The postpartum period, also known as the puerperium and "fourth trimester", refers to the time after birth when changes related to pregnancy return to the pre-pregnancy state. In addition to the physical changes during the postnatal period, there are also hormonal changes taking place. These changes can have an impact on the mother’s emotional state, which sometimes seems like an emotional rollercoaster. Together with MAM Expert Dr. Alexandre Saosaka we have summarized the hormonal changes to understand the impact on your emotional wellbeing and potential symptoms of postnatal depression.
How long does the Fourth trimester last?
The postnatal period begins with the birth of the baby. The end is not exactly defined, but is generally considered to be six to eight weeks after delivery, as then the effects of pregnancy start to reorganize and the body gradually returns to the pre-pregnancy state. However, getting back to a pre-pregnancy condition will happen only gradually after giving birth.
What happens to hormones right after giving birth?
After giving birth to your baby many hormonal changes are taking place. Some of them can have a bigger impact on your mental state than others. However immediately after giving birth there will be a change in hormones. The changes will take place over the first few days after birth:
- Human chorionic gonadotropin (hCG) is the main pregnancy hormone and declines exponentially immediately after childbirth. The hCG levels then typically return to normal non-pregnant levels two to four weeks after a full-term delivery .
- Progesterone and estrogen will decrease right after the baby is born. During pregnancy our bodies produce a great amount of estrogen and progesterone, which are the key to creating our “happiness hormones” dopamine and serotonin. So a decrease in both of those hormones, can have an impact on your mood.
- Oxycotin is released to encourage contractions during childbirth. In addition it plays a major role in forming an attachment between the newborn and mother. However postpartum oxycotin levels will decrease, which can lead to emotional changes, known as “baby blues” in the first few days after giving birth.
- Prolactin will increase in order to encourage your milk supply. Prolaction can also affect dopamine which can result in low energy levels and emotional moodiness.
What happenes to the hormones levels during the first few weeks after giving birth?
Over the
first few feeks and months your hormones will continue to change and adjust to your baby’s development. Around three months postnatal estrogen and progesterone will return to pre-pregnancy levels. In
breastfeeding mothers prolactin and oxycotin will still be increased.
The change in hormones cannot only have an impact on your mood but will also affect your body. The drop in estrogen for example has an impact on hair follicle shedding, which can lead to the known “postpartum hair loss” . But don’t worry, it is usually self-limiting, with restoration of normal hair patterns within 6 to 15 months postpartum.
Furthermore, you may experience “postpartum insomnia” due to the lack of sleep and its decreasing impact on melatonin, a hormone which helps with your day-night-ryhtm.
By the time you start to
introduce your baby to solids, the need for breast milk will decrease, leading the levels of prolactin, the “milk-producing” hormones to drop. This will start stimulating your natural cycle again. However the timeline for this can be different for everyone.
What is the difference between “normal” hormonal imbalances and postpartum depression?
As you can see there are many hormonal changes taking place after giving birth which can have an impact on your mood and energy. Many postpartum symptoms are usually self-limiting and will settle down during the first few weeks. Sometimes more severe symptoms of a postpartum depression can occur. It is always important to take these symptoms seriously and seek help from your health care professional when needed.
Sometimes postpartum depression can be mistaken for the “baby blues” , but the symptomes are more intense and last longer.
Symptoms of the baby blues will last in general from a few days to a week or two after giving birth. Whilst signs of postpartum depression include the following and will continue to last past the initial few days: