The next three blog posts feature a series on perinatal mental health by my friend and colleague Kathy Morelli. Kathy is a Licensed Professional Counselor (LPC) in Wayne, NJ and the Director of BirthTouch® LLC. As an LPC, she provides Holistic Counseling in Wayne, New Jersey with a focus on Maternal Mental Health, Family Systems and trauma from sexual abuse and medical intervention. Kathy is also an author and very engaging speaker on perinatal mood disorders and mental health. When I saw her series on the effects of hormonal changes on a woman’s mood, I knew I wanted to share this important information with Mamas on Bedrest. Almost daily I hear women say, “I feel so sad/angry/lonely/irritable…yet I know that I shouldn’t complain.” It’s not complaining to express how you are feeling and according to Kathy’s articles, there are some real physical and hormonal reasons for how you feel.
The first part of the series is called, Pre-Pregnancy: How Women’s Brain Biology, Hormones and Mood Relate. In this first installment, Kathy gives an excellent-albeit a bit technical-explanation of why women seem to have such wide ranging mood fluctuations. Beginning at birth we are all “pre-wired” with our temperaments based on our innate physiology as well as genetic influences. Then based on our external environments and life experiences, our innate temperaments are either augmented or tempered, but remain underneath it all in the “pre-wired” state.
Next women begin menstruating and the complex neural feedback systems kick into high gear in response. The Hypothalamus-Pituitary-Adrenal Cortex Loop (HPA-C) links the brain with the adrenal glands. It puts out cortisol and adrenaline in response to stress, and sometimes that stress is simply the menstrual cycle. The Ovarian-Hypothalamic-Pitutary Axis (O-HPA) is a feedback loop system between the ovaries. Located in the midbrain, the HPA is in part responsible for regulating menstrual function. The HPA puts out cortisol and serotonin, the “feel good” chemicals while the ovaries put out estrogen and progesterone. The big crux of this feedback system is that the precursor to serotonin is estrogen! So when women begin menstruating and having the various fluctuations in their estrogen and progesterone levels, the messages being sent back to the brain-the variations in estrogen levels-will cause fluctuations in the serotonin levels put out by the HPA and thus impact women’s moods.
There is an important take home message that runs through all three posts. Kathy gives the indepth, bio-physiologic reasons for women’s mental health fluctuations so that women can be aware of when their hormones are up and down and take care of themselves accordingly. Self Care is key to good mental health and with this information, I believe women have some powerful information to use to take care of their mental/emotional health.
In the second part of this series, Kathy looks at the hormonal influences during pregnancy and childbirth!
We’re talking about spacing your pregnancies. I know this sounds absolutely absurd given that you are already pregnant and on bed rest. But I had the great fortune to listen in on a very well done webinar presented by the Association of Reproductive Health Professionals and I feel compelled to share some of the information.
We all know pregnancy ushers in a whole host of hormonal, physiologic, psychologic and emotional changes for women. But what some of you may not know is that when women have pregnancies close together, they deny their bodies much needed time to readjust to the rigors of pregnancy, labor and delivery and their new role as mama. An immediate repeat pregnancy may result in fatigue, anemia, preterm labor, and other physical problems. The second infant may be born prematurely, at a low birth weight, be small for size/age and have other developmental problems. Finally, pregnancies close together shorten the bonding time the first infant has with mama.
We all know life happens. But pregnancies don’t have to happen. In most areas of the US and in most industrialized nations, women have access to a wide range of birth control methods. There’s a lot out there to choose from and I review many of these methods here. And let’s be clear, I am not trying to tell anyone what to do, I merely seek to inform and to educate. And FYI, The literature on spacing pregnancies suggests women space pregnancies at least 18 months, but no more than 5 years apart, with an optimal range of about 2-3 years.
It’s video Wednesday! In today’s video blog, I answer the question,
“Should screening for hypothyroidism be a mandatory/routine part of prenatal testing?”
In this video, I review the common causes of hypothyroidism in pregnancy, the effects of hypothyroidism on maternal health and on fetal growth and development. Personally, I think that prenatal screening for hypothyroidism should be a mandatory part of prenatal screening. It’s an inexpensive test, simple to do and yields pertinent information. While “evidence based medicine” doesn’t deem it cost effective, My personal opinion is that the potential consequences make these relatively inexpensive tests worthwhile.