The loss of a pregnancy or baby is an emotionally traumatic experience for many parents. Learning to process the strong emotions and feeling of grief following perinatal loss can be very challenging. Grieving the loss of a pregnancy or baby is a very personal journey. There are no road maps or instructions on how to process perinatal grief. One thing birthing persons rarely expect following perinatal loss is the natural changes in pregnancy hormones. There are four major hormones involved with pregnancy: estrogen, progesterone, oxytocin, and prolactin.
Estrogen is a hormone that helps the body begin the process of birth. In pregnancy, the high levels of estrogen are found in the placenta. Once the placenta is delivered after birth, estrogen levels drop very suddenly. In fact, after the placenta is no longer in the body, estrogen levels drop so low that that they are the similar to that of a woman who has already undergone menopause.
The hormone progesterone helps to prevent uterine contractions and lactation during pregnancy. Following birth, progesterone levels, like estrogen, drop so low that by 72-hours after birth they often cannot be detected in the blood.
Oxytocin is a hormone that makes the uterus contract during birth. It helps with cervical ripening, a process that must happen for a baby to be born. Oxytocin also causes the release of breastmilk.
Prolactin is a hormone that helps to make breastmilk. When the nipple is stimulated, prolactin is released into the blood. Breastfeeding causes prolactin to stay in the blood, while a lack of nipple stimulation causes prolactin levels to fall.
Researchers have found that as hormone levels rise and fall, they cause changes in mood. This is especially true with pregnancy and birth. Our mood is changed by special signaling cells called neurotransmitters. Serotonin and dopamine are two neurotransmitters that influence our mood. If serotonin and dopamine levels change too much, it can cause depression.
The pregnancy hormones estrogen and prolactin can change the levels of serotonin and dopamine in our bodies. In the postpartum period (the time after birth), the body goes through many changes in hormone levels, even when the baby does not survive. Hormonal changes can be very confusing for grieving parents and may make processing grief even more difficult.
Postpartum depression, caused by hormonal changes following birth, is a common condition that may impact as many as 25% of individuals for up to one year following birth. For parents who are experiencing perinatal loss, hormonal changes causing postpartum depression can make processing grief even more difficult. Here are a few warning signs that are common with postpartum depression:
Emotional Signs
- Feeling overwhelmed
- Becoming easily irritated or angry
- Feeling shame, guilt, or despair
Mental Signs
- Feeling anxious
- Difficulty concentrating
- Difficulty remembering
Physical Signs
- Changes in appetite (under or over-eating)
- Changes in sleeping patterns
- Fatigue
- Muscle aches
- Headaches
- Stomach pains
Behavioral Signs
- Withdrawing from loved ones (friends, family, partner)
- Avoiding tasks or responsibilities
- Not wanting to participate in activities that normally bring joy (hobbies, etc.)
If you notice any of these changes in you or your loved one, please talk to a healthcare professional about postpartum depression.