Healing, and hormonal balance, begin with nutrient-dense nourishment, plenty of rest, and a lot of support for at least the first month postpartum.  However, understanding what is normal for postpartum hormonal changes can help you assess if what you’re feeling is OK, or if an imbalance should be addressed.

First things first.  Let's set the record straight that "postpartum," is a noun, as in: the time-period after birth. Or, "postpartum" can be an adjective, as in: a descriptor of a type of depression.  But using the word "postpartum" to describe a mental state really shows how disillusioned our culture is when postpartum depression is so common that people have simply started calling their depression or their friend's depression, "postpartum."  But postpartum is not a state of dis-ease or imbalance and there are a plethora of ways to experience this postpartum time feeling nurtured and fairly well-rested, and much of this has to do with nourishment and support that begins before conception.

In pregnancy, estrogen (specifically, estradiol) and progesterone rise remarkably, working synergistically together to make the uterus sensitive to contractions, while Progesterone prevents labor from starting too soon.  It could be possible to predict when labor is imminent through labs, indicated by a slight drop in Progesterone while Estradiol remains high.  However, the most significant drop in these two hormones comes with the birth of the placenta, triggering a steep drop in these two hormones.

High progesterone warmed your body through pregnancy and should have prevented the high levels of prolactin from allowing breastmilk to flow.  If there is even a sliver of placenta left in the body, not only will your bleeding be heavier, but your milk may not quickly transition from colostrum to flowing milk.  It usually takes 24-72 hours for these milk-flowing hormonal changes to be noticeable by you.  Your breasts start feeling full and oxytocin (if you’re not too stressed) starts contracting the breasts to squeeze out (let down) the milk.  Without balanced hormonal shifts, sometimes occurring because of retained placenta tissue or lack of support, it may be 4-7 days, or longer, before you start noticing flowing milk which allows your baby to become more satisfied.

Prolactin and oxytocin together create a hormonal blend that allows mothers to feel safe and calm and loving towards their newborn.  At the same time, feeling safe and calm and loving towards your newborn increases your oxytocin and prolactin.  This cycle is enhanced by reflecting on a positive birth experience and holding your baby skin to skin often while gazing into their eyes.  So, the best way to increase milk supply and feel happy after birth is breastfeeding a lot and holding your baby a lot without distractions.  Your baby’s cues to nurse a lot and be close isn’t just for their needs; God created this to provide health and nourishment for you, too.

In the 12 months that follow birth, the thyroid system has dramatic shifts, though most of these shifts will occur within the first few months of postpartum.  As the immune system works to heal the inflammation of pregnancy and childbirth, and lack of sleep increases, thyroid antibodies and cortisol rise in the first few weeks after birth.  This naturally causes the thyroid to become overactive and release stored thyroid hormones into the bloodstream.  Because of this action, a period of underactive thyroid usually results as the thyroid hormones are used up.  With balanced pre-conception health, along with plenty of postpartum nourishment, rest, and support, these changes should be balanced.  The less you create a healing postpartum environment, or the more you were imbalanced prior to conception, the more drastic these changes can be, and feel, and may lead to baby blues or depression.

If your thyroid was overactive prior to birth, you might feel these initial changes by experiencing elevated blood pressure and an “always on” feeling.  If your thyroid was underactive prior to birth, you might feel these initial changes as extreme fatigue.  In both cases, depression is more likely and it may be more difficult for you to fall asleep when you get the chance.  By 3-4 weeks, exhaustion, and depression, peak.

After a joyful birth, many moms feel great and want to get back up to their feet as soon as possible.  But when there are health imbalances, the hormone and detoxification rhythms take a big hit in these first few weeks. If you don’t discipline yourself, ask for support, and rest in bed, your baby’s growth spurts and physical needs can really take their toll. It is worth repeating again that 3 days in the bed, 3 days on the bed, and 3 days near the bed have been prescribed throughout the recent years as a bare minimum to postpartum healing.  But historically, in most cultures that value the health of their mothers and babies, women were expected to rest for the first 40 days.

We don’t need to know all the specifics of the hormonal changes to know how much better we feel when we have adequate sleep, support, and nourishment.  Your body can’t make hormones, and can’t detoxify, without these three basic human needs.  If your baby blues aren’t going away in just 1-2 days, or any symptoms of imbalance are getting worse, it’s time for more support, a different approach to healing, and likely lab tests.