Why The Journey To Recovery Can Be Challenging After Giving Birth: The Impact Of Postnatal Depletion
I remember sitting in front of an Advanced Nurse Practitioner at the doctor's office, unsure of why I was there, but my husband had insisted I go. At the time, we had a 9-month-old and a 2 year-old. The past year had been challenging, with me working diligently at the hospital while pregnant, and following the birth, our youngest child experiencing frequent hospital visits since they were just 6 weeks old. My entire focus had been on raising these two little humans, and I hadn't even considered my own well-being.
I was struggling. I had no energy, I couldn't think clearly, and I had to force myself out of bed in the mornings, only to collapse and fall asleep as soon as I sat down on the sofa at night. My emotions were all over the place - I would cry one minute and be happy the next. Additionally, I hadn't shed the pregnancy weight like I did with my first baby. The nurse mentioned that he would check for iron deficiency. When I followed up a few weeks later to obtain my results, I was simply informed that I wasn’t deficient without any specific levels provided. I had no idea if I was just slightly above deficient or if my levels were high.
Life continued, and my recovery was an arduous and slow process. It took me a staggering 4 years to fully recover physically, mentally, and emotionally from the birth of my second child. Having worked in conventional medicine I just thought that it was normal. Looking back, if only I had known about postnatal depletion, it could have significantly improved my recovery, just as it did with my third baby. After the birth of my third child, I was able to recover quickly and even train for a marathon. It was a transformative experience that showed me the power of understanding and addressing postnatal depletion, and I believe that the same can happen for any mother out there.
What is postnatal depletion?
It’s a syndrome first devised by Dr Oscar Serrallach, which refers to the combination of hormonal, physical and emotional depletion following birth.
Why does it matter?
The postnatal period is a critical time for mothers. It can bring joy, but it can also bring uncertainty, discomfort, pain, and vulnerability. By taking the time to look at postnatal health, women can recover quicker, prevent health complications, and feel supported in achieving overall well-being and fostering a connection with their baby. Neglecting symptoms may result in imbalance which can contribute to long-term diseases, accelerated aging, and the development of chronic diseases over time. It can also lead to a lack of necessary nutrients for optimal cellular function, repair, and regeneration.
How can you determine if you have postnatal depletion?
Recognising the signs and symptoms of postnatal depletion is crucial. Fatigue is a prevalent issue. Other indicators include "baby brain" or brain fog, hypervigilance and anxiety, self-doubt, vulnerability, low energy levels, hair loss, feeling frustrated or overwhelmed, and a loss of libido. These symptoms sadly are often dismissed as normal aspects of motherhood.
When does it affect us and for how long?
Many people are not aware of the long-lasting effects of postnatal depletion. While it is expected to last for weeks or even months, it is concerning that it can persist for up to 10 years, leaving mothers physically, mentally, and emotionally drained. Research has shown that the consequences of childbirth can continue to impact a mother's well-being for an extended period of time. Maternal depression is actually more prevalent four years after giving birth compared to any time within the first twelve months.
What help is available?
In the field of functional medicine, we consider the five roots of personalising lifestyle and environmental factors that influence overall well-being: sleep and relaxation, exercise and movement, nutrition, stress, and relationships. It is crucial to recognise that the postpartum period disrupts all of these areas. Sleep patterns become erratic, relaxation becomes a luxury, exercise is complicated by conflicting advice, proper nutrition and fixing insufficiencies becomes challenging amidst exhaustion and sugar cravings, stress levels skyrocket, and relationships undergo significant changes. It can be overwhelming for any mother to navigate.
If these imbalances are not addressed however, things can spiral out of control, leaving you feeling exhausted and desperate. The good news is we can help in overcoming postnatal depletion by addressing specific imbalances and optimising recovery. Let’s look at a few key areas.
Optimising Nutrition
During pregnancy and childbirth, the body undergoes significant changes and has increased nutritional requirements. The baby takes priority in absorbing nutrients, leaving the mother with whatever is left. An example of this is the body taking calcium from its own bones to provide it to the little one. This nutrient "stealing" can potentially lead to deficiencies in iron, calcium, B vitamins, omega-3, zinc, vitamin D, magnesium, copper, choline, and more..
A good starting point is to address any insufficiencies in micronutrients and imbalances in macronutrients. It is crucial to ensure the body has enough nutrients, especially for repairing the nervous system and brain.
During pregnancy and postpartum the mother’s brain undergoes pronounced grey matter volume reductions in her brain, which have been associated with maternal attachment, and this volume loss can last for at least 2 years. The good news is that the brain can recover the grey matter lost during pregnancy by repleting the nutrients which are insufficient.
Additionally, a nutritional assessment can help identify food sensitivities and intolerances which may arise or worsen during pregnancy.
Managing Sleep Issues
Sleep plays a crucial role in the recovery process. Research has shown that a reduction in sleep duration impacts insulin sensitivity and glucose regulation. Over multiple nights, this results in impaired glucose tolerance and insulin resistance in healthy individuals. The good news is that the right type of exercise can help curb some of the increases in blood glucose that sleep deprivation induces.
Personalised testing can also be used to identify natural sleep enhancers that can be beneficial, especially if one has a winter baby and is struggling with the shorter daylight hours. We can look at different things which can help depending on your situation, such as GABA, 5-HTP, melatonin, and magnesium baths.
Optimising Blood Sugar Levels and Hormones
Blood tests for hormones like thyroid, DHEAs, testosterone, and cortisol can also provide useful insights. Hypothyroidism is a common imbalance women experience postpartum. Approximately 7% of women develop postpartum thyroiditis. This autoimmune condition can cause mood swings, lethargy, thinning hair, and difficulty with weight loss. Women with pre-pregnancy thyroid antibodies are also more likely to develop postpartum thyroiditis.
Interestingly, women need carbohydrates for proper thyroid function, so adopting a keto diet postpartum for weight loss can potentially worsen the issue. Finding the right balance and providing adequate carbohydrates for optimal thyroid function is crucial.
After addressing lifestyle factors, we also consider individualised herbs and supplements to support hormonal health.
Physical activity is important not only for helping with insulin resistance, but it can help protect and treat postnatal depression, and aid recovery. This also has a benefit for the child and their siblings. Studies have shown a direct, positive association between physical activity in children and their mothers – the more activity a mother did, the more active her children.
Physical therapies like restorative yoga and acupuncture can also help teach us how to properly relax, which is always a challenge during this time.
Why should you care?
Postnatal depletion is a real phenomenon that affects many women. However, with the right personalised support and a comprehensive approach, mothers can overcome this depletion and achieve a healthy recovery after giving birth. It's time to rewrite the story surrounding postpartum health and prioritise the well-being of both mothers and their babies. They deserve it. By acknowledging the importance of personalised tests, care, and support, we can ensure that mothers receive the assistance they need to rebalance, recover, and thrive after giving birth.
Dr Caitlin Wiltsher, founder of Cura Body, specialises in providing a whole body approach to health and wellbeing. Utilising cutting edge, scientific research and the latest in laboratory testing, we can help identify the root causes of issues and aid you in your journey to an optimum you.
To find out more about how Cura Body can help with Postnatal Depletion, book a free discovery call today.