What’s happening with your hormones after having a baby?

I know firsthand that the postpartum period can be overwhelming and confusing. As you try to become informed, many terms get thrown around, and it can be difficult to understand the difference between them. Two words that are often used interchangeably are ‘postnatal’ and postpartum. 

In this article: 

• I’ll define each term, 
• explain the key differences between them, and 
• discuss how they might affect you as a new mother. 

Understanding the meaning: Postnatal vs Postpartum

Postnatal and postpartum both refer to the period following the birth of a baby. However, there is a subtle difference in meaning between the two terms. ‘Postnatal’ refers to the time immediately after birth, up until six weeks. Postpartum, on the other hand, encompasses the year after the birth of a baby (though, in my opinion, postpartum is forever as a mother changes irrevocably once becoming pregnant). 

Physical and emotional changes: what sets postnatal and postpartum apart

While there is some overlap between the physical and emotional changes that occur during the postnatal and postpartum periods, there are also some key differences. 

Postnatal changes:

1. Estrogen and progesterone: During pregnancy, levels of estrogen and progesterone increase significantly to support the growth and development of the baby. These hormone levels drop rapidly in the days after childbirth, known as ‘the estrogen dump’, possibly leading to hot flashes, night sweats, mood swings, and vaginal dryness. The severity and duration of the estrogen dump can vary from woman to woman. A drop in progesterone levels after childbirth can potentially contribute to fatigue, depression, and anxiety.

2. Prolactin: Prolactin is the hormone responsible for milk production in breastfeeding mothers. It rises dramatically in the days following childbirth, which can cause breast engorgement, soreness, and leaking.

3. Oxytocin: Oxytocin is known as the ‘love hormone’ because it promotes feelings of bonding and attachment. It also triggers contractions during labour and after-birth pains, often during breastfeeding, to help the uterus return to its pre-pregnancy size and shape after childbirth. 

4. Lochia: the bloody vaginal discharge that occurs after childbirth. It is a normal part of the postpartum recovery process and is the body’s way of shedding the uterine lining built up during pregnancy. Lochia typically lasts 4-6 weeks after childbirth, although the duration can vary from woman to woman.

5. The baby blues: Typically occurring three to five days after birth, the baby blues are characterised by mood swings, tearfulness, and feelings of anxiety or overwhelm. While the baby blues can be distressing, they are a normal part of the postpartum recovery process and usually resolve within a week. The cause is thought to be huge hormonal shifts, but I’d also say the significance of meeting your baby, your birth experience, the end of pregnancy, and the demands of parenting warrant a surge in emotions. 

Postpartum changes

1. Thyroid hormones: Pregnancy, childbirth, and nurturing life can affect thyroid function, increasing the risk of thyroid disorders such as postpartum thyroiditis, hypothyroidism, or hyperthyroidism. Symptoms of thyroid disorders can include fatigue, weight change, and depression.

2. Hair loss: Postpartum hair loss is a common condition that affects many new mothers. During pregnancy, the hormonal changes in a woman’s body can cause hair to become thicker and fuller. However, postpartum hormonal changes can lead to hair loss, typically between two and four months after giving birth, lasting several months. I had two big bald patches around my temples. Really cute. 

3. Mental disorders: Depression and anxiety are common but serious. Unlike the Baby Blues, postpartum mental disorders are characterised by persistent and severe symptoms that can interfere with daily functioning, caring for yourself and your baby, and enjoying your motherhood experience. Causes might be hormonal changes, sleep deprivation, the stress of caring for a newborn, matrescence, your level of support, and a shift in your social and financial status. 

4. Postnatal depletion: This condition uses the term ‘postnatal’ but refers to the months and years after childbirth. Depletion comes from the physical and emotional exhaustion caused by hormonal changes, sleep deprivation, the resources you give to create and nurture life through pregnancy, childbirth, breastfeeding, and the demands of motherhood. Symptoms include poor mental health, chronic physical issues, mood swings, mum rage, insomnia, and brain fog. 

One difference between postnatal and postpartum physical and emotional changes is that:

Postnatal changes are normal and natural and pass quickly.

Postpartum changes are more persistent and can be avoided or managed with proper care. 

Navigating the first few weeks: how postnatal and postpartum care differ

The postnatal and postpartum periods are distinct, and so too is the type of care a mother receives in each phase. During the postnatal period, the focus is on physical recovery and ensuring a new mother can care for her baby. This may involve monitoring for signs of infection, healing from birth injuries, providing pain relief, and offering support with breastfeeding. 

Aside from being checked in the immediate window after birth, it’s standard for a new mother to see her doctor for a check-up six weeks later, when her baby is also checked. The appointment is typically quick, focuses on healing from birth, and contraception, and may or may not involve an internal examination. The health care system tends to leave women alone after this appointment. 

This level of care is not enough. I believe new mothers need continuity of care from someone with whom they have built rapport and trust since pregnancy. Someone who takes the time to listen, does not treat mothers as statistics, holds space for emotional output, and can focus on holistic care and support for the mother. Every woman should receive care from a pelvic floor physiotherapist as standard practice. 

In the postpartum period, a new mother’s care depends on her reaching out for it. Sometimes it’s tough to accept that you are struggling and to ask for help. Setting up support systems is crucial for postpartum wellbeing. 

Postnatal and postpartum exercise: Understanding your body’s needs

Another critical difference between the postnatal and postpartum periods is how you move your body. 

You’ll probably be told to avoid exercise for six weeks after birth, but it is OK to do gentle movements, which can promote healing. This may involve pelvic floor exercises, gentle yoga, and light walking. 

In the postpartum period, the focus can shift to stronger exercise, but listening to your body and avoiding pushing yourself too hard is essential. I recommend following a postpartum-specific plan focusing on healing diastasis recti (knitting your abs back together), core stability, pelvic floor tone, mobility, gentle strengthening, and light cardio. Work with a qualified postpartum exercise professional who can help you develop a safe and effective workout plan.Yoga Coaching

While the terms postnatal and postpartum are often used interchangeably, they refer to distinct periods in a woman’s life following the birth of a baby. Every woman’s experience of the postnatal and postpartum periods will differ, and there is no ‘right’ way to navigate this time.  Understanding the differences between these two periods can help new mothers navigate the challenges they may face during this time and receive the care and support they need.

Disclaimer: This article is for informational purposes only and is not intended to serve as medical advice. If you have concerns about your postnatal or postpartum health, please consult a qualified healthcare professional.