What is happening to our hormones during the post-natal period?
You brought a little human into the world and chances are, you feel like a completely different person with tons of emotions. Read on to find out what can you expect from hormones during the postnatal period.
Our bodies go through so many different changes in preparation for childbirth. During pregnancy hormones rise and fall, affecting our physical and mental health. After birth, our body has quite literally undergone one of the most intense experiences we will encounter in our lives. It is a marathon for our bodies and for lots of women it is an experience which can be traumatic or go in a completely different direction than you originally anticipated.
After the pregnancy, labour and birth, new mothers are often zapped of energy and need to recuperate, which can be incredibly hard when you have to feed and take care of a newborn who is completely dependant on you. To say ‘it takes a village’ is an understatement and having help during the fourth trimester is incredibly important. Nourishing your body during the postnatal period is important for your energy levels, your mental health, your recovery from birth and it is especially important if you chose to breastfeed.
The postnatal emotional rollercoaster is completely normal and happens to many new mothers. There are big hormonal shifts happening in your body. Recovering from birth requires time, patience and often mothers will need lots of support from those around you. It is not only our bodies that have undergone a massive physical change, but our mental state shifts due to becoming a mother and having a newborn baby to now take care of. The term for this is called ‘matrescence.’ This is a word used to describe the physical, psychological and emotional changes people go through during the monumental transformation that is motherhood.
What can we expect from postnatal hormones?
Oestrogen and Progesterone
During pregnancy your oestrogen and progesterone levels are at an all time high. Their functions are incredibly important in preparing your body for the arrival of your baby. Estrogen is the hormone that supports baby’s development, transfers nutrients, and is also thought to help baby develop and mature. Progesterone facilitates a loosening of ligaments and joints throughout the body and helps the uterus get bigger to make room for baby as they grow.
However, these incredible hormones decline as soon as the baby and placenta is delivered. This sudden drop in hormones helps to facilitate the production of colostrum, a baby’s first milk (1). The big drop in hormones contributes to the postnatal ‘crash’ and can cause are mothers to feel low and experience the ‘baby blues’ (mood swings, anxiety, sadness, irritability) which usually resolves within a week or so of giving birth.
These feeling are completely normal and felt by many women after birth. However, this can potentially turn into postnatal depression which has similar symptoms, but takes longer to resolve and is often more intense feelings. When you have postnatal depression, you may feel increasingly depressed and low. Looking after yourself or your baby may become too much. It's important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family (2).
Oxytocin
To compensate for the decrease of progesterone and oestrogen, oxytocin, also known as the ‘love hormone’, takes over and surges straight after birth. It is also the hormone responsible for bringing on contractions during labour. You’ll get a surge of oxytocin in the final stage, so if you’re having a vaginal birth it will help you along with pushing. Oxytocin also reduces stress, calms you down and helps with pain during labour. Impressively, your baby will also produce oxytocin before and during labour.
Oxytocin has been associated with promoting human social interactions and has been shown to reduce fear and pain, as well as physiological and psychological stress (3). This is the hormone which is responsible for your mothering and protective feeling over your child. Feeling so protective over your little human being can also make us feel anxious about anything negative happening and these thoughts can intrude. The dance of oxytocin and anxiety is what can affect your energy levels and mood. It is completely normal for your hormones to feel up and down for months after giving birth, and they can take time to level out again.
A number of studies in rodents have revealed that oxytocin also plays a pivotal role during lactation. Oxytocin causes contractions in the myoepithelial cells, which increases the pressure in the breast, resulting in a wavelike release of milk from the mammary glands through the lactiferous ducts (3). Oxytocin supports mothers after birth in feeling more relaxed and bonded with their baby.
Prolactin
Prolactin is a hormone made by the pituitary gland, which is a small gland at the base of the brain. Prolactin increases to encourage breast milk production during pregnancy and after birth. Prolactin promotes the growth of mammary alveoli, which are the components of the mammary gland where the production of milk occurs. During periods when the mother is not breastfeeding, the prolactin levels decline to a basal level, and mammary gland milk production reduces. If the mother does not nurse her baby, prolactin levels fall to non-pregnant levels after 1 to 2 weeks (4). Prolactin also has other wide ranging functions in the body; from acting on the reproductive system to influencing behaviour and regulating the immune system (5).
Thyroid hormones
Our thyroid hormones can also be affected after giving birth. Thyroid hormones can help regulate body temperature, metabolism and organ function. 5 -10% of women have postpartum thyroiditis (PPT), which is an inflammation of the thyroid gland, and unfortunately the exact cause isn’t known. PPT is a destructive autoimmune disease occurring in the first year after delivery in women without a history of thyroid disease prior to pregnancy (6). Typical symptoms include fatigue, weight gain, constipation, dry skin, depression and poor exercise tolerance. Most women will regain normal thyroid function within 12-18 months after the onset of symptoms (7).
Relaxin
Relaxin is a hormone which is produced by the ovary and placenta. In preparation for childbirth, relaxin increases and relaxes the ligaments in the pelvis and softens and widens the cervix (8). It’s secreted by the corpus luteum—a normal cyst that forms in the ovaries every month, during which a person menstruates (9).
Relaxin is a hormone structurally related to insulin and insulin-like growth factor, which exerts its regulatory effect on the musculoskeletal and other systems through binding to its receptor in various tissues. Relaxin alters the properties of cartilage and tendon by activating collagenase (10). It is not unusual that towards the end of pregnancy you start to feel unsteady as your pregnancy belly grows. It is important to not over-exert yourself with exercise and to be extra careful. A possible complication of too much relaxin is symphysis pubis dysfunction (SPD). This causes sudden shooting pain originating in the front or back of the pelvis, or a steady pain radiating into the abdomen, low back, groin, perineum, thighs and legs. Pain is worse when walking, going up and down steps, bending forward, and getting up from a sitting or sleeping position (11). During pregnancy this hormone increases and it can take up to five months after giving birth for this hormone to return to normal levels.
When you are going through the ‘fourth trimester’ period, your hormones are quite literally on a rollercoaster ride. It is completely normal to feel emotional, anxious and overwhelmed in this period. Having gone through the exhausting birth experience, trying to recover and take care of a newborn is definitely not easy. On top this your hormones are trying to balance out and are finding a new rhythm; there are tons of changes happening both mentally and physically. Give yourself a break and know that this feels like a difficult chapter because it is. To support our hormones post birth we can sleep as much as we can, rest, get as much support as possible, eat a nutritious and healthy diet, drink enough water, go for walks outside and do something that brings joy you every day.
References
https://www.baby2body.com/blog/the-postpartum-hormone-crash-what-to-expect-and-how-to-take-charge-of-your-hormonal-health
https://www.nhs.uk/conditions/baby/support-and-services/feeling-depressed-after-childbirth/
https://www.frontiersin.org/articles/10.3389/fendo.2021.742236/full
https://www.ncbi.nlm.nih.gov/books/NBK507829/
https://www.yourhormones.info/hormones/prolactin/
https://www.ncbi.nlm.nih.gov/books/NBK557646/
https://www.thyroid.org/postpartum-thyroiditis/
https://www.yourhormones.info/hormones/relaxin/
https://raf.bioscientifica.com/view/journals/raf/2/1/RAF-20-0044.xml
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282454/
https://www.wjgnet.com/2307-8960/full/v9/i1/91.htm