Published Sep 21, 2002 in the North Island Weekender
The six to eight weeks following the birth of babies, women go through enormous emotional and psychological changes that are not well appreciated in our society. Dr. Northrup terms it the “Fourth Trimester”. It is normal to sweat and have hot flashes and have hair loss, vaginal dryness and to bleed for 4-6 weeks as the hormones readjust. All of these usually normalize within two months after delivery. It would be nice for new mothers to have full time help for cooking and cleaning for two months after delivery and have time for a nap every day. Unfortunately in this day and age getting this help is rare. Fully 80% of women experience baby blues for up to two weeks after delivery. Approximately 10-15 % of women will go on to experience some sort of mood disorder postpartum ranging from major depression to anxiety disorders. If a woman has a history of depression she is at a greater risk postpartum. If a woman has experienced a traumatic labour she can be left with a type of post- traumatic stress disorder which is made worse by any sense of failure that she had during labour.
Christine, age 35, came in four months after the delivery of her second child. She complained of extreme fatigue and depression postpartum but she wanted to avoid anti-depressants. She had never been depressed before and although she had been tired after her first delivery three years prior, this time it was much worse. She was a nurse and felt that expectations from her peers were so high that she couldn’t talk about her depression with anyone. She had been very fit before her first pregnancy, but since gained 20 pounds that she has been unable to lose. She has never felt quite right since her first delivery.
My workup with Christine included a CBC (complete blood cell count) and ferritin to evaluate her iron status. I find a lot of women have normal CBC’s but ferritin levels are low and iron supplementation makes a big difference with their fatigue. I also measured her T4 and TSH, both thyroid tests. I find TSH levels can be normal i.e. 1.8-2.5 but the T4 is between 10-15 which I find too low. Their basal body temperatures are also less than 97.8 all of which points to a low thyroid. During the physical and the electro-dermal testing for organ stress I find adrenal glands are under functioning as well.
I equate pregnancy and delivery to climbing a mountain. The more fit you are going in to delivery the easier it will be however there is a recovery time where the body needs to heal and the thyroid and adrenal glands may need temporary support to speed this recovery. Other practitioners suggest that the adrenal function of the fetus gives the woman support that she loses at delivery and thus sinks into a depression.
The literature also indicates deficiencies of B12, folic acid, Vitamin A and essential fats during this period of a woman’s life.
Christine did in fact have low thyroid function. I prescribed naturopathic remedies to support her thyroid including selenium, iodine and thyroid glandular. I gave her two injections of B12 which perked her up considerably. I made sure she was getting enough iron, zinc, vitamin A and calcium in the multivitamins she was taking and made sure she was taking a purified cod liver oil that supplemented her with DHA essential fats. Women need to be affirmed that breast-feeding is more stressful on the body than the pregnancy or delivery. Breast-feeding is definitely encouraged so supporting the woman during this time is crucial.
I reassured Christine that her depression had a definite physiological cause and that she would do well on the program. I also encouraged her to get some daily help so that she could get some rest. A simple suggestion of getting a house cleaner once per week can take tremendous stress off her. For more severe cases I recommend homeopathic remedies, additional herbal support and contacting the Pacific Post Partum Support Society in Vancouver 604-255-7999.
Dr. Pincott has been practicing naturopathic medicine since 1985 and is currently practicing in Campbell River. She can be reached at (250) 286-3655 or www.DrPincott.com