One Occupational Therapist. One Gap She Kept Seeing.
Melissa O'Neal, OTR/L hosts Functional Fourth Trimester because the conversation new parents need, the one about how to actually function in daily life after a baby, was not happening anywhere she could find it.
Meet Melissa
Licensed Occupational Therapist | Founder, The Postpartum OT
Melissa O'Neal is a licensed occupational therapist (OTR/L) and the founder of The Postpartum OT, where she works directly with new parents to rebuild functional daily life after birth. She earned her occupational therapy degree at the University of Kansas. She is also a Certified Disability Rights and Accessibility Consultant (CDRAC).
Her own path into OT was not a quiet one. She went back to school for occupational therapy while married with a toddler, working nights and putting in more than 85 hours a week to get through.
In her practice and on this show, Melissa focuses on the parts of postpartum life that shape every day: infant sleep, roles and routines, breastfeeding, pumping and bottle feeding, returning to work, traveling with a baby, and the ways partners and dads can support.
She has sat with parents in their homes, in the real, unglamorous, beautiful mess of early postpartum, and helped them figure out how to cook a meal, get outside, maintain a hygiene routine, and return to the activities that made them feel human before the baby arrived.
On Functional Fourth Trimester, Melissa is the evidence base. When a guest makes a claim, she contextualizes it. When a topic requires clinical nuance, she provides it. She is also deeply practical. If an OT recommendation is not usable by a parent running on three hours of sleep, she will say so. The standard is: does this help real people right now? Everything on this show is held to that standard.
Outside of OT, Melissa and her husband are certified Special Olympics coaches and coached alongside their son for ten years.
Why We Started This Show
The postpartum period, the first twelve weeks and beyond after a baby arrives, is one of the most functionally disruptive experiences in a person's life. The healthcare system addresses it primarily as a physical event: a six-week checkup, a clearance to resume exercise, a pelvic floor referral if you are lucky. What happens to the rest of daily life in those weeks is left largely unaddressed?
An occupational therapist sees it differently. OT asks: what activities matter to this person, and what is getting in the way of them doing those activities? After birth, the answer to that question is different every day, and the work of addressing it is ongoing. It is not a one-appointment problem.
Functional Fourth Trimester exists because there was no podcast asking those OT questions out loud, with the people best equipped to answer them. That seemed like something worth fixing.
What Occupational Therapy Brings to the Fourth Trimester
Occupational therapy is the healthcare discipline concerned with helping people engage in the activities, the occupations, that are meaningful to their daily lives. This includes self-care, work, leisure, relationships, and rest. OT is not just for rehabilitation after injury. It is for anyone whose capacity to live the life they want to live has been disrupted.
Birth is one of the most significant disruptions a person's daily life will ever experience. The routines that sustained function before the baby are gone overnight. The identity built through those routines is suddenly in question.
Occupational therapy is specifically trained to address that gap. Every conversation on this podcast runs through that framework, not to turn parenting into a clinical exercise, but because the OT lens reveals things about postpartum daily life that other frameworks miss.
How This Podcast Began
Functional Fourth Trimester was founded by Lauren Zatezalo and Melissa O'Neal, OTR/L as Lauren's doctoral capstone project while she was an OTD student at the University of Kansas. Lauren co-hosted the show's original episodes and helped create its companion blog posts, driven by the belief that new parents deserve more support, education, and resources than they are getting. Thank you, Lauren, for helping build the foundation of this podcast.
A Note About This Podcast
All content on Functional Fourth Trimester is educational and informational. It is not a substitute for professional medical care, individual occupational therapy, or licensed mental health support.
If you are experiencing significant postpartum mental health challenges, please reach out to Postpartum Support International at postpartum.net.
For individual occupational therapy care, we encourage you to find a licensed OT in your area who specializes in postpartum and maternal health.
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Every episode is built around the specific challenges you are navigating right now.