My Experience with Postpartum
Hi there! I’m so happy to be back writing on here. I hope to continue to provide more blog posts to elaborate on topics related to PCOS and fertility to best support you!
This experience with postpartum was quite different than my last experience for a few reasons. First, I have a toddler on top of managing a newborn. And second, Madison had pretty significant colic. Now that Madison is 3 months old and doing much better, I feel like I can reflect a little clearer on the situation. It was TOUGH. Her symptoms started around 3 weeks and resolved (for the most part) around 2.5-3 months. At the beginning, her symptoms included crying pretty much all day except when she was nursing or sleeping. This crying would sometimes subside if I was holding her in a very specific way and walking her around the house, but even that didn’t always work. I want to say first and foremost, that I’m not complaining because regardless, Madison is otherwise healthy, adorable, and (hopefully) now on the other side of this, but I wanted to highlight this because no matter how much you prepare for postpartum, certain things can come up that you couldn’t predict. I also wanted to highlight this because during this time while I was managing Madison’s colic, I had very little time for myself. It made healing, managing hormonal shifts, and keeping up with my own basic human needs (let alone my PCOS needs such as supplements, nourishing myself, and supplements) quite difficult. I was lucky enough to have my spouse around and extra babysitter help set up ahead of time for this big time of transition. I truly don’t know how I would’ve done it without them.
All that being said, I am so glad I made the effort to prepare freezer postpartum meals and invest in some other postpartum meals/goodies ahead of time. It made the nourishing myself aspect much easier when I was too exhausted and had no free hands to prepare myself a meal or snack.
My line-up of postpartum meals/snacks:
- Breakfast burritos
- Sweet potato turkey skillet
- Brownie bites
- Zucchini and oat cashew bites
- Pork Carnitas meat and shredded chicken
- Sloppy joe meat
- Daily Harvest smoothies, harvest bowls, flatbreads, and more
- Leto smoothies
- A few Costco finds (Egg bites, Harvest bowls, and shredded chicken cauliflower rice bowls)
There are TONS of postpartum meal prep recipes on Pinterest and in Lily Nichols’ book “Real Food for Pregnancy” as well.
What to Expect
Expect the unexpected. Every woman’s experience postpartum is different because no one baby is the same so expect the unexpected! Meaning don’t set your expectations too high for how the baby will act or how you will feel. This is truly a time to listen to your body and prioritize rest, mental health, and soaking up baby snuggles because this time does fly by in the grand scheme of it all.
Another important aspect of setting realistic expectations postpartum is with weight. There is still so much pressure to “bounce back” after baby in terms of weight. Here’s the reality of the situation. Most women have different pregnancy and birth stories so why would we all have the same postpartum journey? You have to let your body heal. As someone that loves exercise, easing back into it and going slow was hard for me but it’s so necessary. Some women seem to be back to their pre-pregnancy weights within a week and some of us take a year or more. It’s all normal! Ease back into body movement once cleared by your doctor and take it slow based on what your body is feeling, what your baby is requiring of you, and based on the type of labor you had (natural vs. c-section). I have been following Kim Perry’s Abs After Baby program with my second pregnancy and I’ve loved how it’s forced me to take it slow and rebuild my core and pelvic floor which is so important after pregnancy and birth. If you’re making small, consistent effort to move and nourish your body then you’re doing great no matter what. It takes time! And for the record, you don’t need to “bounce back”. It’s ok that your body looks different now. Celebrate the fact that your body built a whole other being. That is no easy feat. If that area of flabby skin is my daily reminder that my body is AMAZING then I’m going to do my best to love it!
Mental health awareness. Women with PCOS are at greater risk of developing postpartum depression so it’s even more important to monitor mental health for women with PCOS postpartum. If you’re feeling off mentally at any point postpartum, do not be afraid to reach out for help to family, friends, other moms, a doctor, or therapist. Hormones are running amok during the postpartum period, but if you’re questioning whether what you feel is ok then it’s probably time to seek support. If there’s one thing I can tell you, try not to “just let it pass” because you want to look back on this time with joy and if you’re feeling your best, then often you’re a better mother, spouse, etc.
Increased appetite or cravings. This can happen for a variety of reasons: your body is healing after going through a MAJOR transformation and has a major open wound inside you that needs healing (even moreso if you had a c-section), breastfeeding often increases your calorie needs to maintain milk supply, and lack of sleep can make insulin sensitivity worse. Worsening insulin sensitivity, especially with PCOS, can make blood sugar balance and carb cravings much worse. Keeping up with supplements, body movement when possible, nourishing your body with nutrient-dense foods, and prioritizing sleep can help with this.
Period irregularity. With hormones doing wonky things postpartum, don’t expect your period to come back perfectly, especially if you’re breastfeeding. Breastfeeding raises the hormone, prolactin, which downregulates the menstrual cycle while signaling the brain to make milk for baby. While breastfeeding, it is very normal (albeit frustrating) for periods to be irregular or non-existent entirely. With my first pregnancy, I started wearing my Tempdrop (10% off with discount code: liz002) when Eleanor was about 6/7 months old and starting to eat more food, but still breastfeeding. My basal body temps were all over the place until she was about 9 months and nursing less. At that time, I was able to see my BBTs start to normalize and actually predict when my first period came at around 9 months postpartum…pretty incredible! Wearing a tracking device like Tempdrop when your baby’s food intake increases and milk intake decreases is a great tool to help you understand when to expect the return of your period.
Minimal time for meal preparation. Depending on your baby, this may be more or less difficult for others. But regardless, with a newborn, you’re doing a lot of things one-handed. If there’s ever a time to show yourself grace with cutting corners such as buying precut veggies, frozen meals, utilizing canned and frozen foods, now is the time. There’s is absolutely no shame in this if it means you’re not pulling your hair out trying to manage an infant while trying to get a nourishing meal on the table.
Hormonal shifts. During the 3rd trimester of pregnancy, estrogen and progesterone levels increase significantly. After labor, estrogen and progesterone levels drop dramatically to allow for the milk-producing hormone, prolactin, and oxytocin to rise. This rapid shift can cause mood shifts, sometimes called the “baby blues”. If severe mood shifts persist beyond the first week after labor, talk to your doctor immediately. Estrogen and progesterone will remain lower until your menstrual cycle resumes, which happens at different times for every woman and depends on if you’re breastfeeding.
Breastfeeding concerns. There are some small observational studies that have shown a slight reduction in breastfeeding rate among women with PCOS due to factors such as obesity and hormone imbalance. In particular, higher androgen levels of DHEA-S and testosterone inhibit lactation, posing as a possible reason for women with PCOS to have worse lactation. However, not all studies have demonstrated that PCOS automatically equates to poor breastfeeding outcomes. It appears that obesity and higher body mass index (BMI) is a bigger contributor than having PCOS alone. In other words, just because you have PCOS does not automatically mean you will have issues with breastfeeding. From personal experience, breastfeeding is hard regardless of PCOS. Many things other than PCOS could contribute to a mother’s breastfeeding experience, such as milk production, the baby’s latch, mental health of the mother, skin to skin time with baby, social status, marital status, etc. More research is needed to determine if there is a direct link between PCOS and breastfeeding issues.
Because your body went through such an incredible transformation, it will take some time for it to recalibrate, but there are a few things I recommend monitoring to help make this transition into postpartum smoother.
Thyroid panel (TSH, free T4, free T3 or total T3, reverse T3, thyroid antibodies): this is especially important to monitor if you had any hyper or hypothyroidism in pregnancy or prior to pregnancy. Your doctor should have been monitoring your thyroid throughout pregnancy, but it should also be monitored during postpartum as your hormones continue to change. Issues with hypothyroidism during pregnancy puts a mother at higher risk for postpartum depression so again, monitor, monitor, monitor. In addition, postpartum thyroiditis (inflammation of the thyroid) affects about 1 in 20 women during the first year after birth. Risk of postpartum thyroiditis is increased if you already have Hashimoto’s disease, an autoimmune thyroid disease. This can have long lasting effects if not well-treated. Symptoms to keep a look out for include irritability, trouble dealing with heat, tiredness, trouble sleeping, fast heartbeat (hyperthyroidism) or trouble dealing with cold, moodiness, dry skin, trouble concentrating, and tingling in extremities (hypothyroidism).
Vitamin D (25-hydroxyvitaminD): vitamin D needs go up if you’re breastfeeding and it’s important to make sure you’re not depleted for both you and the baby’s health. Adequate vitamin D levels is essential for good immune function, lowering inflammation, glucose metabolism, cell growth, and bone health.
Blood sugar (fasting blood sugar or hemoglobin a1c): this is especially important to monitor if you had gestational diabetes during your pregnancy. Sleep deprivation is already hard enough on blood sugar management so let’s make sure we are monitoring this to help with weight management, milk production, energy levels, mood, and cravings postpartum.
Supplements to Consider
Choline. In terms of supplements, this will look different for everyone depending on the labs I recommended above. However, at the very least I recommend continuing your prenatal vitamin. In addition, you’ll want to keep an eye on your choline and vitamin D intake especially if you are breastfeeding. Choline needs increase from 450mg (during pregnancy) to 550mg while breastfeeding. Choline is a vitamin essential for early brain development and cognitive performance in baby so it’s important not to overlook this one. Make sure you’re getting enough between food intake and supplementation (if needed). Food sources of choline include eggs, beef liver, ground beef, chicken breast, cod, soybeans, and red skin potatoes.
Vitamin D. Vitamin D is not found in adequate amounts in breast milk. In order to provide enough vitamin D for the baby, mom’s vitamin D needs increase to 6000 IU per day or you can supplement directly to baby with a vitamin D dropper (needs are 400 IU per day if supplementing directly to baby).
Inositol. A side note, taking Ovasitol is safe during both pregnancy and if you’re breastfeeding so feel free to continue this! It’s great to help with reducing androgens, menstrual regularity (especially if you’re not breastfeeding), and cravings.
Magnesium. Lastly, as a new mom, you get very poor quality sleep for an undetermined amount of time depending on your baby. Magnesium can help with improving quality of sleep, lowering anxiety, and improving insulin sensitivity. And remember, women with PCOS are 19x more likely to have inadequate magnesium levels at baseline. A magnesium supplement might be a really great addition to your nighttime routine or consider adding in a magnesium-rich snack before bed, such as dark chocolate with almonds, avocado toast or cashew butter toast with pumpkin seeds, half banana with peanut butter, or simply adding magnesium powder into your tea. I prefer magnesium glycinate, biglycinate, or citrate for optimal absorption.
How to thrive in postpartum
Postpartum is such a magically challenging time. You’re sleep deprived but so incredibly in love with this human you just created. It’s a strange and beautiful juxtaposition. Below are some tips that helped me looking back.
Show yourself grace. This is a time of BIG transitions. You brought a tiny human into this world who requires a LOT from you. In addition, your body takes time to heal. Remind yourself that this is just a small timeframe in the grand scheme of life and it will get easier.
Carve time out of the day for yourself if you can. Taking time to stretch or even go water the flowers outside by myself was life-giving during those first few weeks. Celebrate small moments of your day that you’re able to make special for you, such as sitting down to eat a nourishing meal while someone else holds the baby, going for a walk (with or without baby), taking a long shower, dozing off for a nap instead of cleaning the kitchen, etc. These things, big or small, can really make the postpartum timeframe easier and more enjoyable. Remember, when you take care of yourself, you’re a better version of you for the ones around you.
Meal prep. As you near the end of your third trimester, you may think to yourself “meal prepping is the last thing I want to do” and believe me I get it! But trust me when I say, it is SO worth your time and effort. Having a handful of nutritious meals and snacks available to you is invaluable during those early sleepy days while you’re still trying to get your bearings. I listed some of my favorites above. This can be a great thing to do with friends or family too if they’re looking to help you prepare for the baby. It also helps alleviate some of the work.
Set up resources for additional childcare ahead of time. This applies to those who already have small children at home. My other daughter Eleanor had just turned two at the time Madison was born. The best thing I did was set up some additional childcare for Eleanor during this transition before Madison arrived. I love spending time with Eleanor but I knew she was going to need more of me than I could give in those first few weeks. If you have the financial ability, do it. It is so worth it. It reduced my stress and anxiety of trying to keep Eleanor busy and happy while also tending to a newborn.
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- Hedges VL, Heaton EC, Amaral C, et al. Estrogen Withdrawal Increases Postpartum Anxiety via Oxytocin Plasticity in the Paraventricular Hypothalamus and Dorsal Raphe Nucleus. Biol Psychiatry. 2021;89(9):929-938. doi:10.1016/j.biopsych.2020.11.016
- Schoretsanitis G, Gastaldon C, Kalaitzopoulos DR, Ochsenbein-Koelble N, Barbui C, Seifritz E. Polycystic ovary syndrome and postpartum depression: A systematic review and meta-analysis of observational studies. J Affect Disord. 2022;299:463-469. doi:10.1016/j.jad.2021.12.044
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- Vanky E, Isaksen H, Moen MH, Carlsen SM. Breastfeeding in polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2008;87(5):531-535. doi:10.1080/00016340802007676