ann Johnson’s newly released book, The Fourth Trimester , I was under the impression that there are only three trimesters that exist during the course of a pregnancy.

However, after totally devouring Johnson’s eye-opening and heartfelt book, I now have a deeper understanding of the highly overlooked and under-acknowledged fourth trimester of pregnancy.

Rather than try to explain to you the importance of this often-forgotten aspect of pregnancy and motherhood, I thought it would be even more meaningful to hear directly from the author herself!

I was lucky enough to speak directly to Kimberly Ann Johnson for an intimate look at the experiences that led her to write this book, her thoughts on the fourth trimester and postpartum, and her advice for any new mothers who are struggling.

Before we jump into the interview and hear from Kimberly herself, let’s take a moment to clarify what the fourth trimester refers to.

The fourth trimester is a term that can be used to describe the period of time following the birth of your baby, otherwise known as postpartum.

And while there is a plethora of resources covering postpartum depression or caring for your newborn, there is a severe lack of information on the physical, emotional, spiritual, and interpersonal journey that mothers embark on after giving birth.

Johnson covers everything from preparing your body for birth and healing it after birth to strengthening your intimate relationships to exploring the complex emotions that surface postpartum…and so, so much more.

So, without further ado, let’s hear from the author of this revolutionary and critically acclaimed book and dive a bit deeper into The Fourth Trimester.

MC: Why do you think that the topic of the 4th trimester and the postpartum timeframe is so overlooked in our culture?  How would you like to see this changed and improved?

KAJ: This is a HUGE question. Women’s health has been seen as derivative. In Chinese medicine, women are considered 10 times more difficult to treat than men. That is because our reproductive systems, endocrine systems and therefore immune systems are more intricate.

Two main reasons:

  1. Everything required for the postpartum period is the opposite of what our culture values. Our culture loves productivity, speed, fast results, image. The postpartum time is slow, inward, the long game, and not too attractive. In many ways, the postpartum time represents our cultural shadow, and for that reason it can be a great teacher, and the medicine that we all need. If we can learn to slow down, to attend to our most fundamental needs, our world will change, how we relate to each other will change, the way that we treat the Earth will change.
  2. Women’s sexual health and pleasure haven’t been considered to be important outside of bearing children until recently. Also empowered women, in command of their full sexual expression, are considered dangerous (look what has happened to midwives and witches). Only now, RIGHT NOW, at this historical moment are we waking up, and saying this isn’t good enough. We want to be connected to ourselves, our children AND our partners. We want to heal the Madonna/ Whore divide. We want to be sexual mothers.

 MC: I read that you had a fairly difficult childbirth yourself which played a role in your writing this book…how did you recover after your experience?  What did you find to be the most helpful in your recovery?

KAJ: The birth itself was not especially difficult- the recovery was epic. I had a perineal tear that didn’t heal well and resulted in all kinds of pain and problems. I was confused because I felt depressed, but I knew that it wasn’t chemical. When I searched the internet, all I found was validation that postpartum depression exists, but nothing about what the postpartum period actually IS, what is archetypal and universal rather than individual. I couldn’t find anything on how to heal physically from birth

The most helpful modalities in my healing process were Sexological Bodywork and Somatic Experiencing. In three sessions with my mentor, Ellen Heed, most of my symptoms resolved. Somatic Experiencing furthered the renegotiation of the trauma in my birth experience as well as the duress of the first two or three years of postpartum confusion. Having zero information about the postpartum time as a special one is its own kind of trauma. It is a cultural black hole.

 MC: I also read that you did some travel to explore various postpartum practices prior to writing this book.  In your travels, what did you find to be the most inspiring/memorable/meaningful?  Why?

KAJ: In India, a friend brought me to her house. In the corner was her sister lying on the floor with a newborn, swaddled in cotton. I remember the golden light, that special postpartum glow that is part of the Sacred Window- another name for the Fourth Trimester. That new mom had returned to her own mother’s house to be taken care of away from her husband and her house duties. I remember the feeling of that room- how calm, holy, and sacred it felt.

 MC: What is the most common complaint or struggle that you hear from women regarding their 4th trimester?  How do you respond to this common complaint/struggle?

KAJ: I had no idea how hard this would be. Why didn’t anyone tell me X (that my vagina might look different, that I would hate my husband, that I feel confused and disoriented, that I feel incompetent) My response is that yes, it is a radical change. Having a baby takes a day or two. Becoming a mother takes months. Our needs as mothers are as important as the needs of our babies.

MC: If you could give a woman struggling with her postpartum experience one piece of advice, what would it be?

KAJ: Find other women to be with in person every day. New moms shouldn’t be alone with their babies for more than a couple hours at a time. Tell your friends you need them. Don’t wait until you are underwater to ask for help.

MC: Speaking of being underwater, how in the world did you juggle being a Mom, working, AND writing a book?  What was your experience writing this book like?

KAJ: There was nothing glamorous about it, no sugarcoating of it. It was extremely challenging. My daughter, while totally supportive of me and the mission, could not wait for me to be finished with it. There was no time for anything besides single parenting, seeing clients and writing the book. On this end of things, with the book in hand, I can’t imagine not having the book to offer the world. During the process, there were plenty of times when I wondered if it was really worth it. The learning curve was insanely steep. So many words I had never heard, so much to learn about the stages in book production, working with an illustrator, organizing hundreds of case studies, and so much information into something coherent- as well as interesting. I confronted all my demons- am I the one to write this? Why me? One day I would love the book, the next day I thought it stunk. Everyone tells you, “You don’t make any money writing a book,” which isn’t encouraging. It took me four years to write, and people would tell me they wrote their book in 3 days, and then, deep breath, back to my book and my process. So much to organize, too much to say, to keep track of. It was a lot harder than childbirth. I liked giving birth more than I liked writing the book!

MC: Do you have plans to write more books?  If so, what topics are you thinking about covering?  If not, why?

KAJ: Books have plans for me- (don’t tell my daughter.) It’s one of those soul calls that you don’t have much of a choice about. There is no part of me that goes fishing for ideas, like, “hmmm, what should I write a book about?” There are answer to questions and conversations to have that I don’t see happening out there. There’s information that people need. I’m not sure which book will shove the others out of their places to be written first- a book about sex after trauma, sex and the nervous system, sex and motherhood, or sex is our soul journey.

MC: Your book has received glowing feedback and reviews – any secret to your writing style and ability to really connect with your readers through your writing?

KAJ: I just told the truth. I told the truth and I shared what I would have wanted to hear at that time. I also had the help of working with many, many new mothers, week after week, who would just keep reminding me of what that process is like. They helped keep me moving forward and remembering the real urgency of illuminating this rite of passage.

MC: Although your book has gotten rave reviews, I must ask, have you received or dealt with any negative feedback from the book?  How did you respond to this feedback?

KAJ: So far, the negative feedback I’ve gotten was true! One person said that I told my own story and that the minute I mentioned the word “Sexological Bodyworker” they didn’t want to read any farther. And I just thought to myself, “Well, that is what I set out to do, to tell my story, because I believe that’s how women really connect. No one says, “I am incontinent.”  They say, “I leak when I sneeze, or wouldn’t think of jumping on a trampoline.”  SO, telling my story was important – I’m not writing just as a professional or a journalist, I am speaking from my experience as a mother. And I was excited to put Somatic Experiencing and Sexological Bodywork on the map, since they are so exceptionally helpful, and put the power back in women’s hands.

MC: It sounds like you wear many different hats with your private practice, being co-founder of the School for Postpartum Care, and being a single mom!  Not to mention your experience with being a doula, Sexological Bodyworker, and yoga teacher!  Of all the different work that you’ve done, what have you enjoyed the most?  Found the most rewarding?  The most difficult?

KAJ: I love my job. It is an ever-evolving balancing act as my daughter’s needs evolve, as does my vision of my calling and how that needs to be lived in the world. I have always turned my greatest descents and pain into compost for my work and my mission. Writing a book was the hardest thing I have done professionally so far. I have taught all over the world. I work birth injuries, birth trauma, and sexual trauma. It’s intense, but nothing matches the intensity of the long haul of writing a book that will really change the way we live, that will change our future.

After having the pleasure of reading Johnson’s book and speaking to her, it’s clear that The Fourth Trimester is not only changing her own life and future, but the life and future of so many expectant and new mothers who will find comfort, guidance, practical advice, and genuine support in The Fourth Trimester.

Don’t just take it from me – see what others are saying about The Fourth Trimester:

“Reading The Fourth Trimester from the cocoon of my own fourth trimester with my second son, I feel mothered in the deepest sense. Both gentle and firm, poetic and precise, this book is gifting me the understanding necessary to be fully reverent to the miracle I am living. Feasting on both the practical tools and expansive perspectives that come from one who has lived this path earnestly herself, I move through these precious days with my new baby in kindness and awe. I truly wish every mom-to-be can be blessed with the wisdom contained in this book!” –Brooke McNamara, author of Feed Your Vow

“I’ve long wished for a book like this– one that helps fill what I call The Black Hole in women’s health. Thank you, Kimberly, for embarking on your Heroine’s Journey and transforming your pain into a path of hope and awareness for other women. The Fourth Trimester holds a beautiful blend of personal stories; practical checklists, reflection questions, recipes, and movement practices; and a compilation of postpartum healing arts from cultures around the world. I know every woman on the journey to motherhood (and, in turn, her entire family) will experience greater sovereignty, peace of mind, and vibrant health as a result of this book.” -Sara Avant Stover, founder & author of The Way of the Happy Woman and The Book of SHE: Your Heroine’s Journey into the Heart of Feminine Power

“Twenty-seven years after the very traumatic, emergency caesarean section of my daughter, Kimberly Ann Johnson has worked her wisdom and magic on me. The Fourth Trimester is so comprehensive, so accessible and so consummately useful, that all these years later Kimberly has helped me to create my own coherent, and healing, narrative. This is nothing short of miraculous.” –Sil Reynolds, co-author of Mothering & Daughtering: Keeping Your Bond Strong Through the Teen Years

To find out more about Kimberly Ann Johnson and The Fourth Trimester you can visit her website, or tune in to The Fourth Trimester podcast at

Margot Carmichael

A former teacher with a passion for words, Margot has been writing for years and helping her clients, large and small, to tell compelling stories. When she’s not writing to pay the bills, you can find her working on her lifestyle blog,, dreaming up her next DIY project, cooking, or binge-watching Netflix with her English Bulldog.

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