So you had a baby.. 4 postpartum tests you need to have done
One of my biggest complaints about the setup of our healthcare system is how little anyone cares about you once you’ve had a baby. I know you’ve probably heard some horror stories about postpartum recovery - from any type of birth - but no matter how ‘easy’ or ‘hard’ your birth is perceived to be, postpartum recovery is no walk in the park. For anyone.
I follow @thebellemethod, Nikki Bergen, on Instagram - she’s a pilates and yoga instructor who coaches exercise classes for women who are pregnant and postpartum. She works closely with pelvic floor physiotherapists and has a wonderful program (I actually followed her Bump Method Pilates videos through my pregnancy). Usually she’s sharing inspiring shots of her working out beside a newborn, or sharing tips for exercising while pregnant. But this week she posted a reel sharing that her postpartum recovery from baby #2 was harder than her recovery from open heart surgery. Open. Heart. Surgery. She’s had both, and was appalled to realize how much follow up she had for her heart surgery and how little anyone cared to ask her about her recovery post-birth.
Nourishing, growing, birthing, and keeping alive a tiny human is no easy task. Your body has just done an incredible thing! You grew a new organ from nothing (your placenta)! You grew a single cell into a human being! You created life! From scratch! But as soon as that baby arrives it’s like “Mum, who? How’s the baby??”
Yes, we need to be sure the baby is thriving,
But in order for that baby to thrive - YOU need to be taken care of first. Put your oxygen mask on first, and all that.
I really encourage my pregnant patients to make a plan for their postpartum, because once that baby arrives you’re going to forget all of the things you meant to do, all of the things you’re supposed to test, and who you should follow up with. Book lab appointments and follow ups with your primary physician, your naturopathic doctor, and your other healthcare providers before the baby arrives. And have some basic testing done along with a postpartum check up with me between 6-12 weeks after delivery (sooner if needed).
Nutritional and hormonal deficiencies are basically unavoidable, and we need to test your body to see how best we can support your recovery.
4 Postpartum Tests
Here are the four basic labs you should strongly consider running when you’re between 6-8 weeks postpartum (or any time thereafter if you haven’t checked them yet):
CBC + Ferritin: let’s check that iron status!! It takes a lot of iron to grow a human, and many women end up depleted either during or after pregnancy. Low iron levels will make you more tired than you already are, and can also make you feel short of breath and cause heart palpitations. Research has also linked low postpartum iron levels to postpartum depression (which is a more common experience than you might think). Further, fixing an iron deficiency may result in a 25% improvement in postpartum anxiety and depression (PMID: 15671224)
Vitamin D: although you hopefully tested and corrected for any vitamin D deficiency prior to pregnancy (because vitamin D levels have been associated with a quicker time to pregnancy and also a reduction in miscarriages), you must test it again postpartum. Vitamin D deficiency has been associated with both antenatal and postpartum depression (PMID: 29649128).
This is one nutrient that I find can drop incredibly fast in pregnancy, even when you’re taking a moderate to high dose supplement. My vitamin D levels went from 140 (optimal) before I fell pregnant to 80 (low/normal) within my first trimester, for example. If I hadn’t tested, I wouldn’t have known I needed more. Vitamin D acts like a hormone in our bodies, and is an important regulator of our immune systems and mood. Optimize it to improve your immune function, create high quality breastmilk, and balance your mood.
Vitamin B12: a good indicator of B vitamin status, and an important player in energy production systems. If your B12 levels are low, you’re going to feel more exhausted than you need to. It’s a relatively quick fix with either oral supplementation or IM injections, and can give you an immediate energy boost when you need it most.
Thyroid panel (TSH, free T3, free T4, thyroid antibodies): postpartum, with all of the stress and precipitous drop in sex hormones, is the perfect time for your thyroid gland to act out of control. Postpartum thyroiditis is a relatively common condition characterized by incredibly high levels of inflammation in the thyroid. It can cause a dump of thyroid hormone resulting in anxiety, heart palpitations and rapid weight loss, followed by a crash that feels like low energy, cold body temperature, weight gain, constipation and sluggishness all around. A TSH alone is a good place to start, but add the other components of a thyroid panel to get the full picture.
If you’re recovering from having a baby (whether your babe is a few months old or a teenager) - and you haven’t had these things tested, get in to see your functional doc asap. I’m here to answer any questions you may have about postpartum recovery, and support you on your journey back to health!
Dr Kali MacIsaac
About Dr. MacIsaac - Naturopathic Doctor in Vancouver
I am a naturopathic doctor practicing in Vancouver, BC.
I have a focus on women's health including reproduction, fertility and conditions such as endometreosis. I also focus on digestive health, endocrinology and hormonal balance as well as general naturopathic practice.
I look forward to meeting you!