Post Natal Depletion

Two months after giving birth to her first child, Amanda Foster experienced extreme anxiety, hyper-vigilance, and feelings of inadequacy. Overcome with despair, she sought advice from a doctor who prescribed medication that only made her feel worse. When her anxiety reached a peak, she had her thyroid tested and discovered her levels were twenty times higher than normal. It was then that Foster realised she was suffering from postnatal depletion.

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What is postnatal depletion?

Postnatal depletion describes the emotional and physical depletion that many women go through after having children, explains Cristina Tahoces, holistic nutritionist and owner of Thrive Nutrition Practice. The condition is characterised by symptoms that include, but are not limited to, exhaustion, anxiety, depression, low libido, and hormonal imbalances that can manifest themselves in thyroid and adrenal issues. Sufferers can also experience low immunity and inflammation symptoms such as allergies, eczema, and brain fog.

“Postnatal depletion is not limited to the immediate months after birth, just as motherhood is not limited to that moment when we give birth,” says Tahoces, who, alongside Sofie Jacobs, founder of midwifery service Urban Hatch, recently pioneered a series of “Bloom, Hatch and Thrive” workshops to support women’s physical and emotional wellbeing on their pregnancy, labour and parenting journey.

According to Dr Oscar Serrelach, a family practitioner in Australia who coined the phrase ‘postnatal depletion’, women can feel depleted up to ten years after giving birth. While he suspects that around 50 per cent of mothers have postnatal depletion, Tahoces reckons the number is much higher in urban cities like Hong Kong.

Why it occurs

In the first instance, women worldwide are having children later and are controlling when they do, typically through hormonal birth control. The pill depletes a woman’s body of folate, vitamin C, zinc, B6, B12, magnesium and other nutrients. “As a result, women could already be depleted when they get pregnant, depending on how long they were on the pill and what their lifestyle and diet was during that time,” says Tahoces.

Once pregnant, women do not realise just how much a baby is taking from them for its own growth and development. The transfer of nutrients then continues during breastfeeding. As a mother focuses on juggling her parenting role with other daily responsibilities, nutrient-dense foods that are essential for optimal maternal health may be replaced by quick and easy snacks, children’s leftovers, and coffee, as fuel to make it through each day. “Our diet, in general, is short on vegetables but tall on lattes, sugars, and other carbohydrates. If a woman is not having six to eight cups of vegetables daily, a palm-sized portion of protein with every meal and a good dose of healthy fats and fibre, she is running the risk of not eating enough nutrients to support the needs of both her and her baby,” Tahoces advises.

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Pollution and exposure to toxicity can also increase the risk of postnatal depletion, which is why more than 50 per cent of women in Hong Kong are likely to be at risk, says Tahoces. Hong Kong’s ten-week maternity leave, lack of paternity leave, and demanding careers that may entail long hours and time-zone travel are all contributing factors. Add sleep deprivation to the mix and it’s no wonder why so many women experience postnatal depletion.

Thrive in motherhood

According to Cristina Rodenbeck, Wellness Coach and Executive Coach at Manipura Wellness Practice, women are naturally brave and resilient. She likens women to the Oak tree – a common symbol of strength and endurance – that can withstand strong winds, storms and the effects of time. It rarely bends down to signs of exhaustion or depletion. “The main problem with this is that when the Oak does finally fall, the fall can be severe and dangerous. Women are amazingly resilient as they are the foundation of the family but they do need to learn to listen to and address the signs before they ‘fall down,” warns Rodenbeck.

There are ways that women can take care to thrive and not only survive on their pregnancy and parenting journey.

Before contemplating motherhood, women could consider alternative birth control options, says Tahoces. If they do choose to go for hormonal birth control pills, they would need to be more vigilant about diet to ensure they are replenishing nutrients that are being depleted.

Jacobs works with her clients to cultivate a healthy mind/body connection. Through mindfulness techniques, she helps women become aware of what is going on in body and mind. Only then can a woman recognise and address her personal needs.

She advises clients to add exercise into their daily routines, as long as there are no contraindications. “Exercise in pregnancy needs to be adaptable and adjusted to what is needed. This is the time to pick exercises that energise and nourish, rather than deplete,’ says Jacobs, who is certified in Exercise in Pregnancy and a qualified Pilates teacher.

During and post-pregnancy, a woman can also focus on a diet that improves her gut health, says Tahoces.

“70 per cent of our immune cells and 90 per cent of our serotonin (our happy hormone) are manufactured in the gut. If we do not adequately replenish nutrients such as tryptophan, Vitamin B-6, other B-vitamins, iron, and magnesium that have been depleted by pregnancy and breastfeeding, our brain will not produce sufficient serotonin, and we can experience anxiousness. Mothers need to have three meals which maximise and prioritise nutrient intake,” she advises.

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Sleep is also imperative for mothers, as difficult as this may be to achieve in the early months. According to Rodenbeck, sleep deprivation exhausts the body’s nutrition resources, increases the toxins in the system, and suppresses the immune system. “This is when the support network can help. Reaching out for help from husbands, older children, family, domestic helpers and friends is critical,” she says.

Women need their own ‘Congress’ in order to thrive during pregnancy and motherhood, Jacobs comments. “Most women nowadays are already part of a tribe or urban family, which is great, but what’s more important during pregnancy is for women to get their very own Congress together, which is essentially a handpicked group of trusted individuals. Your personal Congress could include a few friends, perhaps (though not essential) a family member, as well as a few professionals.”

Since recognising her condition, Foster started seeing an endocrinologist to manage her thyroid levels, a therapist to help address her anxiety issues, and a holistic nutritionist to formulate a tailored nutrient-dense diet. She has eliminated sugar from her diet, reduced her intake of alcohol, coffee, and processed foods, and now exercises four times a week to build her endorphins. “I have a wonderful helper and husband who encourage me to get to the gym or take a knitting class. I am finally taking time for myself! If I don’t make a conscious effort to focus on myself, I slip back into feeling like I need to spend every second with my son in order to be a ‘good mummy’ and forget to take care of myself,” she says.

Be true to yourself

Most women do not realise the support they could have in place if they were to have open discussions and call for help. “I often witness a lot of ‘silent sufferers’ where fear, pride, shame and working with false assumptions (‘no one can help’ or ‘it is only my responsibility’) take over,” says Rodenbeck.

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Cora Ha, Family Coach and Educator at Family Foundations Ltd, believes these assumptions are borne from societal and self-pressure to be and do everything. For example, during pregnancy, working women may feel pressure to perform at the same level at work while finding the time to exercise, eat a balanced diet, attend prenatal classes and read up on everything child-related in the market. Post pregnancy, there’s pressure to get back into bikini-fit shape, return to work, socialise and get baby into a perfect sleeping and eating routine to prove competency as a parent. Failure to meet these goals can make mothers feel guilty and ashamed.

“Take the time to define your personal and parenting goals so that, instead of succumbing to peer and external pressures, you are able to care for yourself and your children in a way that resonates with your core values. Discuss and define boundaries with your partner. Often, depletion happens when there isn’t a clear understanding of the roles that each parent plays and one ends up taking more while the other may be left out of the equation. And, finally, monitor who you spend time with; some people will give you high blood pressure the moment they open their mouths with all the things you ‘should’ be doing. Be true and kind to yourself; focus on your personal physical and emotional wellbeing, and reach out for support. Only then can you thrive as a mother,” she concludes.

Angela Baura

Angela Baura

Angela was born and bred in not-so-sunny England, where she spent most of her childhood years performing on stage, writing poetry and reading books. Her head was so buried in her books she completely forgot to apply to universities. In a mad rush, she copied a friend’s application forms and found herself studying information technology for three long and boring years. After two equally dull years of working as an IT consultant, she decided to ditch programming and head for the glamorous world of public relations. In 2006, Angela and her husband both found opportunities to continue their careers in Hong Kong. Shortly afterwards, Angela took on her most exciting and fulfilling, albeit challenging, role - motherhood. Angela now spends her days playing chef, driver, entertainer, nurse and teacher to her three children, and her evenings writing about the fun and fears of parenting.