The Impact of Hormonal Changes on Mental Health During & After Childbirth
https://www.sciencedirect.com/science/article/abs/pii/B9780444642394000023
Bringing a new life into the world is a miraculous journey that comes with incredible changes, both physically and emotionally. As a woman or birthing individual, you're not just preparing to welcome your bundle of joy, but your body undergoes a symphony of hormonal changes leading up to and after childbirth.
Below, we'll explore the remarkable hormonal fluctuations that occur during pregnancy, bith, and postpartum, as well as the impacts these hormones have on mood.
***If you're a new or expectant mother in Colorado seeking therapy, consider taking the next step to schedule a free consultation.
Hormonal Changes During Pregnancy
Pregnancy is initiated by the release of an egg from the ovaries and its subsequent fertilization by sperm. Once fertilization occurs, the body undergoes a series of hormonal changes to support the growing fetus. These changes are primarily orchestrated by the placenta, a temporary organ that forms during pregnancy.
Human Chorionic Gonadotropin (hCG): Shortly after conception, the body begins producing hCG, which is the hormone detected by pregnancy tests. This hormone helps maintain the corpus luteum, which in turn produces progesterone to support the uterine lining.
Progesterone: Plays a crucial role in maintaining the uterine lining, preventing menstruation, and supporting the early stages of fetal development.
Estrogen: Levels also rise significantly during pregnancy, promoting the growth of the fetus and the development of the placenta.
Human Placental Lactogen (hPL): Produced by the placenta, hPL helps prepare the breasts for lactation and contributes to the regulation of glucose levels.
Oxytocin: Although primarily known for its role in labor, oxytocin begins to increase during pregnancy, promoting uterine contractions in preparation for birth.
Hormonal Changes During Birth
As pregnancy progresses, the body prepares for labor and birth, leading to a surge in certain hormones that facilitate the birthing process:
Oxytocin: Levels continue to rise, causing uterine contractions that push the baby down the birth canal.
Endorphins: The body releases endorphins during labor to help manage pain and create a sense of well-being.
Cortisol: Often referred to as the "stress hormone,” cortisol increases to help the mother cope with the physical demands of labor.
Hormonal Changes During the Postpartum Period
The postpartum period, often called the "fourth trimester," encompasses the time immediately after childbirth and the first few weeks or months of motherhood. Hormonal changes continue during this phase to support the mother's recovery and the demands of breastfeeding.
Prolactin: This hormone is responsible for milk production and remains elevated during breastfeeding. However, if a mother chooses not to breastfeed or when she starts weaning, prolactin levels will gradually decrease.
Oxytocin: While oxytocin remains elevated for some time to promote uterine contractions and bonding with the newborn, its levels eventually return to normal.
Estrogen and Progesterone: After childbirth, there is a rapid and significant decrease in estrogen and progesterone levels. The sudden drop in these hormones triggers several physical and emotional changes, including uterine contractions and mood swings. These hormones gradually return to pre-pregnancy levels, contributing to the regulation of the menstrual cycle.
Impact of Hormonal Changes on Mental Health
Motherhood is an extraordinary journey that brings joy and fulfillment, but it can also be challenging, emotionally intense, and overwhelming at times. In this section, we'll explore the significant impact hormonal changes during pregnancy and postpartum can have on your mental health.
Pregnancy Bliss
As pregnancy progresses, increases in estrogen and progesterone can create a rise in dopamine and serotonin, neurotransmitters in the brain responsible for regulating mood. For this reason, some women may experience improved mood during pregnancy, while others, especially those predisposed to mental health challenges, have a history of hormonal disorders, or are under increased stress during pregnancy, may experience a worsening of symptoms.
Baby Blues: Riding the Emotional Wave
As mentioned, the dramatic shift in hormones directly following birth often leads to an adjustment period known as the "baby blues.” This is where mood swings, tearfulness, and feelings of anxiety and sadness are common. Roughly 4 in 5 (80%) of parents experience this, with symptoms typically lasting anywhere from 2-3 days to 2 weeks. While the baby blues usually subside on their own as hormones begin to rebalance, it's essential to have a support system in place to help you navigate this emotional rollercoaster. If symptoms last longer than 2 weeks or get progressively worse, a more significant diagnosis may be present.
Postpartum Depression: A Silent Struggle
In some cases, the hormonal rollercoaster after childbirth can take a more severe turn, especially if you are predisposed to mental health challenges, experience mental health difficulties in pregnancy, or are lacking adequate support and safety. Postpartum depression (PPD) affects around 10-15% of new mothers and can look like increased and prolonged feelings of sadness, hopelessness, loss of interest or pleasure, irritability, debilitating fatigue, and difficulty bonding with your baby. In many cases, it can also present as an anxious depression, where feelings of excessive worry can increase or trigger a depressive shutdown.
Postpartum Anxiety: When Worry Takes Over
Hormonal changes, combined with the stress and adjustment to new motherhood, can contribute to postpartum anxiety, OCD or panic. Symptoms may include excessive worrying, restlessness, and physical symptoms like rapid heartbeat or shortness of breath. Questions like “am I doing this right?” or fears pertaining to your baby’s wellbeing and safety are to be expected as a new parent, however, it if your thoughts are causing you significant distress, begin to worsen and become reoccurring, or are noticeably impacting your relationships and ability to sleep, function, and engage with the world around you, additional support is recommended.
Risks of Postpartum Mania
The perinatal period can be particularly challenging for individuals with both diagnosed and undiagnosed bipolar disorder. Hormonal fluctuations and the stress of caring for a newborn can trigger mood episodes, including manic or depressive episodes. For individuals with an existing diagnosis, it's crucial to have a comprehensive postpartum mental health plan in place, including support from healthcare providers, therapists, and family. For those who may be undiagnosed, a mental health screening or assessment is highly recommended. While symptoms of a depressive episode may resemble postpartum depression, postpartum mania or hypomania will look like elevated mood, increased energy, reduced need for sleep, and impulsivity. Both requires treatment to prevent potential harm to both mom and baby.
Postpartum Psychosis
In rare cases, women may experience postpartum psychosis, which is a severe and potentially life-threatening condition that often requires immediate intervention, medication, and inpatient treatment or hospitalization. It involves hallucinations, delusions, severe mood swings, and disorganized thinking. Hormonal changes, genetic predisposition, a postpartum bi-polar diagnosis, and other factors may contribute to its development.
Embracing motherhood is a journey like no other. Understanding the powerful hormonal changes your body undergoes during pregnancy and postpartum can shed light on the emotional challenges that accompany this transformative experience. However, it's important to note that while hormonal changes are a significant factor in the perinatal experience, they also interact with various other physical, psychological, and social factors. Every person's postpartum journey is unique, and the effects of hormonal fluctuations can vary from one individual to another.
Support from healthcare providers, family, and friends is crucial during the postpartum period to help new mothers navigate these hormonal changes and any associated emotional challenges. If postpartum mood disturbances become severe or prolonged, seeking professional help and support is essential for a mother's well-being and the well-being of her newborn. You've got this, mama!
If you're a new or expectant mother in Colorado seeking therapy, consider taking the next step to schedule a free consultation.
Finding a therapist who specializes in maternal mental health and perinatal mood and anxiety disorders can help you receive the support and guidance you need during this significant life transition. Together, we can work to address any challenges you may be facing and develop strategies to enhance your well-being and confidence as you navigate pregnancy, childbirth, and the postpartum period.