Iron Deficiency, Fatigue and PPD

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Postpartum Depression is the most common birth complication to date, effecting anywhere from 1 in 5 new mothers every year. After experiencing PPD myself after the birth of my second daughter, I can really relate to what it’s like to be completely overcome by exhaustion, among other things, but, still needing to continue to care for a new born baby and a toddler, 24 hrs a day. I really feel this was a major contributing factor to my PPD but, it’s difficult to pin point the exact cause leaving you wondering what you could have done differently to reduce your risk factors. The studies here really showcase the strong correlation between iron deficiency, fatigue and PPD and how the proper screening and interventions can really improve the health of our new mothers and, possibly prevent this from happening in the first place. As a postpartum doula my goal is to, provide my clients with evidence based information to ensure they have all the tools they need to make informed decisions and get off to the healthiest start possible. Being that postpartum depression rates are so high, this is a major topic of conversation I have with all of my new clients, in efforts to help them really understand what the basic needs are for the new mother and how, when we meet those needs, it acts to lower their risk of developing PPD, resulting in happy healthier families.

So to begin with, we need to start looking at the basic nutritional needs of the new mother, specifically iron. Historically, it’s been known that the postpartum period is the least vulnerable time for women to be iron deficient because, the woman is no longer responsible for supplying the iron requirement for the new baby and, maternal iron stores are immediately relieved of the additional demand, returning iron stores to normal capacity after delivery. Although recent research is suggesting that, inadequate iron levels are much more common than we have thought sparking more research into the problem. The study “Have we forgotten the significance of postpartum iron deficiency?” by Lisa M. Bodnar, PhD, MPH, RD,a,* Mary E. Cogswell, DrPH, RN,b Thad McDonald, MDc suggests that, the rates for iron deficiency, anemia, and iron deficiency anemia are around12.7%, 10.3%, and 4.2% in all women ages 20-40 who are 0-6 months postpartum. Iron is extremely vital to our overall health and has been proven to benefit us in many ways including things such as, increased physical and aerobic endurance, immune function, cognitive abilities and more importantly mood. Woman who suffer from low iron levels during the postpartum period, usually suffer from symptoms that fall into the category of what’s “normal” for the early weeks of having a baby, such as inability to think clearly, weakness and complete exhaustion, which in the end go undetected and unfortunately untreated.

The second major contributor to PPD that we need to begin taking a stronger look at is, postpartum fatigue (PPF) and its roll in sending a new mother into a downward spiral of exhaustion and overwhelm. In today’s society, PPD is really attached to a lot of underlying stigma where, the public believes that this is caused due to the mother being an, awful or even ungrateful parent, social circumstances such as family support or lack of income that can be avoided, or that the mother is just plain crazy. With PPD affecting so many new mothers and, the fact that it is very damaging and even life threatening in some severe cases, research is beginning to shine some much needed light on this subject which is very encouraging. In the study titled “The Impact of Fatigue on the

Development of Postpartum Depression” by Elizabeth J. Corwin, Jean Brownstead, Nichole Barton, Starlet Heckard, and Karen Morin, really uncovered a major component of the true underlying cause of PPD and that is, Postpartum Fatigue (PPF). They’ve confirmed past research that, women who score less than or equal to 11, on the CED-S depression scale have a peak in fatigue prenatally and then, slowly decline by 28 weeks postpartum. Women who score greater than or equal to 11 on the CED-S also peak in the prenatal time but, do not see the same decline in fatigue over the 1st month postpartum. What’s really ground breaking is the research they have extended to reveal that, Postpartum Fatigue (PPF) levels greater than or equal to 6, on the Modified Fatigue Symptom Checklist (MFSC) at 14 days postpartum, positively identifies the development of PPD at 28 days postpartum, which is a success rate of 91%. This is a huge development in the tools we have to serve our postpartum women and potentially prevent the onset of PPD. If we can be checking in on that 14th day and assessing the new mothers fatigue level, we may be able to intervene and make proper recommendations for rest and self-care before she slips through the cracks and becomes ill.

With all of this new research coming to light, it really clarifies the impact of how poor iron intake during pregnancy can leave a women with very low reserves going into the delivery of her child. During childbirth the woman is not only losing iron to her baby but also, she is susceptible to postpartum hemorrhage and of course the loss of the very important placenta and cord blood that is not typically recovered. So how can we make a difference in the prevention of iron deficiency in our postpartum mothers? Well, one way of course is increased education and proper screening during pregnancy but, the second is even simpler than that. We need to start looking at using the power of the placenta that has been used long throughout history to effectively treat postpartum fatigue. Placentas are amazing in the fact that they are grown specifically for both the baby and the mother. After the birth of a baby in our society, the placenta is typically thrown away without a second thought. But, in recent research they are now uncovering the truth about the complete iron content remaining within the placenta and its cord. In the study “Iron Content of Intact Placentas and Cords” by Bonnie A. McCoy, M.S, Roberta E Bleiler, PH.D. And Margaret A. Ohlson, PH.D, they have confirmed that the total iron content of placenta and cord is on average 75 mg and the total concentration of the mineral is around 13.6 mg per 100 gm of the wet weight of the sample. This measurement represents around 8.4% of the 900 mg of iron that is currently recommended for pregnant women. This significant finding further supports the positive impact of the traditional Chinese practice of ingesting the placenta in the postpartum to treat fatigue as it, immediately boost and restores the iron supply of the new mother, resulting in increased energy, clearer thinking and of course a more positive mood.

Contact me today learn more about my Postpartum Home Care packages or, to book Placenta Encapsulation Services for your upcoming birth.

Sara Beckel-Owner Family First Doula Service

Labour/Postpartum Doula, Placenta Encapsulation Specialist