As a chiropractor who specializes in hormone health, prenatal & perinatal health, I have seen many moms who feel lost when it comes to navigating postpartum or never realized their hormone imbalances years after giving birth were related to the stress of the birthing event.
These new moms come to me feeling exhausted, foggy, and overwhelmed, wondering if what they can do besides waiting it out. I want to delve into this topic from a scientific perspective so that there is an understanding of why some women bounce back postpartum and some mom's may have a harder time.
The Role of the HPA Axis
The hypothalamic-pituitary-adrenal (HPA) axis is a complex network that regulates our body's response to stress. It involves the hypothalamus, pituitary gland, and adrenal glands, which work together to produce and regulate hormones such as cortisol, a key player in our stress response.
Cortisol and the Stress Response
Cortisol, often called the "stress hormone," is crucial for our body's stress response. It helps us by increasing blood sugar levels, enhancing brain function, and suppressing the immune system to prioritize immediate physical responses. However, chronic stress can lead to dysregulation of the HPA axis, resulting in persistently high or low cortisol levels, which can disrupt various physiological functions.
HPA Axis Dysfunction in Postpartum Moms
HPA axis dysfunction occurs when this regulatory nervous system is disrupted due to chronic stress, leading to abnormal cortisol production. This is particularly relevant for postpartum mothers, who face unique stressors such as hormonal changes, sleep deprivation, and the physical demands of caring for a newborn. Symptoms of HPA axis dysfunction in postpartum moms can include:
Severe fatigue and exhaustion
Insomnia or disrupted sleep
Brain fog and difficulty concentrating
Mood swings and irritability
Weakened immune system
Anxiety and depression
Weight gain or difficulty losing weight
Hans Selye's General Adaptation Syndrome
Hans Selye, a pioneering endocrinologist, introduced the concept of General Adaptation Syndrome (GAS) to describe the body's response to prolonged stress. GAS consists of three stages: the alarm reaction, the resistance stage, and the exhaustion stage. Understanding these stages can provide insight into how chronic stress affects postpartum mothers.
Stage 1: Alarm Reaction
The alarm reaction is the initial response to stress, where the body recognizes a threat and activates the "fight-or-flight" response. For moms going through labor, this pathway is triggered to help birth the baby. The HPA axis kicks into high gear, releasing cortisol and adrenaline and other hormones to prepare the body for immediate action. Stage 1 is a very normal response in anyone's body and the body should be able to manage the increase in stress and bring the body back to homeostasis (balance).
Stage 2: Resistance
During the resistance stage, the body attempts to adapt to the ongoing stress. Cortisol levels remain elevated to maintain a state of readiness. Postpartum mothers might experience this stage as they cope with the continuous demands of caring for a newborn, often sacrificing sleep and self-care. Stage 2 is a more common presentation from women in my office because these women have higher stress and demands of having a newborn. This doesn't allow for the nervous system to find that homeostasis as well as it would if your body wasn't under these higher stress demands.
Stage 3: Exhaustion
If stress persists and the body's adaptive mechanisms are depleted, the exhaustion stage occurs. The HPA axis may become so dysregulated that this stage can manifest as severe fatigue, irritability, and difficulty recovering from physical exertion. Most of my patients will come in and feel completely flat lined or feel very depressed.
What Do These Stages Mean For Struggling Moms?
Figuring out what stage of adaptation a mother is in is crucial for better recovery. Stage 1 & 2 typically require adaptogenic supports like ashwagandha, rhodiola, maca, cordyceps, reishi, ginseng, etc. can be extremely helpful for a faster recovery. Stage 3 may require different glandular supports to help bring mom out of a flat lined state. These types of supports should be taken with a health care provider's recommendations for proper dosaging and best care for the patient.
In addition, managing chronic stress is crucial for postpartum mothers' overall well-being. Here are some lifestyle changes that can significantly improve health and energy levels:
Balanced Diet: Eating a diet rich in whole foods, including fruits, vegetables, lean proteins, and healthy fats, can support overall health and recovery. I STRONGLY encourage you to focus on foods rich in Vitamin C all throughout the day as that nutrient is crucial in supporting this pathways we've discussed.
Exercise: Engaging in gentle physical activity, such as walking or postpartum yoga, can help manage stress and improve energy levels. Do what's easy for you, stretch or do gentle movement at home. Hold your baby and do some squats or lunges if tolerable. I love glute bridge exercises for new mom's to help with pelvic floor and pelvic stabilization recovery. If you are recovering from a C-section, consult with a provider on what movement you are cleared to do.
Adequate Sleep: Prioritizing rest and seeking support from family and friends to care for the baby can help mothers get the sleep they need. Lavendar Oil has been proven to help with anxiety and sleep. Applying some to your wrists or having some in a diffuser at night can be very beneficial. Just remember that not all oils are created equal - this is the blend I use and recommend to patient's for better sleep. (https://doterra.me/2INUjq)
Mindfulness Practices: Techniques such as meditation, deep breathing exercises, and mindfulness can reduce stress and enhance mental clarity. Put your favorite soft music on and try your best to get 5-15 mins daily of quiet time, if possible.
Postpartum mothers do not need to suffer in silence or push through overwhelming fatigue and stress without support. By identifying the level of HPA axis dysfunction and addressing it with appropriate lifestyle changes and medical interventions, new moms can significantly improve their well-being. It's important to seek professional advice if you or someone you know is struggling, as symptoms may overlap with other medical conditions. With the right support, postpartum mothers can navigate this challenging period more smoothly and reclaim their health and vitality.
For more in-depth information on other reasons for postpartum symptoms and solutions you can explore my postpartum education course: https://itlist.com/i/2843/postpartum-education-solutions
References
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Groer, M. W., Davis, M. W., Hemphill, J. (2002). "Postpartum stress: Current concepts and the possible protective role of breastfeeding." Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31(4), 411-417. Link
Field, T., Diego, M., Hernandez-Reif, M., Figueiredo, B., Ascencio, A., Schanberg, S., Kuhn, C. (2010). "Prenatal and postnatal depression effects on early interactions, HPA axis functioning, and behavior." Psychoneuroendocrinology, 35(1), 141-153. Link
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., Bruyère, O. (2019). "Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes." Women's Health, 15, 1745506519844044. Link
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Chien, L. W., Cheng, S. L., & Liu, C. F. (2012). "The effect of lavender aromatherapy on autonomic nervous system in midlife women with insomnia." Evidence-Based Complementary and Alternative Medicine, 2012, 740813. Link
Kasper, S., Gastpar, M., Müller, W. E., Volz, H. P., Möller, H. J., & Dienel, A. (2010). "Lavender oil preparation Silexan is effective in generalized anxiety disorder—a randomized, double-blind, placebo-controlled trial." International Journal of Neuropsychopharmacology, 13(5), 729-739. Link
Woelk, H., & Schlafke, S. (2010). "A multi-center, double-blind, randomized study of the lavender oil preparation Silexan in comparison to lorazepam for generalized anxiety disorder." Phytomedicine, 17(2), 94-99. Link
Lis-Balchin, M., & Hart, S. (1999). "Studies on the mode of action of the essential oil of lavender (Lavandula angustifolia P. Miller)." Phytotherapy Research, 13(6), 540-542. Link
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