LIMITLESS LEARNING | Health & Hormones in the Fourth Trimester

Let's cut the cutesy talk and get real about the early days of motherhood. Sure, there’s the pure bliss of holding your bundle of joy, but there's also the bone-deep exhaustion, the vulnerability that comes with having another human entirely dependent on you, and let's not forget the rollercoaster of wild hormones.

Our bodies are changing and healing, our moods are swinging, and we can struggle to maintain routines, sleep, and friendships. Amidst the blur of the (caffeine-fuelled) fourth trimester, it's easy to question how we fit into our new world. But you aren't alone.

Thankfully, society is starting to (finally) recognise the importance of postpartum health, with a growing emphasis on providing new mothers with the care and support they need during the fourth trimester — a period which lasts from the moment a baby is born until the end of their first three months. 

Enter Kate Whelan, a clinical nutritionist who specialises in women's health and hormones. Inspired by her own experiences with hormonal imbalances, Kate offers invaluable insight into the physical, emotional, and sexual well-being of new mums during the fourth trimester and beyond.

Here, Kate’s talking to us about all things postpartum, from the messy physical changes to the mayhem of emotions to your libido (or lack thereof). She’s not holding back on how fourth-trimester hormones can seriously affect your sex life, but she's also got some expert tips and strategies to help you navigate this tricky terrain. And if you're not up with the latest lingo, she’s also breaking down buzzwords and explaining exactly what "matrescence" means too.
 
This is the insider knowledge you need to know to get through those first few tricky months (and beyond) with your sanity (and maybe even your sex life) intact.

Portier: So Kate, we’ve survived the pregnancy and the blur of childbirth, but the hormonal rollercoaster is far from over. Exactly what can women expect, hormonally speaking, in the fourth trimester?

Kate: The fourth trimester refers to the first three months after giving birth, during which time a woman's body undergoes significant hormonal changes. These changes are necessary to support the transition from pregnancy to motherhood and include:

A decrease in estrogen and progesterone- During pregnancy, the levels of estrogen and progesterone in a woman's body are high to support the growth and development of the baby. After giving birth, these hormone levels drop significantly, which can cause symptoms such as mood swings and fatigue. 
An increase in prolactin- Prolactin is a hormone that stimulates breast milk production. After giving birth, prolactin levels increase, which triggers breast milk production.

An increase in oxytocin- Oxytocin is a hormone that plays a crucial role in childbirth and breastfeeding. It helps to stimulate contractions during labour and triggers the let-down reflex that releases breast milk. Oxytocin levels also increase during skin-to-skin contact with the baby, which helps to promote bonding.

An increase in cortisol- Cortisol is a stress hormone that can increase during the postpartum period. This can be due to factors such as lack of sleep, hormonal changes, and the stress of adjusting to a new role as a mother.

Portier: How long after birth can it take our hormones to resettle? Should we still expect wild mood swings (and wilder cravings) for months? 

Kate: It's important to understand that every woman's postpartum experience is unique, and hormone levels can vary widely. However, in general, it can take several weeks to several months for hormones to stabilise after giving birth. Many women start to feel more like themselves between three and six months postpartum as hormone levels stabilise and they adjust to the demands of motherhood. However, it's essential to remember that there is no set timeline for recovery, and every woman's experience is different. Be particularly kind to yourself during this time.

Estrogen and progesterone levels typically drop sharply after delivery, with levels returning to pre-pregnancy levels within a few weeks. Prolactin levels, which stimulate milk production, remain elevated as long as a woman is breastfeeding. Once breastfeeding stops, prolactin levels will drop, and estrogen levels will begin to rise.

It's also important to remember that physical and emotional recovery after childbirth can take time, and it's normal to feel tired, emotional, and overwhelmed during the first few weeks or months after giving birth. It can take several months for your body to heal from the physical demands of pregnancy and childbirth and adjusting to a new role as a mother can be challenging.

Portier: Time to tackle the taboo: How do our fluctuating hormones impact our libido during this time? Are we talking about a completely non-existent sex drive or something more complicated?

Kate: After giving birth, hormone levels drop, and the body undergoes significant physical changes, which can affect sexual desire and function.

In the early postpartum period, many women experience a decrease in libido due to factors such as fatigue, hormonal changes, and physical discomfort. Vaginal dryness, pain during sex, and changes in body image can also contribute to decreased sexual desire. It's important to wait until after your six-week check-up before engaging in sexual intercourse again.

For some women, breastfeeding can also impact libido, as high levels of the hormone prolactin can suppress ovulation and reduce sexual desire.

Each woman's experience will be different. It's important to communicate openly with your partner about your needs and desires and give yourself time to adjust to the physical and emotional demands of motherhood.

Portier: What is the most common misconception when it comes to postpartum hormones?

Kate: It's more an overall lack of understanding and support for mamas during their postpartum phase. My mission is to help women understand their bodies better so they can thrive in their bodies.  

Portier: What is your number one piece of advice for new parents navigating the whirlwind of hormones in the fourth trimester? 

Kate: Be kind to yourself and talk about how you are feeling. Have open and honest communication with your partner, family and friends so they know how to best support you. You don't have to go this alone.

Portier: "Matrescence" is a term that's been gaining popularity and used to describe the hormonal changes and identity shifts new mother’s experience. And honestly, it's a welcome replacement to the outdated and frankly insensitive term "baby brain." But where did this new term come from?

Kate: "Matrescence" is a term that has been coined to describe the psychological and emotional transformation women experience during pregnancy and motherhood. It refers to the profound changes in identity, relationships, and priorities that occur as women transition to motherhood. The hormonal changes that occur during pregnancy and the postpartum period can significantly impact a woman's emotional and psychological well-being. Many women experience a range of emotions, from joy and excitement to anxiety and fear, as they adjust to the demands of motherhood.

Matrescence is a complex process that can be challenging for many women. It can involve a shift in priorities, relationship changes, and the need to develop new skills and coping mechanisms. Women may also experience a sense of loss or grief as they navigate the changes in their identity and relationships.

Portier: What can matrescence tell us in terms of what support new mothers actually need to navigate this journey? 

Support for new mothers can take many forms, from helping the new mum out with caring for other children if this is not her first bub, household tasks such as cooking and cleaning to emotional support and validation of their experiences. It's essential to listen to new mothers and to provide them with the resources and support they need to adjust to this new phase of their lives.