Postpartum Overwhelm: Your Guide to Stress and High Cortisol Postpartum, and How To Effectively Navigate Them
Note: this article is part of a larger series on Postpartum Hormone Recovery.
Stress doesn’t go away after a baby is born.
That may seem like the most obvious statement ever, but TBH, I looked forward to my daughter’s birth because I truly believed that it would provide this encapsulated time in my life where she and I could bond, shielded from the outside world, from work, from any other responsibilities.
Here, we could rest together and connect inside a world where time was set only according to the sun and moon, and our hunger and thirst signals.
But the world was upon us the moment she was born and I felt stuck. I was trapped by my own need for recovery alongside her needs as a brand new baby, plus the need to drive, clean, shower, make food, attend her doctor appointments, and everything else that invaded the quiet postpartum space I’d intended.
A very rocky five months after her birth I was diagnosed with postpartum depression, and if I’d had my cortisol levels tested, I’m sure they would have been way too high.
Cortisol is a powerful hormone, one we need to survive. However, chronically high cortisol levels are bad for us in many ways, especially postpartum: high cortisol has negative effects on our mental health and our cardiometabolic health, which is a big problem for women who are also recovering from gestational diabetes, hypertension, preeclampsia, or other cardiometabolic issues that often occur in pregnancy.
So let’s talk: here’s what the research says about cortisol and its effects on postpartum recovery, including on your recovering hormones, and how we can naturally support a healthy return to balanced hormones by supporting our adrenals.
Understanding Cortisol Levels in Women
Let’s start by breaking down cortisol’s functions in our bodies.
Cortisol’s Roles in the Body
Cortisol is a hormone produced by your adrenal glands in response to stress. Essentially, cortisol helps you maintain energy balance during stressful or high-intensity times.
Raising blood sugar: cortisol stimulates glucose production, which is rushed into the bloodstream for quick energy
Influencing how fat and protein are metabolized, also for quick energy
Controlling inflammation: cortisol modulates immune activity to direct your body’s resources to dealing with the stressor (in ancient times, the sabretooth tiger. Today, traffic or work or your MIL or … life with a newborn)
Cortisol is present in almost every tissue, so it has an impact on many organ systems including the brain, cardiovascular system, and muscles. Cortisol levels naturally rise and fall during a day, and at certain times of our lives. But when cortisol levels become too high or too low long-term, it can cause health problems.
Changes in Cortisol Levels and Health Issues
Changes in the quality of our cortisol pattern, or curve, as well as higher- or lower-than-expected levels are all associated with health problems.
Flattened cortisol levels throughout the day, a weaker morning spike known as the cortisol awakening response (CAR), and disruptions in the usual daily rhythm of cortisol have been linked to conditions like depression, poor sleep, obesity, diabetes, and other forms of cardiometabolic disease.
For instance, a weak CAR has been associated with depression, while a flat cortisol pattern, where levels don’t decline properly during the day, is associated with long-term stress and mental and physical illness. Monitoring cortisol levels can help identify these risks early and guide interventions to improve both mental and physical well-being.
Cortisol in Pregnancy
In a normal pregnancy, cortisol levels naturally go up as the pregnancy progresses; rising cortisol levels, especially in the second trimester, are essential to support your baby’s natural development in utero, especially brain and lung development, and may help us prepare for childbirth. In fact, cortisol levels in pregnancy don’t peak until childbirth.
Our bodies naturally have protective mechanisms in place to keep baby from being overexposed to cortisol in utero, mostly via the placenta.
However, there may be a cortisol threshold. A preliminary study demonstrated that moms with higher cortisol levels in their third trimester were more predisposed to stress, anxiety and depression. These women were more likely to have unexpected childbirth complications, as well as feeling more distressed up to two months after childbirth.
But what does this mean for postpartum cortisol levels and your recovery? What’s “normal”, what’s not, and how can you tell, based on how you feel postpartum?
And a really important question I get all the time from my postpartum people: is it worth it to test cortisol levels postpartum?
Let’s shift to that conversation.
Postpartum Cortisol: What’s Normal, What’s Not
It’s important to begin here by acknowledging that there is a lot of research we still need to do to understand what’s actually happening in the postpartum period.
So far, here’s what we know:
When we’re healthy, our cortisol levels pulse rhythmically throughout the day, supporting optimal energy levels, alertness, and balancing this out with our need for rest and recovery.
Research shows that certain changes in cortisol levels, which are typically linked to poorer health outcomes in the general population, may actually support better physical recovery and mental health in postpartum women.
Expected Cortisol Patterns Postpartum
In postpartum women, cortisol levels undergo predictable changes as the body adapts to the demands of motherhood.
During pregnancy, cortisol levels gradually increase, peaking in the third trimester. After childbirth, cortisol levels drop significantly within the first 3 days due in large part to the loss of the placenta, which is a big regulator of cortisol levels.
The diurnal cortisol rhythm usually returns to pre-pregnancy levels within 2 to 3 months.
However, markedly lower levels of cortisol postpartum may actually be protective. For example, in healthy postpartum women, the Cortisol Awakening Response (CAR) is much lower—about 84% less—than in women who aren’t postpartum, which seems to help them adjust to motherhood and feel mentally well.
I wonder if the lower CAR could be connected to the shorter, fragmented sleep patterns we experience postpartum. Perhaps this reduced CAR reflects an adaptation that allows us to function on brief bursts of sleep, making it easier to feed and care for our newborns. Could this lower CAR actually help us rest whenever we get the chance during the day?
Anyway:
This decline in cortisol reflects a decrease in activity of the hypothalamic-pituitary-adrenal (HPA) axis, which conserves energy for breastfeeding, boosts immune function, and reduces maternal stress.
Postpartum cortisol should return to an expected daily rhythm, with a steep morning rise (CAR) and a gradual decline throughout the day. These patterns are essential for physical recovery and emotional stability, helping new mothers adjust to the postpartum period.
Cortisol Changes Linked to Postpartum Issues
When cortisol patterns deviate from these expectations, postpartum women may face increased risks for mood disorders like depression and anxiety.
For example, a blunted CAR—where the cortisol curve stays low, or even flat, in the morning—has been linked to postpartum depression.
Similarly, a flatter daily cortisol rhythm, where levels fail to decline as the day progresses, can indicate chronic stress and emotional difficulties. Women with depressive symptoms six months postpartum often show higher overall cortisol levels, a smaller morning rise, and a sharper drop later in the day. In contrast, severe anxiety in postpartum women is associated with lower overall cortisol production.
Causes and Symptoms of High Cortisol Postpartum
After childbirth, cortisol levels should reset quickly, but in some women, they remain altered. Temporary shifts in cortisol can help mothers stay alert for nighttime feedings and diaper changes, but feeling constantly overwhelmed, stressed, or depressed may signal the need for professional support from a functional medicine or mental health provider.
Common causes of high cortisol postpartum include:
Life stressors like finances, baby health, or adapting to motherhood (first-time moms can have higher cortisol levels than those with prior children)
Preexisting blood sugar issues and a diet high in low-quality, processed foods
Symptoms of high cortisol postpartum may include:
Trouble sleeping or feeling “wired but tired”
Persistent high blood pressure, high blood sugar, or brain fog
Mood changes such as anxiety or irritability
Cravings for sugary, carb-heavy, or salty foods
It’s important to understand that some of these symptoms may be a normal part of postpartum recovery. If you have any questions or concerns about how you’re feeling, it’s essential that you speak with your doctor right away.
How High Cortisol Postpartum Affects Your Recovery
When cortisol remains high over a long period, it starts to affect several parts of your postpartum recovery:
Mood
Elevated cortisol can make it harder to relax and stay calm. You might feel more anxious, short-tempered or more easily upset by small things. This shift in mood can make it harder to bond with your baby, enjoy quiet moments, or find joy in everyday tasks.
Energy
Chronic stress often leads to fatigue. It might seem strange that feeling “wired” can also make you feel exhausted, but that’s exactly what happens. High cortisol initially gives you a burst of energy, but if it stays high, it begins to wear you down. Over time, your body becomes less responsive, and you can end up feeling more tired, even after a full night’s sleep—if you’re lucky enough to get one.
Milk Supply
Breastfeeding depends on a delicate balance of hormones, including prolactin and oxytocin. High cortisol postpartum can interfere with these hormones, making it harder for your body to produce and release milk.
This can lead to concerns about whether your baby is getting enough to eat, adding another layer of anxiety.
Understanding that these issues—mood swings, constant fatigue, and milk supply concerns—might be linked to high cortisol postpartum can help you begin to focus on the root cause rather than feeling like something is wrong with you personally.
Simple Strategies to Lower High Cortisol Postpartum
Reducing high cortisol levels postpartum often requires a few small, manageable steps:
Ask for Help
Many new moms struggle alone, feeling they should be able to handle everything themselves. But sharing the load takes things off your plate so you can focus on your recovery, and on building your relationship with your baby.
Ask family or friends to help with chores, meal prep, or baby care so you can get a nap or enjoy a moment of peace. If you have the means, consider hiring a postpartum doula, babysitter, or housecleaner. Support is fundamental for lowering stress.
Get Enough Sleep
Getting “enough” sleep has a very different meaning postpartum than in any other time of life. But whether you’re finding more time at night for rest, or taking an extra nap during the day, ask your partner, friends or family members for help watching the baby so you can rest. This is a non-negotiable for your recovery.
Eat Regular Meals of Healthy Whole Foods
Follow the Mediterranean diet to maximize your nutrient intake, reduce inflammation, support a positive mood, boost recovery from childbirth and balance blood sugar postpartum. All of this supports healthy cortisol levels.
Get Fresh Air
Get outside for walks as soon as you’re ready. Gentle movement, sunlight, and deep breaths of fresh air are all great ways to support a healthy cortisol balance.
Connect With Your Baby
While it might sound too simple to be true, spending quiet, loving moments with your baby can actually help lower your stress.
Holding your baby skin-to-skin, looking into their eyes, or even singing gently can increase oxytocin, sometimes called the “love hormone.” Oxytocin counters the effects of cortisol, helping you feel calmer and safer.
This not only improves your mood and reduces cortisol levels but can support healthy milk supply by promoting prolactin release.
In other words, bonding isn’t just good for your baby; it’s good for your hormonal health too.
Professional Guidance
Sometimes, talking with a professional can make all the difference. They can help you understand whether hormone testing or specific treatments might be helpful.
They can also teach you coping strategies to manage stress, offer resources for postpartum support groups, or guide you toward therapy if needed.
By introducing a few stress-reducing practices and reaching out for help, you can start to bring cortisol levels back into balance. Over time, these small efforts can lead to big changes in how you feel and function.
When to Seek Help
If you find that your anxiety, mood changes, or difficulties with breastfeeding don’t improve with simple adjustments, it might be time to talk to a healthcare provider. Postpartum life is challenging enough, and your body is undergoing the huge process of recovery; you do not have to struggle through it alone.
Is It Worth It To Test Cortisol Levels Postpartum?
Many of the women I’ve worked with want to know if and when they should get their hormone levels checked postpartum.
While I generally don’t recommend women invest in expensive testing for hormones like estrogen, progesterone, or testosterone earlier than 6 months postpartum, women suffering from issues that could indicate high cortisol may benefit from assessing their diurnal cortisol rhythm. This can help provide more targeted diet and lifestyle support to build resilience from stress while also recovering.
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