Postpartum Hormones: what’s happening in your body and how to care for yourself

I have yet to experience postpartum myself, but I’ve had many clients and readers that have been through that season of life. Maybe as you read this, you are currently walking through the postpartum period. Every woman’s body is different, therefore every woman’s experience after giving birth will be different. What works for one woman, might not work for the next. While one woman might go through postpartum and adjust to newborn life quite seamlessly, another woman might find it much more difficult. She might need the support of medication, therapy, extra help and many other things. One way is not better than the other – they are simply two different ways of navigating the postpartum period. I hope this post helps you better care for yourself, whatever that means for you. There’s no right or wrong way to care for yourself as a mom or your new baby.

Postpartum brings about drastic shifts in your hormones, body and emotions. Couple that will sleep deprivation and the unrealistic expectations our media and culture illustrate and you’ve got a recipe for a hard transition. While I haven’t experienced this myself yet, what I’ve heard from other women is that it can be challenging, intense and overwhelming. If you feel that way, I can guarantee you’re not alone. Considering that the hormonal shift (more like a drop) that occurs postpartum is the most intense sudden hormonal swing any one human will experience, it makes sense this transition is tough!

So what happens to your hormones during the postpartum period?

While pregnant, your estrogen and progesterone levels increase A LOT. A lot, a lot. So if you felt emotional and unlike your “normal” self while pregnant, that’s okay. Your body was/is going through a lot. If you’ve ever been on hormonal birth control, imagine taking handfuls of birth control per day. I mean handfuls upon handfuls. That’s how much your estrogen and progesterone levels rise during pregnancy. During your menstrual cycle (when not pregnant of course) your body experiences a hormonal drop right before your period begins. This is the reason you might feel moody, tired, bloated and not like yourself the week before your period. If these symptoms interfere with your day to day life, that would be something to explore, but some different body sensations and thoughts/feelings before your period can be normal. Most women know what that hormonal drop feels like before their period and some experience it more drastically than others. Now take that hormonal drop and times it by like 100. That’s the hormonal drop that happens after pregnancy. It’s huge!

This drop in hormones post birth takes about 1-2 weeks to begin to settle out to levels similar to pre-pregnancy. By this time, another hormone comes into play – oxytocin. Oxytocin is a hormone released by the hypothalamus and released into the bloodstream by the pituitary gland. It causes contraction of the uterus during labor (and after so the uterus shrinks back to its original size) and stimulates milk to move into the breast ducts. Oxytocin is a feel good hormone or the “love” hormone. It plays a huge role in mother-infant bonding, and outside of pregnancy it’s released when we hug, kiss, have sex, etc. So after that first week or so, oxytocin levels rise and should lift a new mom’s mood and make her feel better after the drastic postpartum hormonal drop. But in order for oxytocin to do this, enough of the hormone needs to be released.

Hormonal Differences: Breastfeeding vs Formula

Breastfeeding tells your brain to release oxytocin. And as baby latches and feeds, the oxytocin pushes breast milk out of the ducts and nipple and into baby’s mouth. As baby feeds, more oxytocin is released. This is why mom’s tend to swoon over their babies and feel sleepy and relaxed when breastfeeding.

Then there’s another hormone called prolactin, which determines how much milk you, as mom, will produce. This increased production in prolactin is also why many (but not all) women don’t get their period, or experience irregular periods, while breastfeeding. Prolactin inhibits the release of gonadotropin releasing hormone (GnRH) and therefore, LH (luteinizing hormone) and FSH (follicle stimulating hormone) aren’t released, you don’t ovulate and therefore, you don’t get a period. This is what we call physiologic amenorrhea, meaning menstruation is ceased for normal reasons – those two reasons being pregnancy and/or lactation.

Every woman’s body is different. Some women do get their period back while breastfeeding, some women experience irregular periods, and some women don’t menstruate at all. I would not recommend breastfeeding as a form of birth control. On the flip side, if your baby is exclusively formula fed, you won’t experience the same release of oxytocin and prolactin and their effects. There are many reasons a mom might not be able to breastfeed. Remember every woman is different and doing the best she can to care for her baby. That is what matters. A fed and nourished baby is best.

Breastfeeding and Weight Loss

First of all, talk around breastfeeding and weight loss is so entrenched in diet culture. But I do feel like it’s important to address instead of just ignoring how messed up this conversation has become. Women will experience varying degrees of these above hormonal changes due to genetic and environmental factors. So if one woman proclaims, “I breastfed and the weight just fell off!” that doesn’t mean something is wrong with your body because it didn’t. Weight loss while breastfeeding isn’t good or bad…it just is.

Like we talked about above, progesterone and estrogen are usually suppressed during breastfeeding due to prolactin, progesterone and estrogen play a role in metabolism. Keep in mind your body also WANTS AND NEEDS energy and nutrients to keep up your milk supply. If you feel ravenously hungry – that’s your body doing everything it can to make sure you take in the energy and nutrients you need to nourish your baby. Caring for a new baby is also a stressful period and you’re likely not getting the best sleep of your life, so your cortisol levels might be higher and appetite hormones might be off which might make you crave sugary/carby foods. THAT IS OKAY.

Your body is smarter than you are! It wants to keep fat stores around as back up energy. Your body is providing a food source for another human! It isn’t going to put up with famine and it will do everything it needs to do to prevent famine, especially when sustaining another life. If you feel more focused on losing baby weight versus caring for yourself and for baby, I’d really encourage you to do some self reflection, talk to a safe friend, or reach out to a counselor or therapist for support. You deserve to get the support you need. Our culture applauds women for getting their “pre-baby body” back. You just grew and birthed a human. Your body is okay just how it is, there is nothing wrong with your body postpartum body. Your body very likely will never look the same and that is normal and expected. And in a season of your life where everything feels different and out of control, it makes sense that you are trying to cope by controlling food and your body. Your job is to take care of you and your baby. Your body’s job is to micromanage it’s size.

4 Steps: How to Best Care for Yourself Mentally, Emotionally and Hormonally After Birth

If you struggled with food rules and body image before/during pregnancy, it is understandable that navigating a peaceful relationship with food and your body after baby would feel really, really hard. Remember, you’re human and you’re doing the best you can.

The most important thing is to nourish your body with all the macronutrients (carbs, protein and fat) and adequate energy. If you’re restricting calories and/or food groups you will feel crappy emotionally, mentally and physically. Keep taking your prenatal vitamin and fish oil. You’re already emotionally vulnerable and inadequate nourishment will only add another layer of vulnerability. I love this Real Food pyramid to illustrate healthy nourishment.

1. Move your body in ways that feel good.

Be gentle. Stretch, go on walks with your new baby, do some light yoga. DO WHAT FEELS GOOD AND WHAT YOU ENJOY. If you don’t enjoy it and it doesn’t feel good to your body, it’s doing nothing beneficial for your health. Also of course, get medical clearance from your health care provider before doing any movement.

2. Get the best sleep you can.

Everyone is going to have a different baby. Sleep the best you can. I haven’t experienced newborn life yet, but I’ve heard from other women that it’s helpful to nap when the baby naps. This helps them feel exponentially better. It won’t be perfect, that’s okay – I imagine for many moms napping when their baby naps feels impossible. Remember, you’re doing the best you can. Sleep deprivation is another reason to not engage in stressful/unenjoyable physical activity. Your body doesn’t need the extra stress.

3. Wear clothes that feel good on your body.

Pregnancy and breastfeeding are suppose to change the size and shape of your body. If your “pre-baby” clothes don’t fit, that doesn’t mean there is anything wrong with your body. Your body is not the problem, the clothes are. This post by Kylie on her postpartum body is fantastic.

4. Remember this is your story and your journey.

You are your own person. Your journey isn’t going to look like that other woman’s journey. Making a postpartum self care basket might be a really good idea. Having some positive mantras might be another good idea. Put the good stuff in. Focus on your health, your baby’s health, reach out to your safe people for support, and soak up this special life season. You’re right where you need to be.

References

Nowakowski, S., Meers, J., & Heimbach, E. (2013). Sleep and Women’s Health. Sleep Medicine Research, 4(1), 1–22.

Schiller, C. E., Meltzer-Brody, S., & Rubinow, D. R. (2015). The Role of Reproductive Hormones in Postpartum Depression. CNS Spectrums, 20(1), 48–59. http://doi.org/10.1017/S1092852914000480

Stuebe, A. M., Grewen, K., Pedersen, C. A., Propper, C., & Meltzer-Brody, S. (2012). Failed Lactation and Perinatal Depression: Common Problems with Shared Neuroendocrine Mechanisms? Journal of Women’s Health, 21(3), 264–272. http://doi.org/10.1089/jwh.2011.3083