Postpartum Hormones: Navigating the 4th trimester with body awareness

Many people will spend their entire pregnancy focusing on their birth and little time actually preparing for the fourth trimester. Given how little exposure we have to witnessing the birthing process before our own labour, it is no surprise that so much of our energy is consumed in either preparing to birth, or fearing it.  

The period of convalescence, identity shifts, bonding, and growth that occurs after birth is a sacred time. This is a period where we are meant to lean on our community like never before. A time for us to focus on healing and bonding as the new born “mother-baby” unit. 

After giving birth, when your body is adjusting to life post-pregnancy, understanding what is happening with your hormones can help provide guidance and acceptance during this time as you navigate all the ebbs and flows of the fourth trimester. Let’s take a deep dive into what is happening in your body:

Estrogen and Progesterone Drop

During pregnancy estrogen and progesterone shift from being produced predominantly in the ovaries, to the placenta. Both estrogen and progesterone remain high throughout your pregnancy. Following the birth and delivery of the placenta, there is a notable decrease in both estrogen and progesterone to levels that are comparable to those found in menopausal women. This drastic decline in hormone levels can result in heightened sensitivity, feelings of sadness, and potential mood swings. It is also linked to an increase in the production of prolactin, a hormone essential for initiating and maintaining breast milk production.

The effects of the drop in estrogen and progesterone may not be perceptible until approximately 48 hours postpartum, when the natural endorphins from labor begin to diminish. This transition often correlates with what is commonly referred to as the "postpartum blues," a temporary phase that usually stabilizes within two weeks as the hormones begin to level out. It is advisable for partners and caregivers to monitor for signs of prolonged low mood or severe mood swings beyond this period, as these may be indicative of postpartum anxiety or depression.

As the menstrual cycle resumes, progesterone levels will normalize. Consequently, women who opt for birth control during the postpartum period will typically be prescribed progestin-only contraceptives, such as pills or IUDs. This is because the inclusion of estrogen could negatively affect breast milk production. 

This drop in estrogen during breastfeeding can persist for some women who may experience symptoms of low estrogen such as mood swings, irritability, hot flashes and night sweats as well as vaginal dryness, low libido, tenderness and discomfort during sexual intercourse. If you are experiencing discomfort during intercourse, using a clean lubricant or engaging in more foreplay may help. If symptoms persist, you may want to check in with a pelvic health physio for a physical assessment or your naturopath for topical estriol cream or other herbal supplements.

Understanding these hormonal shifts is essential for both healthcare providers and new mothers, as it helps inform postpartum care and supports the transition into this significant phase of motherhood. It's a complex process, but one that is a natural part of bringing new life into the world.

Oxytocin Overload 

Oxytocin, also known as the "love hormone," floods your system, promoting bonding with your baby and stimulating milk production and milk ‘let-down’. This hormone is also produced when we snuggle or have intimate contact with our partner’s or baby. This is one of the reasons why skin-to-skin contact immediately after birth and throughout your fourth trimester is so important. Most respond well to rising oxytocin and feel extra lovey-dovey, however some people are sensitive to high levels and may experience irritability, anxiousness or overwhelm while breastfeeding. 

Thyroid Fluctuations 

Thyroid hormone levels can go haywire postpartum and are often overlooked by medical professionals because of the overlap of symptoms that are considered ‘normal’ for the postpartum period. One other reason it can be missed is that some women will experience an initial hyperthyroid state that turns into hypothyroidism after a few weeks. This might mean that bloodwork looking at thyroid levels may not catch the whole picture as the fluctuations occur.

Postpartum thyroiditis can show up in 3 ways; hypothyroidism, hyperthyroidism, or as mentioned above- a combination. Here is a look at some of the symptoms you may experience to help you differentiate or identify if this is happening to you:

Hyperthyroidism (Over-active Thyroid):

• Nervousness, anxiety and irritability

• Rapid heartbeat and palpitations

• Intense appetite – famished, hungry all the time

• Weight loss

• Sweating

• Difficulty sleeping

• Fatigue

• Frequent or loose stools

Hypothyroidism (Under-active Thyroid):

• Fatigue or downright exhaustion

• Depression

• Decreased milk volume

• Unexplained weight gain, inability to lose the “baby weight”

• Constipation

• Carpal tunnel syndrome, tendonitis, joint or muscles aches

• Puffy face

• Increased sensitivity to cold

• Muscle weakness

• Heavier than normal menstrual periods

• Dry or brittle hair and nails, hair loss

If your concerns aren’t being properly investigated or are being overlooked by your doctor, consider looking for a second opinion or working with a Naturopath or Functional Medicine Doctor who will look into your whole Thyroid Panel (TSH, Free T4 and T3, thyroid antibodies, reverse T3) instead of just testing your TSH.

Some simple ways you can support your postpartum hormones

Rest & lots of skin to skin when you have the opportunity (Hire a postpartum doula)

Drink lots of filtered and remineralized water

Nourish your body through warming & blood-building foods

Take supplements to help your body heal and metabolize all the hormones and neurotransmitters involved in mood and energy production (See a Naturopath)

Move your body in ways that are appropriate (see a Pelvic Health Physio to help you get back to movement safely)

Ensure your body is healing physically to support your internal organs responsible for producing or metabolizing hormones (See a Chiropractor, RMT, Reflexology, Naturopath or Osteopath)

Oxytocin produced through breastfeeding and skin to skin can improve the postpartum blues (for most) (See a lactation consultant)

Build a support network to help you move through any challenges (See a counsellor/therapist, yoga therapist or Reiki practitioner)

Lean on your Community (& WOMB Family)

Understanding what is happening in your body postpartum, when it comes to hormonal fluctuations that are both normal and abnormal, is an important way for us to process and advocate for our needs. In addition to these hormonal shifts, your body has just grown a little human (amazing!) and is continuing to nurture and nourish your growing little one while healing from the physical and mental demands of the birth and pregnancy. 

Knowing that you have a supportive community is one way that we allow ourselves to surrender to the fourth trimester and focus on ours and our baby’s needs. Here are some ways that The WOMB Guelph is here to be your village, and help you navigate your fourth trimester with ease:

• Child-minding services available if you need an appointment and someone to watch your little one nearby.

• Services to help your postpartum mind, body & spirit: Lactation support, Postpartum Doula Services, Counselling services (individual and Couples), Naturopathy, Chiropractic, Massage, Osteopathy & Manual Therapy, Pelvic Health Physiotherapy, Reflexology, Reiki, Speech Language services and Myo-functional Therapy.

• Fitness classes and workshops for new parents to educate, rehabilitate and build community.

• No appointment needed to come in and grab a coffee, tea or water and sit and chat with our care team or other parents in the community. 

See you soon! ❤️