For some mothers, the news of pregnancy ushers in excitement and immense joy. However, just as how any new change in our lives is hard to adapt to, the transition from normalcy to pregnancy to motherhood can have a huge impact on the mother’s mental health. During and after pregnancy, The role of pregnancy hormones is significant in affecting the mental health of pregnant women and mothers. These hormones also play a huge role in the fetus’ growth and development. After delivery, as many as 50 to 75% of new mothers experience a shift in their emotions, colloquially termed as ‘’baby blues’’ (1). These different mental health disorders and hormones explained in this article, to open our minds to the trials and tribulations of pregnancy and motherhood.
What about mental health issues after birth? The most widely known is Postpartum depression. Postpartum depression is a complex mix of physical, emotional and behavioural changes that, after birth, contribute to chemical, social and psychological changes (1). There are three types of postpartum depression that also have different levels of severity. The most common form is the postpartum blues that occurs during the initial week after delivery. Women experience periods of crying, sadness and anxiety and may need some encouragement and help. However, this is transitory and dials down within two weeks without requiring treatment.
The more severe kind of postpartum blues is postpartum depression, which is longer lasting. Fluctuating hormone levels and the subsequent psychological changes are known to lead to postpartum depression. Though it is more severe with its symptoms being frequent crying, tiredness, guilt, anxiety and impatience, psychotherapy and antidepressants are known to help.
Lastly, the most severe and rare form is postpartum psychosis which requires emergency medical attention. This affects 1 in 1000 women (1), and is a grave condition as it creates the risk of harm to the baby and suicide. The symptoms include hallucinations, delusions, paranoia, confusion, hyperactivity and mania. This can last for several months, but immediate medical attention and medication can protect both the mother and the baby.
After giving birth, women may experience birth-related post-traumatic stress disorder, or PTSD. PTSD includes two elements: firstly, experiencing or witnessing an event involving actual or threatened danger to the self or others, and secondly, responding with intense fear, helplessness or horror. Symptoms include obsessive thoughts about the birth, feelings of panic when near the site at which the birth occurred, feelings of numbness and detachment, disturbing memories of the birth experience, nightmares, flashbacks and sadness, fearfulness, anxiety, or irritability.
We’ve talked about some of the mental illnesses that pregnant women and mothers may face, but what actually causes them? Hormones like oestrogen, progesterone, oxytocin, prolactin and HCG all play a role in these sudden emotional switches that hugely impact a woman’s mental health. Just like a coin that has two sides, these hormones are instrumental to the process of getting pregnant and giving birth, but they do not come without their harm.
Starting with HCG (human chorionic gonadotropin), a hormone that is responsible for stimulating the production of progesterone in early pregnancy. Many women have to supplement it, but supplementing HCG can lead to side effects like depression and anxiety.
Ovarian hormones, oestrogen and progesterone, are largely responsible for postpartum depression. This is because, during pregnancy, oestrogen levels are high but during birth, these levels exponentially decrease. These fluctuating levels are hypothesized to contribute to the onset of depressive symptoms. Elevated progesterone, on the other hand, during pregnancy, can predispose postpartum women to panic attacks and can lead to a panic disorder. Increased progesterone is known to cause an increase in the partial pressure of carbon dioxide (a measure of carbon dioxide in the arterial and venous blood), and lead to hyperventilation and a subsequent panic response.
Prolactin is another hormone that benefits a woman physically but harms her mental health. Prolactin, during pregnancy, causes mammary glands to enlarge in preparation for breastfeeding, and it stimulates milk production in women after the delivery of the baby. However, high levels of the prolactin hormone are also shown to increase anxiety and hostility in women.
Referred to as the ‘’hormone of love’’, oxytocin plays a major role in maternal behaviour, social affiliation, lactation and sexual pleasure. This hormone contributes to increased warm social and physical contact after delivery. However, a study conducted shows that synthetic oxytocin given to induce labour increases the risk of postpartum depression and anxiety (3).
The outlined effects of mental disorders on pregnant women and the possibility of harm on the fetus clearly shows how the stigma around mental health needs to be addressed and more awareness should be created. Pregnancy and motherhood, though exciting and happy times, can also be difficult and stressful. More information on postpartum depression, hormonal effects and ways of treatment should be widely available to expecting mothers, as well as their families, friends, and colleagues, so that the concept of pregnancy and giving birth does not seem daunting and does not cause permanent damage to both the baby and the mother. With adequate support from loved ones and medical staff, pregnant people will be much more likely to have an environment where they can recover from these mental illnesses and be the best mothers to their newborn children.
Written by Svasti Tewari
1. Statistics and Definition. Postpartum depression.
2. Mood and anxiety disorders during pregnancy.
3. Synthetic oxytocin and its effect on postpartum mood and anxiety.
4. Hormones and fetal growth.
5. Actions of prolactin in the brain
6. Prolactin and Infertility
7. Pregnancy hormones
8. Coping with the baby blues
9. Estrogen-mediated effects
10. Does HCG mess with emotions?
11. Taking care of your mental health during pregnancy.
12. Pregnancy and postpartum disorders
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