Motherhood: The "Re-birthing" of Every Woman
One year after giving birth, and my curiosity has lead me to question why women’s bodies go through so many significant changes postpartum. Questions such as why do so many women experience postpartum depression and anxiety after giving birth? Why could my husband sleep soundly after our baby arrived, while I struggled for months to fall into a deep sleep? Most recently, why does weaning from breastfeeding suddenly make me feel as if I’m in the early stages of postpartum once again?
With my background in biology and psychology - and a curious mind that can’t easily be put to rest - I was determined to get some answers. We spend hours researching the best method to sleep train our babies, the best food to offer them, and even finding the cutest outfits for them online (guilty as charged!). Where is the time that we devote to ourselves and understanding the changes happening to our emotions and physical body that we must now learn to adapt to? Although research is limited, we are finally starting to learn more about the the drastic neurological changes that women must go through.
Our Brains During Pregnancy
Studies have found that women’s brains actually get smaller in size and volume during pregnancy (Hoekzema et al., 2016). So yes, “Pregnancy Brain” or “Mommy Brain” is a thing! Grey matter that contains most of our cell bodies decreases in certain regions of a pregnant women’s brain. It is believed that this reduction is done to make more efficient use of a women’s energy. One of these changes in grey matter is seen in the hypothalamus, the brain region responsible for memory. Remembering what items you need from the grocery store no longer becomes as important, and that energy is used elsewhere to promote the growth and development of your growing baby.
Our Brains After Birth
As if learning to care for your little one isn’t enough, our brains also begin to change after we give birth. Increases in grey matter volume of the amygdala and hypothalamus were found in postpartum women (Kim, Leckman, Mayes, Feldman, et al., 2010). What exactly does this mean? Put simply, our brains now increase in volume with a substantial amount of our resources going towards crucial brain functions. One of these changes is seen in the the amygdala, the brain region responsible in activating our “flight or fight response”. This is the automatic response that tells our body to respond when there is perceived threat. How does this play a role in motherhood? Increased activity in our amygdala makes us more sensitive to the quiet “coos” that our babies make to communicate their needs. With our brain working at such a heightened level, we are always on alert to attend to our child’s every need - even when we are sleeping.
Hormonal Changes
Immediately after giving birth there is a significant reduction in two crucial hormones - estrogen and progesterone (Fuschs, 1984). These hormones play a key factor in regulating our menstrual cycle, and sustaining pregnancy. Although levels of these hormones are high during pregnancy, after giving birth estrogen and progesterone levels immediately begin to decline. What does this change in hormone levels mean for our mental health?
Low levels of progesterone leads to low levels of serotonin - the “happy chemical” that helps us regulate our mood and sleep cycle. New mothers already face disruption to their sleep cycle from having to care for a newborn. Compounding the loss of sleep with low levels of serotonin further impacting our sleep cycle. With the changes that come to one of our most crucial systems - the sleep-wake cycle, it is no surprise that “baby blues” or postpartum depression might make an appearance after giving birth.
One hormone that drastically increases after giving birth is oxytocin. Often called the “love hormone”, the surge of oxytocin helps promotes bonding and attachment to our new baby. However, this rush of oxytocin comes with its own challenges. High levels of oxytocin can also lead to feelings of fear and anxiety. Therefore due to an increase in oxytocin, a new mom is on high alert, while simultaneously feeling an immense level of love for their child.
When thinking of this neurological change, The “Mama Bear” reference might come to mind - imagine a loving, yet overprotective bear, shielding its cub from danger. The perfect combination of immense love and anxiety.
Amnesia
Do some women experience a level of amnesia after childbirth? I recall one of my friends asking me, “ Is it true, does the surge of hormones after giving birth make you forget all the pain you just experienced?”. She was due to give birth a few months after me and was looking for the reassurance that nature takes care of the pain of childbirth . This question was similar to that of my husband’s 89 year old grandmother, when visiting me in the hospital she looked at me with a big smile and said, “You’ve forgotten all the pain haven’t you?”. It seemed like such an odd question to me at the time. However, both of their statements suggest there is belief that for some women, the birthing experience is merely a series of flashbacks, with the experience of pain omitted.
Why is it that some women might have a difficult time recalling specific memories of their birthing experience? Some studies suggest that the surge of oxytocin post delivery has an amnesic effect on our brains. This might be nature’s way of helping us forget the pain we experienced to encourage us to reproduce once again. Although a very fascinating topic, the research on this topic is still emerging.
The Last Stretch - Weaning
For breastfeeding women, a final change in hormones comes during the process of weaning. Producing breastmilk is no small task, our bodies are providing nutrition, and helping build the immunity of our developing newborn. Therefore, it should only be expected that when our bodies stop producing breastmilk, there will be a series of physiological changes that follow.
This is where the hormones, oxytocin and prolactin begin to drop. When prolocatin levels drop, the hormone estrogen shoots back up. When estrogen levels are high, progesterone levels begin to decrease. As previously mentioned, a decrease in progesterone can bring upon symptoms of anxiety and depression. Low progesterone levels are also associated with headaches, weight gain, acne, and irregular menstrual cycles. If our changing hormone levels after weaning can cause such significant physical changes in our bodies, it is no surprise that this period also causes many emotional changes to our mental health. Until our bodies regulate after weaning, women might be more susceptible to mood swings, depression, and anxiety.
What Does it all Mean?
During pregnancy we have an array of information available to us. There are multiple pregnancy apps that will tell us how our baby is developing week by week, and which size of fruit they can be compared to. This is all very interesting, however, more education needs to be provided to women about what they can expect after giving birth. More research needs to be placed on this “fourth trimester” - the changes to brain structure, hormones, and our physical body that a women experiences post-partum.
The information in this article was not easy to find. This is because there are a limited number of research studies that look at the postpartum period in women. What this tells us is that the importance placed on women’s postpartum care is lacking. Why is it that women can easily research how to “get fit after pregnancy" - but it is so difficult for them to learn more about the very changes their body is going through? The important changes that are impacting their day to day mental health. Someone recently told me that once a women gives birth, they are “re-born” - meaning a new part of them emerges. Let us acknowledge the significance of the journey into motherhood - and pay more attention in caring for our clients, friends, sisters, and partners during this transformation.
References:
Elseline Hoekzema, Erika Barba-Müller, Cristina Pozzobon, Marisol Picado, Florencio Lucco, David García-García, Juan Carlos Soliva, Adolf Tobeña, Manuel Desco, Eveline A Crone, Agustín Ballesteros, Susanna Carmona, Oscar Vilarroya. Pregnancy leads to long-lasting changes in human brain structure. Nature Neuroscience, 2016
Fuchs AR, Fuchs F Br J Obstet Gynaecol. 1984 Oct; 91(10):948-67.
Kim P, Leckman JF, Mayes LC, Feldman R, Wang X, Swain JE. The plasticity of human maternal brain: Longitudinal changes in brain anatomy during the early postpartum period. Behavioral Neuroscience. 2010;124(5):695–700. doi: 10.1037/a0020884.