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Beyond Birth: Don't Forget About Us! The Unseen Mothers Postpartum



While the experience of pregnancy and bringing forth a human life into this world is excellent, beautiful, and miraculous, let's discuss mothers' experiences once that baby is born. 


 Once again, thank you, mothers, for giving life and risking your lives to create something so precious and beautiful. Thank you for your sacrifices in nurturing, protecting, and raising another human life to the best of YOUR ability; therefore, let's discuss you!


I read an online article that elaborated on how women's healthcare needs are often not prioritized as high as those of their infants and children by many well-funded maternal health programs and tend to view the "baby as the candy and the mother as the wrapper." (University of Illinois at Urbana-Champaign, 2024).


Mothers can experience neglect and isolation, even though they are caring for an infant. However, there is a difference, newborns and infants require attention and depend on the mother. Mothers are self-sufficient and do not require dependency on eating, feeding, dressing, bathing, toileting, and grooming, generally speaking (excluding mothers with disabilities). Mothers lose their individuality. A mother may have had previous roles before a baby came along, such as a sister, an aunt, a cousin, a wife, a fiancé, a girlfriend, a blogger, a lawyer, a doctor, and the list can go on, but most importantly, she was a woman, she was an individual, and most times when a woman becomes a mother, she may experience revocation of those other roles and titles.


I want you to know we see you, we support you, and we want to continue being seen, protected, heard, and supported. Wanting to feel valued is normal and justified because you are human and an individual yourself! Your body experiences so many hormonal changes every step during pregnancy. You must be seen and acknowledged at every stage of pregnancy and mamahood.


Hormonal Changes before prenatal 

While many women experience brief periods of anxiety and sadness during pregnancy, most manage this transition without significant mental health issues (Trifu et al., 2019). However, for those who do experience depression during pregnancy, the consequences for both mother and baby can be severe (Trifu et al., 2019). Depression is the leading psychiatric condition in pregnancy, affecting over 13% of expectant mothers (Trifu et al., 2019). Antenatal depressive symptoms are prevalent among adolescents, urban women, and those with a history of major depression. Though less frequent than postpartum depression, antenatal depression remains a critical concern (Trifu et al., 2019).


Hormonal Changes During Pregnancy 

Pregnancy involves a delicate balance in the endocrine system, with interactions between the mother, placenta, and fetus (Trifu et al., 2019). Any disruption to this balance could potentially lead to mental health challenges during pregnancy (Trifu et al., 2019). During pregnancy, hormonal changes can mimic conditions like hyperthyroidism, pituitary adenoma, Cushing's disease, and diabetes, which are known to cause psychiatric disturbances (Trifu et al., 2019).


Exposure to high levels of maternal stress during pregnancy can adversely affect maternal mental and physical health, as well as fetal development (Trifu et al., 2019). Furthermore, hormonal imbalances, such as cortisol reactivity and hypothyroxinemia, are linked to perinatal depressive symptoms and cognitive function issues, even after adjusting for depression and sleeping problems (Trifu et al., 2019). During pregnancy, hormonal shifts can disrupt sleep patterns, causing insomnia, particularly in the later stages (Trifu et al., 2019). This lack of sleep is linked to feelings of depression and suicidal ideation (Trifu et al., 2019). 


Hormonal changes after pregnancy

Progesterone takes center stage during pregnancy as the primary hormone (Trifu et al., 2019). However, post-birth, there's a sharp decline in progesterone levels, which may play a role in postpartum depression (Trifu et al., 2019). One potential explanation is that progesterone and its brain metabolite, allopregnanolone, typically help reduce irritability (Trifu et al., 2019). Since the ovaries don't resume progesterone production until after the first menstrual cycle, this temporary hormonal shift may contribute to imbalances (Trifu et al., 2019).


After childbirth, the body adjusts to lower estradiol levels to support lactation. It's well-known that estradiol can boost serotonin levels in the brain, which helps to ease depressive symptoms (Trifu et al., 2019). However, the drop in estradiol after giving birth works in the opposite way, reducing the body's natural defense against depression (Trifu et al., 2019).


During childbirth, beta-endorphins rise, reaching a peak before delivery, and then decline postpartum (Trifu et al., 2019). These heightened levels help women manage the birthing process by inducing an altered state of consciousness (Trifu et al., 2019). Afterward, mothers often feel more alert, attentive, and joyful (Trifu et al., 2019). In the initial postpartum phase, endorphins and oxytocin are believed to play a role in strengthening the mother-infant relationship (Trifu et al., 2019). 


After childbirth, higher levels of testosterone are linked to increased mood swings. Additionally, during labor, corticosteroids peak and then drop significantly within four hours after birth, leaving women emotionally vulnerable (Trifu et al., 2019). The combination of high prolactin, low estradiol, absence of progesterone, potential decrease in dopamine, and fluctuations in thyroid hormones can result in significant psychological effects during this period (Trifu et al., 2019).


Final Thoughts

To all the mothers out there: as you embark on the incredible journey of pregnancy and childbirth, remember that your needs and well-being matter as much as those of your precious newborn. It's all too common for mothers to feel overlooked or sidelined once their baby arrives. Still, you must recognize that you are more than just a caretaker. You are an individual with unique needs, desires, and roles beyond motherhood.


We want to acknowledge the sacrifices you make, the challenges you face, and the incredible strength you demonstrate daily. You are not alone, and it's okay to prioritize your own health and happiness amidst the demands of motherhood. While caring for your newborn is undoubtedly important, remember to care for yourself too.


Throughout pregnancy and mamahood, your body undergoes countless hormonal changes, which can impact your mental and emotional well-being. From the rollercoaster of emotions during pregnancy to the postpartum adjustments, it's normal to experience a range of feelings. However, if you find yourself struggling with depression or anxiety, know that help is available, and you deserve support.


We see you, we support you, and we want to empower you to prioritize your own needs alongside those of your baby. You are more than just a mother; you are an individual with dreams, aspirations, and a life outside of parenthood. Embrace your identity, honor your journey, and remember: "Don't forget about us!"



References

Trifu, S., Vladuti, A., & Popescu, A. (2019). Neuroendocrine aspects of pregnancy and postpartum depression. Acta Endocrinologica, 15(3), 410–415. https://doi.org/10.4183/aeb.2019.410


University of Illinois at Urbana-Champaign. (2024, April 4). Researchers call for policy changes to address perinatal mental health disparities. News-Medical. https://www.news-medical.net/news/20240403/Researchers-call-for-policy-changes-to-address-perinatal-mental-health-disparities.aspx

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