As previously mentioned, I will be publishing an abbreviated collection of themes, ideas and direct quotes from podcasts and books that I find impactful. I hope it will be especially useful for those who can’t find the time to read a book cover-to-cover or dig through a two hour podcast. I will be titling them “reviews” but it is helpful to understand they are not necessarily “critiques”; they are simply notes with which to re-view the material in a concise manner.
Title: Are You Still Recovering From Pregnancy Years Later?
Who: guest Dr. Oscar Serrallach + Goop CCO Elise Loehnen
Listen to the full episode: goop.com/the-goop-podcast/are-you-still-recovering-from-pregnancy-years-later
Themes covered: postpartum supplementing, sleep deprivation, Leptin resistance, motherhood support
Please note, in transcribing this conversation, I have made minor edits for clarity.
[3:20] Serrallach: …There’s this gaping hole in medicine when it comes to the physiology and the workings of a woman’s body in the time after the birth of a baby. That was my starting point.
Why a hormone panel can be insightful
[7:07] Serrallach: I think it’s really important to do a full hormone panel and a lot of primary care physicians may not be used to, or familiar with, checking for hormones that aren’t in the disease paradigm. It’s probably the most important set of testing to get done. And then to get a really good micro-nutrient panel done, looking at things like iron and vitamin D, zinc, copper…just to name a few.
[9:36] Serrallach: The earliest I would probably do a hormone panel check is at three months [postpartum].
Coping with the lack of sleep
[12:33] Serrallach: The average mother loses 700 hours of sleep in the first year. It’s really important to reestablish sleep patterns and circadian rhythm.
[13:18] Serrallach: DHEA is only made when we sleep. So if you have fragmented sleep, one of the hormones that is going to allow you to recover [DHEA] isn’t being made in sufficient quantities.
[17:44] Serrallach: Lack of sleep is real Achilles’ heel for a lot of mothers. My first piece of advice is that sleep is non-negotiable: try to get to sleep as early as possible. So many of my mothers say, “Once baby goes to sleep I’ve got a few hours for me.” In terms of recovery, those couple of hours are not worth it. It can definitely slow your recovery if you’re up later than you should be. So going to bed early is number one. If you’re having broken sleep during the night then I recommend trying to do things during the day that will help you better cope with the effects of sleep deprivation. Take micro naps…if you sleep longer than that 15-20 minutes it can actually corrupt your ability to get good quality sleep later. But you can have as many of those 15-20 minute naps as you’d like. It’s almost like you want to touch sleep, but not necessarily go to sleep.
New parents need staff not visitors
[20:04] Loehen: When you have a child you have a lot of people who want to descend on you…I love the way you have reframed that as an opportunity to martial friends and family to do things you need them to do. Can you talk a bit about ways of redirecting the attention of visitors?
[20:30] Serrallach: Often there are many family and friends who have the best intentions but end up getting in the way. And the last thing you want a depleted mother having to do is be servant to her parents or friends coming over and having show time with the baby. I teach my mothers and their partners, no visitors only staff. So if you have anyone coming over in those first few months, sure they can see the baby but give them a job to do. The job can be something like preparing a meal or taking the trash out. It can be helping with something in the garden or getting your car serviced. The feedback I get is that those people are really appreciative because they want to help.
[21:58] Loehnen: And using your partner to direct so you don’t feel bad about it.
[22:07] Serrallach: Partners often feel good to be given a directive. They can be the policeman at the door… I’ve heard really warm stories about helping create communities around the recovering mother… At the end of the day, building communities is what we’re trying to do with this mother care and mother revival.
Leptin resistance / carrying excess weight
[25:35] Serrallach: Leptin is made by the fat cells to signal to the brain how much fat or energy stores the body has. There’s something called leptin resistance where the brain gets confused with the signal. So the fat cells start producing more and more leptin but the brain doesn’t hear it. The brain gets tricked into thinking the body is really skinny [even when] the mother can be quite overweight or carrying extra pounds… So exercise and diet don’t work particularly well. Those mothers need a lot of support in helping reduce the leptin resistance. What’s interesting is that the cause of the leptin tends to be an ongoing disruption of sleep patterns. So the circadian rhythm is really affected… These are the mothers that start to gain weight for no particular reason; they’re not eating that much, they’re tired, they have brain fog… I’ll coach my mothers through a leptin reset.
[30:04] Serrallach: I’ve seen this in the dialogues I’m hearing in the media and amongst society that it’s okay to take three months maternity leave or have a team of people around her; she’s not being selfish. That’s a starting point in terms of helping mothers because no mother is not trying hard enough but so many others don’t have enough support…what supports does that mother have with their budget and with their resources, [and who] can they bring into that circle?
[31:54] Serrallach: There’s also a real belief that you can do it all yourself. And then the lack of extended family. A lot of other countries still have aunties and grandparents living at least close by. I’m amazed in America that many people aren’t even living in the same state as their extended family. From a family point of view, it’s very isolated. Trying to get help from neighbours or friends, it’s a much harder rally call because they may not understand your needs or necessarily be that interested.
[5:26] Loehnen: Women can experience this for seven to ten years after they have a child. [This is] not necessarily a new-mom syndrome.
[14:05] Serrallach: Probably the three most important are DHA, which is an Omega-3. It comes from fish and algae. It’s very hard to get enough of that in your diet. Secondly, magnesium and zinc. It’s not easy to get huge amounts of magnesium and zinc through diet so I often will supplement with those for three to six months depending on what the mother needs, and then [we examine] how can we get those things through food.
[11:52] Serrallach: From a physiological level, I would try to get my moms to wait at least two years between babies. In the animal world, apes for example, tend to have offspring every three to five years.
[Book] The Postnatal Depletion Cure
When I really enjoy a podcast guest I try to dig a bit deeper into their research. I borrowed Serrallach’s book The Postnatal Depletion Cure from the library. Here are some passages that complement the podcast.
[Page 33] There are some complex and wonderful things that occur during sleep to help replenish you brain and body. The brain does a lot of its housekeeping, including clearing toxins and repairing damaged cells, during sleep…
Getting enough sleep is a really big deal. Chronic sleep deprivation increases day-to-day negative emotions, such as sadness, anger and negative self-talk, leaving you at higher risk for depression. It can also reduce self-esteem and marital satisfaction. That’s why it’s particularly devastating that pregnancy and parenthood can disrupt your sleep just when you need them the most.
[Page 34] Many studies have shown that chronic sleep deprivation has an effect on alertness and reaction times equivalent to a 0.05 to 0.1 percent blood alcohol content. (In the US a driver is considered legally impaired at 0.08)
I failed to bookmark it, but in the early chapters Serrallach notes the routines of immediately post-partum mothers in other cultures – mostly Eastern and indigenous. Some common themes included diet (slow-cooked foods for optimal nutrient bioavailability) and some degree of social isolation to promote bonding and healing.
Food for thought
A few GOOP podcast guests have touted the merits of running hormone and micro-nutrient labs. I like the idea of quantifying health rather than speaking in abstract terms. (“I feel low energy right now.”) This week I met with a naturopath to investigate hormone and nutrient testing. I’ll follow this post up with an overview of that initial visit and how much these elective labs cost. I opted to start with a vitamin D, vitamin B and iron lab which required a simple blood test.
Postpartum ladies, use your partner as a bouncer. What great advice!
Supplementing: I’ve read that most people are generally vitamin D deficient, so I have been supplementing 1,000UI a day. However, my naturopath has suggested upping that to 2,000UI/d which will be confirmed with my lab results. You pretty well can not overdo it on vitamin D, so supplementing won’t harm most people. I also take a vitamin B complex supplement, krill oil* (for EPA & DHA) and a blend of medicinal mushrooms (by capsule) called Complete360 by Purica. I opted for a krill oil versus fish oil because small fish oils can be made with shotty ingredients or sourced through dirty supply chains. However, my naturopath has suggested NutraSea as a reliable Canadian manufacturer of anchovy-based fish oil.
I was a great example of sleep (or lack-thereof) as an Achilles’ heel. I wouldn’t go so far to identify as PPD or PPA (maybe?), but broken sleep and the round-the-clock nutritional demands of baby exasperated a lot of negative self-talk. “Sleeping when baby sleeps” (as annoying as that advice is) was crucial, though I certainly didn’t limit myself to micro naps. Getting to bed by 9 or 9:30 was my other saving grace.
We’ll be moving to the burbs in the next few months which will place us further from friends and family supports. That said, I’m looking forward to the social interactions Hank will glean from daycare. Having reflected upon his “fourth trimester”, when we have our next baby I anticipate that our family will be investing in some hired help for those early months. While that might sound like a total luxury, I frame it as an investment in marital well-being. Co-owning a small business places certain demands on our time and the way I see it, the ROI on gross domestic happiness is worth the money.
Thoughts? Comment below!