Motherhood is not for the weak at heart. And anyone who tells you differently is either lying or delusional. Every stage of motherhood will come with a variety of ailments, concerns, and risks. This is part and parcel of becoming a parent.

Your obstetric and pediatric providers have seen it all and will be your biggest champions in educating you on the normal changes in your body. But there are some physical and mental changes that need more than a little extra TLC from your healthcare provider. Below are a few examples of how motherhood can make you sick.

Mood Disorders

One in three adults will experience a mood disorder in their lifetime, and Covid based research suggests women are predominantly more prone to depression, anxiety, and post-traumatic stress disorder. As many as 1 in 5 women will experience mood disturbances during or after pregnancy. However common mood disorders are, they are surprisingly unreported by women for a variety of reasons.

Common complaints of women suffering from mood disorders:

1.Unable to perform activities of daily living

2. Ongoing sad, empty, hopeless, or helpless feelings

3. Irritability, anxiety, quick to anger, or restlessness

4. Loss of appetite or overeating

5. Insomnia or oversleeping

6. Physical pain that does not respond to treatment

Left untreated, mood disorders can lead to thoughts of self-harm, harming others, or suicide. ALWAYS tell your provider if your behaviors or thoughts have changed since pregnancy. There are several medications and non-pharmacological interventions that can help, but the first step is to seek help. In addition to medication and/or counseling, women can consider exercise, sunlight, building support systems, and decreasing sugar and high-fat foods.

Irregular Periods

Menstrual cycles can take several months to return to normal, or your cycle could be significantly different. It is not uncommon for women to have increased cycle lengths, increased cramps, and irregular bleeding. In addition, women may not ovulate or bleed at all while strictly breastfeeding.

It is important to remember that ANY time you have unprotected sex during the postpartum period, you can become pregnant. Especially if your cycles have not returned to normal and you cannot track them using regular methods. Consider a barrier method in the postpartum period to prevent a surprise pregnancy.

Clots larger than a golf ball, foul vaginal odor, or soaking through more than one pad an hour are never normal in the postpartum period. Talk to your healthcare provider if any of these occur to rule out infection or postpartum hemorrhage.

Hair Loss (Telogen Effluvium)

Listen…postpartum hair loss is no joke. Women often say they feel like they are going bald. Major hair loss occurs after childbirth or a miscarriage. This is due to the hair cycle returning to the pre-pregnancy hair loss phase and is completely normal. But major hair loss can be a symptom of other health conditions and should be discussed with your healthcare provider if accompanied by other symptoms.

Low thyroid levels: Hair loss, unexplained weight gain, brittle/dry skin and nails, constipation, fatigue, depression, sensitivity to cold, and muscle aches or cramps.

Iron-deficiency anemia: Hair loss, extreme fatigue or lethargy, headaches, weakness, difficulty concentrating, shortness of breath with activity, and cold hands or feet.

Less common conditions include nutritional deficiencies, birth control pills or implants, immunodeficiency conditions, hereditary hair loss, and/or over-styling.

If you haven’t already noticed, these symptoms are vague and can occur at any point during or after pregnancy. When the symptoms do not improve or negatively impact your life, you need to report them to your provider.

This list is not all-inclusive, and pre-existing medical conditions and/or medications can alter the “normal” changes associated with the postpartum period. Make sure you discuss anticipated postpartum changes with your healthcare provider so you know what is abnormal for you.

This article was contributed by MacArthur Medical Center’s Certified Nurse Midwife Jen Rockhold.

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For most women, a spike in estrogen levels when you fall pregnant offers a brief respite, as this natural shedding process is placed on hold. Many women experience an increase in volume and vibrancy in their hair during pregnancy, but it’s short-lived. You can’t cheat nature and as your estrogen levels return to normal after giving birth, that spare hair you’ve saved up on over the last nine months is going to go.

That rate of 100 hairs a day can speed up to around 300 as your body makes up for lost time. You’re not going to go bald overnight, its just nature balancing things out again. This is the normal influence of the hormonal changes pregnancy subjects you too. For some women though, the shock of pregnancy and its effects can have a different outcome for their hair.

The condition is called Telogen Effluvium (TE) or stress-induced hair loss and it can result in hair loss of 30% or more. The good news is that for most women the condition resolves with the birth of your child or shortly thereafter. There are certain health issues you need to consider if you are pregnant and experiencing aggressive hair loss.

Hair loss can be caused by:

• hormones
• stress
• nutrient deficiencies
• medical conditions related to pregnancy

Medical issues can be a contributing factor

In terms of underlying health conditions during pregnancy that may be connected to you experiencing TE, the following need to be considered and excluded by your doctor. All the conditions listed below, depending on their severity, can contribute to TE.

• gestational diabetes
• high blood pressure
• hyperemesis gravidarum
• hormone imbalances
• vitamin deficiencies

Your Thyroid and your hair

Sometimes pregnancy hormone levels can fluctuate into the danger zone. Thyroid conditions like hypothyroidism (too little thyroid hormone) and hyperthyroidism (too much thyroid hormone) can cause hair loss.

There are several other signs of hypothyroidism, which affects about 2 to 3 percent of pregnant women:

• constipation
• exhaustion
• cramps

The risk of hypothyroidism rises once you’ve given birth. Five to 10 percent of new moms experience postpartum thyroid problems. Thyroid issues are treatable. Your doctor can order a blood test to confirm the diagnosis and then advise you on the best form of treatment.

Iron Deficiency Anemia

Pregnancy increases your risk of iron deficiency anemia. If you’re carrying more than one child, have severe morning sickness, or got pregnant soon after giving birth, your risk of iron deficiency anemia rises accordingly.

Low iron levels mean you don’t have enough red blood cells to efficiently carry oxygen through your body. This causes hair thinning, along with several other symptoms which include:

• exhaustion
• irregular heartbeat
• shortness of breath
• frequent headaches

Anemia isn’t restricted to pregnancy and if it’s responsible for your hair loss, your hair will remain unhealthy until you address your iron levels. If you’re pregnant and think you might have anemia, talk to your doctor. A simple blood test can determine whether you need iron supplements.

What happens postpartum?

Once you gave birth, your estrogen plummets back to its pre-pregnancy level. It’s not great news for your hair, but it’s no reason to worry.

Excessive hair shedding usually peaks at 4 months postpartum. Losing handfuls of hair while you’re recovering from birth is no fun — and it can be scary to see giant clumps in the shower or on the floor — but this type of telogen effluvium typically self resolves in a few months.

When Telogen effluvium isn’t to blame

Telogen effluvium usually makes your hair thinner all over. Noticeable bald patches or clumps from one side or the top of your head could indicate a genetic or autoimmune condition. These conditions cause baldness or hair loss regardless of whether you are pregnant or not..

Androgenetic alopecia, also referred to as female pattern baldness, shortens your hair’s growth phase and lengthens the shedding phase.

Alopecia areata triggers patches of head hair and body hair. Some people experience a cycle of regrowth and hair loss, while for others the loss is unpredictable. There’s no cure for alopecia areata, but some treatments can help.

Is there anything I can do to stop TE?

It depends on what’s causing your hair loss in the first place. If it’s related to an underlying health condition, then addressing that condition may help. There are also a few other things you can consider doing to give your locks a breather as they recover.

• Be gentle. Compulsive hair twister? Stop! Resist the urge to rub, pull, or twist your hair. If possible, skip tight ponytails, extensions, and weaves for a few months.
• Scalp Massage. Great for increasing blood flow to the scalp, reducing stress and who doesn’t love a good scalp massage. Now’s your chance
• Use a wide-toothed comb. Wash your hair carefully and use only your fingers or a wide-toothed comb to detangle it.
• Say no to harsh styling. Give your mane regular breaks between uses of hot rollers, curling irons, hot oils, and harsh chemical treatments.
• Nourish your hair from the inside out. Getting a healthy balance of protein, fats, and other important nutrients help your hair stay strong and beautiful. Speak to your doctor about a prenatal vitamin — they’re great for hair, skin, and nails!
• Talk to your doctor. Your doctor can help you identify any medication or supplements that have hair-thinning side effects. They can also help you get to the root of your hair loss.
• Choose volumizing hair products. Some shampoos and conditioners can make your hair appear more full and bouncy.
• Try a different haircut. Short bobs and strategic layers can help hair look thicker. If you’ve already lost a lot of hair, a shorter, lighter haircut might be helpful while you work on growing back your crowning glory.

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