Postnatal depletion is a new-ish term used to describe the depleted state many mothers find themselves in after having a baby.

Dr. Oscar Serrallach says in his book, The Postnatal Depletion Cure, “Postnatal depletion is a constellation of symptoms affecting all spheres of a mother’s life after she gives birth. These symptoms arise from physiological issues, hormonal changes, and interruption of the circadian day/night rhythms of her sleep cycle, layered with psychological, mental and emotional components.”

Postnatal depletion (not to be confused with postnatal depression, although the two may be linked) is a complex syndrome and one we have little understanding of. What we do know is women are not recovering from pregnancy and childbirth, instead they’re becoming burnt out, exhausted, depressed, anxious and sick.

What causes postnatal depletion?

There is no one factor that is contributing to women becoming depleted. It’s more likely a combination of factors:

  • Modern life stress
  • Social pressures
  • Lack of support
  • Inflammation
  • Existing nutrient deficiencies
  • Having children in quick succession (i.e. a small gap between pregnancies)

Remember, postnatal depletion is complex and is caused by a combination of factors and your symptoms and severity of symptoms may be different from other women. Symptoms might include:

  • Severe fatigue, exhaustion on waking
  • Sleep issues
  • Low sex drive
  • Brain fog
  • Loss of confidence and self-esteem
  • Sensitivity to bright lights or sudden sounds
  • Digestive issues (that have worsened since the birth of your child)
  • Developing a medical condition during or after your pregnancy

Thyroid Disease

My story with postnatal depletion centres around thyroid disease and the development of hypothyroidism after the birth of my first child in 2017.

Unfortunately, despite thyroid dysfunction being common during pregnancy and the postpartum period, we don’t screen women for thyroid function i.e. we’re not testing thyroid hormones to see if they’re within a normal range. I urge you to look into postnatal depletion and thyroid disease if you are struggling with your health after baby (physically, mentally, emotionally).

The thyroid undergoes substantial changes during pregnancy; I’ve heard it said pregnancy is a stress test for our thyroid. Our thyroid needs iodine to make thyroid hormone and this is why our iodine requirements increase during pregnancy and breastfeeding. Every cell in our body needs thyroid hormone to function; “the thyroid gland produces hormones that regulate the body’s metabolic rate as well as heart and digestive function, muscle control, brain development, mood and bone maintenance.”

We should be able to cope with these normal changes but if we have an underlying thyroid condition, or an iodine deficiency, we’re at risk of developing thyroid disease in the postpartum period. For some women, this might not happen until well into the first year of motherhood.

Thyroid disease can look like:

Hyperthyroidism

  • Rapid or irregular heartbeat
  • Nervousness
  • Irritability and mood swings
  • Weight loss
  • Heat intolerance
  • Fatigue and sleep problems
  • Hand tremors
  • Muscle weakness and palpitations
  • Goiter

Hypothyroidism

  • Weight gain
  • Depression
  • A slowed heart rate
  • Dry skin, hair (hair loss) and nails
  • Insomnia
  • Constipation
  • Menstrual cycle irregularities (including infertility)
  • Sensitivity to cold
  • Fatigue, weak

If not managed, hypothyroidism can increase the risk of miscarriage and preterm birth, as well as making postpartum life a living hell (in my experience).

For me, it was likely the combination of undiagnosed hypothyroidism, severe sleep deprivation, lack of social support and isolation that contributed to postnatal depletion.

How to get help

Postnatal depletion might be caused by physical factors like nutrient deficiencies, hormonal issues or an autoimmune condition.

If you have some of the symptoms of postnatal depletion, or you’re simply feeling like something is wrong, missing or not quite right; get to your GP to have blood tests taken. Specifically, your GP should test iron, zinc, vitamin D and vitamin B12 levels, as well as test your thyroid function, including TSH, T3 and T4.

Written by Emily Parks, nutritionist and Mum of two