What to Expect with Postpartum Hormones

While the birth of a child is undoubtedly a miracle, it also ushers in a period of significant physical and emotional changes for the mama.

One of the most important aspects of this postpartum period is the fluctuation of hormones, which plays a crucial role in a woman's journey through motherhood.

In this blog, we will explore everything you need to know about postpartum hormones, their impact on a new mother's body and mind, and how to navigate this rollercoaster of change.

What Are Postpartum Hormones?

Postpartum hormones refer to the hormonal changes that occur in a woman's body after giving birth.

These changes are essential for the body to recover from pregnancy and childbirth and prepare for the demands of breastfeeding and caring for a newborn.

Some of the key hormones involved in the postpartum period include:

Estrogen and Progesterone:
These hormones, which are significantly elevated during pregnancy, drop dramatically after childbirth. This drop triggers various physical and emotional changes.
Oxytocin:
Often referred to as the "love hormone" or "bonding hormone," oxytocin plays a critical role in stimulating uterine contractions during labor and promoting the release of breast milk.
It also helps foster the emotional bond between a mother and her newborn.
Prolactin:
Prolactin is responsible for milk production. After birth, it surges, encouraging the mother's body to start producing breast milk.
Cortisol:
Stress hormone levels are high during labor, but they gradually decrease postpartum, allowing the mother to relax and adapt to her new role.
Thyroid Hormones:
Changes in thyroid hormone levels can impact a mother's energy, mood, and metabolism during the postpartum period.

Understanding these hormonal changes is crucial for new mothers and their support systems to provide the necessary care and emotional support.

The Phases of Postpartum Hormonal Changes

The postpartum period is not a one-size-fits-all experience. Hormonal changes occur in several phases, with each phase having distinct effects on a mother's body and mind.

Immediate Postpartum Phase (0-48 Hours)

In the immediate postpartum phase, the body experiences a rapid decrease in estrogen and progesterone levels.

This drop can trigger mood swings, irritability, increased fatigue, and tearfulness. 60-80% of women will experience symptoms of baby blues typically from 2 days to 2 weeks postpartum due to the hormonal drop and sleep deprivation.

An important distinction between baby blues and postpartum depression is that self-esteem remains unchanged and outlook is overall positive.

If symptoms include feelings of guilt and hopelessness or persist past 2 weeks postpartum then this is a red flag for postpartum depression.

Early Postpartum Phase (2-6 Weeks)

During this phase, the body continues to adjust to the changes in hormone levels.

Prolactin levels remain high to support breastfeeding, while estrogen and progesterone gradually stabilize.

Baby blues symptoms should fade. This is the time to be mindful of any signs of postpartum depression as 15-20% of women will develop this condition.

Mid-Postpartum Phase (6 Weeks - 6 Months)

As the early postpartum phase progresses, hormone levels continue to stabilize.

Many women start to regain a sense of normalcy during this period, with mood swings becoming less severe.

However, fatigue and the demands of caring for a newborn can still take a toll on a mother's mental and physical well-being.

Late Postpartum Phase (6 Months to 1 Year )

In the late postpartum phase, hormone levels should return to pre-pregnancy levels.

For breastfeeding mothers, prolactin and oxytocin levels may remain slightly elevated, but the impact on mood and energy levels is minimal.

The body has largely adapted to the postpartum hormonal changes, and most women begin to feel more like their pre-pregnancy selves.

Emotional Impact of Postpartum Hormones

Postpartum hormonal changes can have a profound impact on a new mother's emotional well-being.

The majority of women experience mood swings and heightened emotions during the postpartum period.

However, it's important to understand the distinction between normal emotional changes and more serious conditions like postpartum depression and postpartum anxiety that require professional treatment.

Baby Blues

The "baby blues" is a common experience for new mothers with up to 80% of new mothers experiencing these symptoms.

It typically involves feelings of irritability, exhaustion, and tearfulness and occurs within the first two weeks after giving birth. These mood swings are generally mild and temporary, but they can be challenging for new mothers to navigate.

Postpartum Depression

Postpartum depression is a more severe and long-lasting condition that affects about 1 in 5 women.

The symptoms of postpartum depression include overwhelming sadness, guilt, hopelessness, sleep disturbances, changes in appetite, fatigue, loss of interest in daily activities, difficulty bonding with the baby, and, in some cases, thoughts of harming oneself.

Postpartum depression is a medical condition that requires treatment, which may include therapy, medication, or both.

Postpartum Anxiety

Postpartum anxiety is characterized by excessive worry, restlessness, agitation, trouble relaxing, worry that something awful may happen, and physical symptoms like rapid heart rate and muscle tension.

It can co-occur with postpartum depression, but it is a distinct condition that affects many new mothers.

Postpartum OCD

Postpartum OCD is different from generalized anxiety and mood disorders.

This condition is marked by intrusive thoughts, often involving harm or danger to the baby, that lead to extreme distress.

These thoughts are inconsistent with the mother's true desires, and she is repelled by them.

In an attempt to alleviate the anxiety caused by these thoughts, mothers may engage in compulsive behaviors, such as excessively checking on the baby, sterilizing baby items repeatedly, or following strict routines.

The intrusive thoughts experienced in postpartum OCD do not reflect a mother's true intentions or character.

Instead, they are a product of the anxiety associated with the condition. It's essential to understand that having these thoughts does not mean that a mother is a danger to her child.

In fact, mothers with postpartum OCD are often overly concerned with their baby's safety. They may worry that they are “going crazy” when in fact this is a treatable medical condition impacting 3-5% of new mothers.

Postpartum Psychosis

Postpartum psychosis is a rare (1-2 out of 1,000) but severe condition that may include symptoms such as extreme confusion, paranoia, disorganized thoughts, hallucinations, delusions, and thoughts of harming oneself or the baby.

The condition is treatable but it is a medical emergency, and immediate treatment is essential.

Women with this condition are at a high risk of harming themselves and/or their babies. While postpartum OCD involves thoughts that are inconsistent with what the mother wants to have happen, postpartum psychosis thoughts are outcomes that the mother does want to have happen.

Early intervention is essential as this is a very dangerous condition.

If you have the symptoms of postpartum psychosis or are near someone who shows signs of it, it’s important to seek immediate help.

If you believe someone is a danger to themselves or others, you should immediately dial 911 (or your local emergency services number).

Mom with baby who has postpartum hormones.

Coping with Postpartum Hormonal Changes

Coping with postpartum hormonal changes requires patience, self-care, and a strong support system.

Here are some strategies to help new mothers navigate this transformative period:

1. Seek Support

One of the most crucial aspects of coping with postpartum hormonal changes is having a strong support system.

Whether it's your partner, family, or friends, having someone you can confide in and rely on can make a world of difference.

2. Communicate

Open and honest communication is key.

Let your loved ones know how you're feeling, whether it's the "baby blues" or more severe symptoms.

Remember that seeking help is a sign of strength, not weakness.

3. Self-Care

Take time for self-care. Rest when you can, eat nourishing foods, and engage in activities that bring you joy and relaxation.

Self-care is not selfish; it's essential for your well-being and your ability to care for your baby.

4. Get Adequate Sleep

Although it can be challenging with a newborn, getting enough sleep is crucial for managing your mood and overall health.

Enlist the help of a partner or family member to take turns with nighttime feedings and diaper changes.

5. Consider Professional Help

If you're experiencing symptoms of postpartum depression or anxiety, it's essential to seek professional help. Therapy, medication, or a combination of both can be highly effective in treating these conditions.

6. Join Support Groups

Many communities offer support groups for new mothers.

These groups provide a safe space to share experiences, concerns, and tips for coping with postpartum hormonal changes.

Postpartum Support International has a number of online support groups that meet daily.

7. Be Patient

Remember that the postpartum period is a phase, and it will eventually pass.

As hormone levels stabilize and you adjust to your new role as a mother, you will likely start to feel better.

Breastfeeding mom with postpartum hormones.

Breastfeeding and Postpartum Hormones

Breastfeeding plays a significant role in postpartum hormonal changes.

When a mother breastfeeds, her body releases oxytocin, often referred to as the "bonding hormone" or the "love hormone."

This hormone helps strengthen the emotional connection between the mother and her baby.

Additionally, breastfeeding triggers the release of prolactin, which is responsible for milk production.

It's essential to remember that every woman's experience with breastfeeding is unique.

While some women may find breastfeeding to be a positive and rewarding experience, others may encounter challenges or decide not to breastfeed for various reasons.

What's most important is that you make the choice that is best for you and your baby.

The Phenomenon of D-MER in Breastfeeding

While postpartum hormonal changes can bring about a range of emotions, there is a unique and often misunderstood phenomenon that some (around 9%) breastfeeding mothers experience known as Dysphoric Milk Ejection Reflex (D-MER).

D-MER is a condition that causes negative emotions, often described as a sudden and intense feeling of sadness, anxiety, or irritability, just before the milk letdown reflex occurs during breastfeeding or pumping.

This condition is not related to postpartum depression or the typical emotional fluctuations of the postpartum period but is specifically tied to the physical act of milk release.

Understanding D-MER

D-MER can be a challenging experience for mothers, as it can create a sense of dread or discomfort during what is supposed to be a bonding and nurturing moment with their baby.

The negative emotions associated with D-MER typically begin just before the milk starts flowing and dissipate as soon as milk ejection occurs.

The exact cause of D-MER is not fully understood, but it is believed to be related to fluctuations in the hormone dopamine.

When a mother begins breastfeeding or pumping, the body releases prolactin to stimulate milk production.

However, for those with D-MER, there is a temporary drop in dopamine levels just before milk ejection. This dip in dopamine can lead to the sudden onset of dysphoric feelings.

D-MER is a challenging aspect of the breastfeeding experience for those who encounter it, but with understanding, support, and self-care, it is manageable.

Many mothers find that over time, the intensity of D-MER lessens or disappears altogether, making the breastfeeding journey a more positive and fulfilling one.

Postpartum Hormones and Relationships

The emotional changes brought about by postpartum hormones can also impact a new mother's relationships, particularly her relationship with her partner.

The combination of sleep deprivation, mood swings, and the stress of caring for a newborn can create challenges in maintaining a strong connection.

Here are some tips for nurturing your relationship during this period:

1. Communicate Openly

Talk to your partner about your feelings and concerns. Encourage them to share their thoughts as well.

Open and honest communication is vital for understanding each other's needs and experiences.

2. Make Time for Each Other

While caring for a newborn is demanding, it's essential to set aside time for each other.

Even small moments, like sharing a meal or watching a movie, can help maintain the emotional bond between you and your partner.

3. Seek Help When Needed

If you or your partner are struggling with the emotional impact of postpartum hormones, consider seeking the support of a therapist or counselor.

They can provide guidance on coping with these changes and strengthening your relationship.

4. Share Responsibilities

Dividing baby care and household responsibilities can alleviate some of the stress that comes with caring for a newborn.

Share the responsibilities as equally as possible to ensure both partners have time for self-care.

Postpartum Hormones and Returning to Work

Many mothers face the challenge of returning to work after maternity leave, and this transition can be emotionally and hormonally charged.

Balancing the demands of a new baby, work responsibilities, and the emotions of the postpartum period is no small feat.

Here are some strategies to help ease the transition:

1. Plan Ahead

Before returning to work, create a plan for childcare, feeding, and your daily routine.

Knowing that your baby is in good hands and that you have a structured plan can provide peace of mind.

2. Gradual Transition

If possible, consider a gradual transition back to work.

Start with shorter workdays or part-time hours and gradually increase your workload.

This approach can help you ease into your work routine.

3. Communicate with Your Employer

Discuss your needs with your employer. Many companies offer flexible work arrangements or accommodations for new mothers.

Open communication can help you find a solution that works for both you and your employer.

4. Prioritize Self-Care

Remember to prioritize self-care during this period.

Working mothers often have a lot on their plates, so it's essential to make time for rest and relaxation to manage the emotional and hormonal changes.

Takeaways

The postpartum period is a time of tremendous change, and understanding the role of postpartum hormones is essential for new moms and their support systems.

While the emotional and physical challenges can be daunting, with the right support, self-care, and communication, you can navigate this transformative phase with confidence and resilience.

Embrace the changes and remember that you are a strong and capable mother, capable of facing whatever comes your way!

With love and solidarity,

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Everything You Need to Know About Postpartum Hormones