Sex After Baby: When are New Parents Getting Back into Bed?
Growing up in the early 90’s meant a few things: big bangs, Saved by the Bell, awkward slow dances to November Rain while wrapped up in a thick cloud of Debbie Gibson’s Electric Youth perfume (I know, I know…)
It also meant you could probably find me in front of the big mirror in my bedroom, playing Salt-n-Pepa while I was Aqua-netting my hair (I can still smell it!), doubling up on my neon socks, and chewing stupid amounts of watermelon Bubble-yum.
[So glad my teeth are okay…]
But I digress.
In my tiny corner of the internet, and in the real world, I get enough questions about returning to sex post-baby that I think it’s worth a conversation.
So let’s kick this convo off right with a quote from the legendary Salt-n-Pepa:
“Let’s talk about sex, baby…”
What Do Doctors Recommend About Sex After Baby?
Let’s get the technicalities out of the way first:
Well, really, there are no technicalities, as the American College of Obstetricians and Gynecologists acknowledges. [1.] There is no set time frame after which it is uniformly “okay” to return to sex again.
Many OB-GYNs recommend waiting at least six weeks before having sex after the baby is born. But six weeks may not be enough time to recover physically from childbirth (and mentally and emotionally), and if that rings true for you, congratulations: you’re totally normal.
Many birthing parents are on a completely different planet than the one where they want anything to do with sex six weeks after bringing another human life into planet earth.
But I know, it can feel really distressing, even awful, when you think you should want to, or when your partner hopes you do, but you just don’t want to have sex.
What are Some of the Possible Reasons I Don’t Feel Ready for Sex Yet?
There can be a lot of medical reasons for that. Let’s talk about the big ones:
Hormones and Postpartum Recovery
This is the essence of this entire writing. Your postpartum recovery is EVERYTHING because it’s how you heal, how you recover your health, how you slowly, gently, and with great self-respect allow your body’s hormones to return to balance. Which takes a while. Plan on at least six months, but give yourself a year to fully recover.
We will return to this point time and time again, but know that postpartum recovery, that return to yourself, is a journey–not a bounce-back.
Let’s dive into the reasons why you may not physically be back on board for sex yet. And know that as your body recovers and your hormones rebalance, you will get your libido back.
But for now, you’ve got enough to focus on: your health, and your relationship with your new baby.
Here are the common reasons that new parents may not feel ready for sex just yet:
Breastfeeding
Along with all the changes that happen to hormones in pregnancy, childbirth and postpartum, breastfeeding can also have its own set of hormone shifts and corresponding experiences and emotions.
Libido can fluctuate massively postpartum (after it returns, which can also take a while!). Your hormones are on a rollercoaster, and your libido is very dependent on them. Breastfeeding will also have major impacts on your hormone levels.
For example, breastfeeding stimulates the release of oxytocin, which is the connecting hormone: it’s released during intimacy and during breastfeeding, to help you connect with your partner or your baby. Oxytocin is also important for milk ejection, so it serves multiple purposes for breastfeeding parents. [10.]
Oxytocin, good for libido. But then there’s estrogen….
Estrogen reduces breast milk production. [9.] It’s also one of the hormones responsible for the sexual arousal response, including vaginal lubrication. Breastfeeding bodies naturally want to keep postpartum estrogen levels lower to maintain milk production.
In pregnancy, estrogen levels skyrocket to maintain the pregnancy, and to prepare your body for birth. Those super-high estrogen levels are responsible for the pregnancy hair and the glowing skin you might have enjoyed before the baby arrived. But postpartum, your levels of estrogen and progesterone plummet when the baby arrives.
Oxytocin, estrogen, progesterone, random sleep schedules, baby feedings, your body’s healing, massive changes in your body’s fluid levels… there is A LOT happening to any postpartum breastfeeding/chestfeeding person’s body. So it makes sense that some postpartum people might not feel sexy too soon after giving birth…
And it’s important to know, too, that for people who are ready to have sex again, your body’s wild shifts will probably happen in the bedroom too.
When you’ve got so much going on physiologically, and you’re having sex, some unexpected things can happen. For example, because of the complex interplay of hormonal and sensory signals going on inside their bodies, breastfeeding people may have a milk ejection reflex when they orgasm. Prior to orgasm, milk may leak from the breasts as well.
This is totally normal, and due to the breastfeeding parent’s increased sensitivity to hormones such as prolactin and oxytocin, which promote milk production and ejection.
Also, as I mentioned, vaginal lubrication can be down while breastfeeding, so if you’re having sex or you want to, consider investing in a high quality vaginal lubricant.
Ultimately, it’s SO important to take everything you’ve got going on into consideration, too. Are you sleeping? Are you eating well? Do you feel supported by your partner? How do you feel about breastfeeding: satisfied and connected, or stressed and frustrated? All of these factors are massively important to your hormonal health and your libido.
Breastfeeding was a MUCH more emotional experience for me than I had ever dreamed it would be. If you’re feeling that way, that’s totally okay, and totally normal. Speaking with an expert such as a lactation consultant may help you get a sense of what’s normal and what’s not.
Also, there are a lot of perfectly healthy, natural ways to feed your baby available to you. We go through these and more inside my book POST: The Essential Guide to Creating Your Postpartum Self-Care Plan in Pregnancy, and inside my Postpartum Wellness Program, where we dive deep with women to help them normalize their experiences with feeding their babies, and get them the support they need.
Grab your copy of the book POST here.
Thyroid
A pregnant person’s thyroid gland goes through SO MUCH!! Thyroid function gets upregulated in pregnancy because thyroid hormone is an essential component of healthy brain development for your baby.
Thyroid hormone also steps up to modulate your physiology, because pregnancy is a long-term cardiometabolic event.
Postpartum, women can experience something called postpartum thyroiditis, which is inflammation of the thyroid gland that happens after childbirth. While this can initially look like hyperthyroidism, which causes symptoms like anxiety, sleeplessness, irritability, rapid heartbeat etc., it will eventually swing back into hypothyroidism, with symptoms like exhaustion, depression, brain fog, weight gain.
And our thyroid glands have a big impact on our sex hormones, including estrogen and testosterone, which are big regulators of libido. Make sure your doctor is monitoring your thyroid postpartum, and if you have any concerns about your thyroid health, contact your doc right away.
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The Wild, Crazy Emotional Ride of Pregnancy, Childbirth, Becoming a Parent, etc.
Sometimes life feels like more than you can handle. Being a new parent is usually one of those times. If you are feeling overwhelmed in this journey, just give yourself time and space. Take deep breaths. Eat healthy food. Find someone to help you with childcare so you can grab a quick nap. And talk with your partner.
Make sure they know how you’re feeling; this opens the door to intimacy, and it opens a door for them to step up and help you, which is one of the sexiest things they can do.
Nutrient Deficiencies
Pregnancy, childbirth and postpartum recovery are all depleting. If you’re feeling exhausted, overwhelmed, or like you’re just trying to get through the day, there are good reasons why.
Changes in sleep, the pressure of being a new parent, and lactation (for those parents who choose to) are big ones. But one often gets missed, although it definitely needs to be a part of the conversation with your doctor: nutrient deficiencies.
There is good research out there on the benefits of iron [3.], vitamin D [2.], iodine [8.], and vitamin B12 [5.] for women in pregnancy and postpartum. These vitamins and minerals can often get depleted in pregnancy and postpartum, so they need to be checked regularly.
Also: are you eating enough? Are you really eating enough? Postpartum, many women feel like they need to race back to some former version of themselves, so they cut calories to try to drop the baby weight.
But this can put you in a state of stress (calorie depletion, especially during an acute healing period, is stressful) and keep your hormones from getting back into balance, for starters.
A state of calorie depletion will also keep you from healing quickly, and it will slow your metabolism long-term, ultimately making it harder to lose weight in the long run.
And for those parents who are lactating, it can also reduce the quality and quantity of your breast milk.
When you’re recovering from childbirth and learning how to be a parent (whether this is your first baby or you’ve done it before), you need enough nutrient dense calories.
Eat lots of whole foods including protein, healthy fats and carbs (there is a ton of great research on the Mediterranean diet for postpartum health, including postpartum weight loss! When in doubt, go Mediterranean).
Talk with your doctor about monitoring your vitamin D, iron, and B12 levels, as well as your thyroid function (really, the best way to get a sense of iodine levels). Make sure you’re supplementing if you are depleted in any of these nutrients, but always speak with a doctor prior to starting any new supplements, especially if you are pregnant or breastfeeding.
And know that, as your body heals and learns its new normal, a healthy dose of daily nutrition is an essential step to get you back to the lean, sexy version of you that you know is inside.
Mood Issues Including Postpartum Depression and/or Postpartum Anxiety
The medical community is just beginning to realize how critical a mother’s/birthing parent’s mental health is in pregnancy and postpartum, and that she can have big mood swings, long bouts of depression and/or anxiety, and even postpartum psychosis, for a long time after birth.
The same is true for the partner: depressive symptoms have also been seen in up to 10% of new fathers and partners up to one year postpartum. [11.] That’s up to 1 in 10 dads! And for the partners, depressive symptoms can also cause a postpartum drop in libido. [4.]
These can all be reasons to want to avoid sex. (They are also MAJOR red flags that signal a need to reach out to your healthcare provider now. If you are struggling with your mental health after giving birth, talk with your doctor right away. Your health and safety, and your child’s health and safety, are too important).
If you are aware that mood issues are a big factor in your not wanting to have sex, talk with your doctor or with a licensed mental health professional right away to get help. This is NOT something you need to deal with on your own.
Constant Fatigue
If you’re struggling to get through your day, OF COURSE sex will be the last thing on your mind.
Here’s a little doorway into my postpartum experience: following a postpartum hemorrhage in which I lost almost 2 liters of blood, I was exhausted. For months I could barely get through my days, which were spent going from bed to a chair at the table to sit with my mom and my baby, or to my couch.
I’d camp out there all day, just waiting for dinnertime and the return to bed which quickly followed.
When I had to return to work, I would try my best to prep the day before but inevitably I’d be so spent from caring for others, pumping, and breastfeeding my baby that again, all I could focus my hazy vision on was bed.
It was at least a month before I could go out for a walk. Literally. And I couldn’t return to any form of exercise for a few months after that.
Fatigue can be caused by a lot of factors, including a birth parent’s age in pregnancy and delivery, sleep problems, mental health struggles like postpartum depression and anxiety, and even the length of your baby’s delivery. [7.]
Also, moms who describe having a more challenging relationship with their new baby, including those who see their new baby as being a more challenging baby than others, also had more postpartum fatigue according to one observational study of 10,000 postpartum women at 10 days, 1 month, and 3 months postpartum. [7.]
It’s also important to know that your thyroid will go through a wild ride in pregnancy and postpartum, and that may cause prolonged feelings of fatigue or even exhaustion postpartum. Talk with your doctor about whether you’re getting enough nutrients that can impact your energy levels including iron, iodine, B vitamins including vitamin B12, and vitamin D.
Fatigue is real. And you’ve just done something truly amazing with your body: you’ve grown and birthed a brand new life into this beautiful, grateful planet: so THANK YOU. If you need a little bit more time to rest, just talk with your partner about what’s going on and how you feel.
And ask for the support you need.
After all, six weeks isn’t really all that long to recover from the massive transformation of becoming a mom.
Being Worried About Getting Pregnant Again
Your OB-GYN should discuss birth control options post-baby, although it’s best to decide in pregnancy what you want to do. Some families know they want to have more children closer in age, so they opt not to use birth control post-baby.
Others know they want or need to wait before having another baby. For these folks, knowing your options and choosing the one that works best for you is best.
If you intend to breastfeed, you’ll want to know a few things about your options, especially regarding hormonal contraception. Because of their effects on prolactin (pro-lactation, basically—this is the hormone that promotes lactogenesis or milk production), hormonal contraception can impair lactation. Your prolactin levels rise throughout pregnancy, but high levels of estrogen and progesterone that are also present in pregnancy block prolactin’s effect on your breasts, keeping you from full-on lactating while you’re pregnant. Then, after birth, your estrogen and progesterone levels drop quickly so your breasts lose their inhibitory effect, leaving prolactin to stimulate milk production.
The effect of estrogen-containing birth control options is most associated with a possible impairment in milk production. For this reason, it’s recommended that women wait a minimum of 6 weeks, or as late as possible to ensure their milk supply is well established, to initiate estrogen-containing hormonal contraception, and that they use the lowest possible dose (increasing estrogen doses increases risk of shutting down milk production).
With that said, you have a lot of options for contraception. Let’s review them now.
Copper IUD
A copper IUD is a non-hormonal option that works by causing persistent mild irritation to the uterine wall, which prevents joining of the egg and sperm, and/or implantation of an embryo. There are no hormones associated with the copper IUD, so it has no known effect on lactation. The copper IUD is a great option for many women, but it can cause an increase in pain, cramping, and bleeding (precisely because it increases inflammation in uterine tissue).
If this is your preferred option for contraception, the copper IUD can be placed as soon as minutes after birth, or whenever you are ready. You and your doctor can also plan to insert it during an early postpartum visit. There is an increased risk of the IUD coming out of the uterus when it is inserted right after birth.
Progestin-Only Contraception (IUD, Injectable, Implant, Pill)
These are hormonal forms of birth control containing progestin, a synthetic form of progesterone. They do not contain estrogen or any estrogen analogues. Theoretically, a progestin-containing option can impair milk production in the early postpartum period; however, studies show that progestin-only forms of birth control do not seem to reduce a woman’s milk supply or negatively affect infant growth and development.
As with the copper IUD, you can have a progestin-containing IUD inserted right after a vaginal or cesarean birth, although there is an increased risk of the IUD coming out if it is inserted at that time. If you intend to breastfeed, you may also want to consider waiting at least 4-6 weeks before starting this, but speak with your doctor or midwife to weigh the risks and benefits of waiting vs. immediate placement. A progestin-only form of birth control is less likely to cause breastfeeding issues than birth control containing estrogen.
Women who won’t breastfeed can get their first IUD, implant, or injection, or begin taking pills, right after a vaginal or cesarean birth.
With both IUD options, delaying insertion makes it more likely that women will not return for a follow-up visit to have it inserted, increasing their odds for an unplanned pregnancy.
Combination Hormonal Options
Combination hormonal birth control options contain estrogen and progestins, and they’re available as pills, patches, and the vaginal ring. There is a greater association with impaired milk production when using combination hormonal options: if you’re breastfeeding, it is recommended to wait a minimum of 6 weeks to initiate combination birth control, until your milk supply has been well established.
Additionally, there is an increased risk of blood clots when using combination hormonal birth control, and there’s also an increased risk of developing a DVT (deep vein thrombosis) in the first 6 weeks of the postpartum period (one more reason to wait a minimum of 6 weeks before initiating combination oral contraception). A healthy diet, regular movement, good hydration, and not smoking will all reduce your risk of developing a DVT.
Women who aren’t breastfeeding and who don’t have an increased risk of DVT can begin using combination hormonal birth control 3 weeks after childbirth.
Barrier Methods (e.g., Condoms, Diaphragms, Spermicide, Cervical Cap, Sponge)
Barrier methods are another non-hormonal form of birth control and are also easily available. Additionally, condoms provide additional protection against STIs, which other forms of birth control do not provide.
You can use condoms and spermicide any time after childbirth. The cervical cap, diaphragm, and sponge can be used beginning 6 weeks after childbirth, when your cervix and uterus have returned to their normal size. Note that the sponge and cervical cap are much less effective after you give birth.
Additionally, if you use a cervical cap or diaphragm, you’ll have to be refitted after birth. Remember too that a diaphragm can increase your risk of UTIs, so make sure to clean your diaphragm with mild soap and water after every use, and wash your hands well before inserting or removing your diaphragm.
Rhythm Method
OB-GYNs and women’s health experts everywhere may grimace at this, but many women want a non-hormonal option that puts them in control of their bodies and that respects their natural rhythm. So here we go:
Without a doubt, the rhythm method is the least effective method of birth control for women in the postpartum period. You can resume ovulating as soon as a few weeks after childbirth, especially if you’re not breastfeeding.
Because you ovulate roughly 2 weeks before your period arrives, you can become fertile again and not even know it. So there is a window of time in the postpartum period where you will have absolutely no idea if you are fertile or not, especially if you are not breastfeeding, or you are combination feeding.
When your period returns it can be erratic, and quite unlike your cycle pre-pregnancy; you may ovulate at unpredictable times during the postpartum period, while your body is relearning its natural rhythm. For this reason, the rhythm method is not considered a reliable method of birth control in the postpartum period.
With that said, once your period returns you can certainly resume tracking your body’s signs and signals. After your period has started again, take your basal body temperature and monitor your cervical mucous.
You should still have an additional contraception method on board until your body has resumed a highly predictable, regular cycle.
Additionally, if resuming the rhythm method of contraception is important for you then I would recommend working with a medical professional who specializes in women’s health to help you monitor and make sense of your body’s shifting hormonal patterns in the postpartum period.
Lactational Amenorrhea
Lactational amenorrhea is the technical term for infertility due to breastfeeding. This occurs because the suckling reflex reduces the release of gonadotropin releasing hormone, luteinizing hormone, and follicle stimulating hormone, which all promote ovulation. It also stimulates the release of prolactin, which promotes milk production and further suppresses ovulation.
This, broadly speaking, is how breastfeeding reduces a woman’s likelihood of a new pregnancy while breastfeeding.
If a woman is amenorrheic (not getting her period), and is fully or nearly fully breastfeeding a baby less than 6 months old (if she is expressing milk every 2-3 hours), then she is likely not ovulating, which means that she has only a 1-2% chance of pregnancy at this time.
With that said, there is always the chance that ovulation can resume without you knowing it! Many women note that their periods resume about 6 months after giving birth, and ovulation may have occurred about 2 weeks before that.
It is generally accepted that an exclusively breastfeeding woman has about 6 months of infertility before she resumes ovulation, but if you are certain you do not want to become pregnant again, you may want to consider an additional form of birth control as you approach the 6 month postpartum mark.
Permanent Birth Control
The technical term is sterilization, but I will call it “permanent birth control.” In women, permanent birth control involves closing off or removing the fallopian tubes.
This can be done at the time of delivery, especially following a cesarean birth, or later. If you’ve had a cesarean section, they can use the same incision to perform this procedure, or it can be done laparoscopically.
In men, a vasectomy may be performed, which involves clipping and removing a portion of the vas deferens, or tube that delivers sperm from the testicle. Note that it can take up to 2 to 4 months for the man’s body to become free of sperm, so there is a chance of pregnancy for a little while after the procedure. During this time, a second method of birth control should be used.
Trauma, Tragedy or Loss
Trauma and tragedy are subjective, but when they happen, you know. A difficult birth can cause birth trauma, leaving the birth parent traumatized and possibly completely out of touch with their sexual organs and identity.
Birth can also bring up old feelings or memories of sexual trauma that happened in the past, that is totally unrelated to one’s recent birth.
BIPOC and/or transgender parents, as well as obese parents, are more likely to experience trauma in pregnancy and/or in medical settings, which predisposes these birth parents to increased health risks, potentially with less access to medical care. [12., 13., 14.]
If your health is suffering in any way, along with the added burden of trauma, you probably won’t want to have sex.
Transgender birthing parents can also have their own experience with pregnancy and childbirth that cause a complete lack of sex drive.
We’re just beginning to hear the stories of transgender birthing parents, but trans parents may be extra-susceptible to a traumatic birth experience and perinatal mental health issues, especially if their journey into parenthood also calls up feelings of gender dysphoria or a loss of their sense of identity on a whole new level. [6.]
Loss will also take a person’s mind off sex. Losing a baby that was expected, wanted, hoped for, is an absolute tragedy that I truly wish no one had to bear living through. Whether the loss happened recently or in the past, this can have a profound effect on your sex drive.
The moment you learn you’re pregnant, the journey you take is a wild one. It’s a path you’ll walk alone, one that no one else has ever gone down before, or ever will after you. It’s your journey to walk alone, and each pregnancy and postpartum journey you have will be different.
If you’re not ready to have sex yet, that’s totally okay. Talk with your partner about why you feel the way you do, and ask for their support. Because even though it is your journey to walk alone, there are unlimited allies waiting in the wings for you, if you’ll only let them know you need support.
Natural Support For Healing, Hormones, + Your Libido
There is no magic bullet. Healing takes time, and so does hormone rebalance.
The good news is that the answers are simple:
A healthy diet, and eating enough
Sleep
Hydration
Movement, when ready and as appropriate
Stress management
A Healthy Diet
You’ve got to eat enough of the right foods (too many new moms want to restrict calories to try to lose the baby weight. This isn’t the way to do it. Your body needs healthy calories from protein, fat, and carbs to heal, and so do your hormones.
Starving or living in a big calorie deficit while recently postpartum sets you up to slow down your metabolism, long-term. This goes doubly for those who are lactating.
The best thing to do - eat enough, and eat well.
Research on postpartum healing has shown time and again that the Mediterranean diet is the way to go. It benefits cardiometabolic and mental health, and provides a good amount of healthy fats, protein and carbs.
I have tons of Mediterranean diet resources including meal plans and shopping lists available through my book, POST: The Essential Guide to Creating Your Postpartum Self-Care Plan in Pregnancy; click here to grab your copy.
Sleep
Sleep is essential for recovering your physical and mental health, as well as for hormone health.
It may also be one of the hardest conversations to have with a postpartum person.
Many women struggle with sleep in pregnancy, possibly due to pain or discomfort, or hormone shifts. In postpartum, what keeps many of us up is the new baby, who must eat every couple of hours during her or his first few months of life, and who is also building out the proper sleep architecture; before this sets in, their circadian rhythm is not fully developed so they wake up often throughout the night.
For postpartum people struggling to sleep because of the baby, I recommend a couple of things:
First, find people who can come over for 1 or more hours during the day so you can nap. Any sleep is MUCH better than no sleep.
Second, if your baby is waking more often at night or staying up past feedings, there may be a reason why. Ensure that your child isn’t cold, hot, or in pain in his or her sleep space. If they struggle to return to sleep after eating, they may have GERD or feel colicky; there are many things to try for these babies.
For GERD, keeping them elevated after eating to prevent acid reflux may help. Remember, their little digestive system is only just beginning to learn how to work for the first time ever, so it must be treated gently!
Colicky babies may benefit from mom’s making changes in her diet, or incorporating chamomile tea. Get the okay from a doctor or midwife before adding in anything new, including herbal teas.
Some babies cry or fuss after eating because they’re still hungry; there can be many possible causes for feeding troubles, and speaking with a lactation consultant is highly recommended. A pediatric dentist can also assess for a lip or tongue tie, which can impair a baby’s feeding ability.
This list is not comprehensive; inside my book I go through many reasons why a baby might be crying, fussing, or otherwise not sleeping, along with more resources.
Hydration
Hydration is essential for cardiometabolic and hormone health. While it almost seems too simple, getting and staying hydrated changes peoples’ lives: I see this every day.
Outside of elite athletes, postpartum people have the highest water needs that they will have throughout their lifetime, especially if they are breastfeeding.
The general rule of thumb for how much water to drink: drink half your body weight (in pounds), in ounces of water daily.
So a 160 pound person needs 80 ounces of water daily.
A pregnant and postpartum person should drink half their body weight in pounds, in ounces of water daily, plus more to satisfy thirst.
A postpartum lactating person should drink half their body weight in pounds, in ounces of water daily, plus more to satisfy thirst, plus an additional glass of water for every breastfeeding or pumping session.
Movement, When Ready and As Appropriate
Don’t push it; your body will let you know when it’s ready. When it is, begin with gentle walking before getting the all-clear from your medical provider to resume any more intensive exercise.
Exercise and movement (like walking) are essential for hormone balance and keeping your body as healthy as possible while healing.
The Postpartum Self-Care Plan inside POST guides readers through the creation of an exercise plan in pregnancy and postpartum.
Stress Management
Easier said than done, I know! But stress shuts down digestion so a stressed person absorbs fewer nutrients while burning through more vitamins and minerals (due to higher levels of stress hormones); stress robs a person of vital, healthy sleep; it keeps hormones from ever being able to get back into balance; and it puts extra pressure on a person’s cardiometabolic system with absolutely no health benefits.
But it’s tough to even conceive of stress management as a busy new parent. I get it.
Here’s what I did, and what I recommend my patients do: find one self-care routine that hits the stress reset button, and do it every day. For me, it was walking and/or spending time in the kitchen, eating healthy food.
I called my walks stress management. I called my hang time in the kitchen, stress management (no, I wasn’t cooking; mostly I was warming things up or pulling pre-cut things out of the fridge, like cheese and veggies, olives and fruit to make cheese plates. Cooking was NOT on my radar postpartum.).
You have to find the thing that makes you feel good, that chills you out, and do it. As with all of these suggestions, I have much more in-depth info inside my book.
Want more postpartum support?
Click here to schedule a private call with me and discover your options.
xo, Dr. Emilie
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References
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[3.] Bodnar LM, Cogswell ME, McDonald T. Have we forgotten the significance of postpartum iron deficiency? American Journal of Obstetrics & Gynecology. 2005;193(1):36-44. doi:https://doi.org/10.1016/j.ajog.2004.12.009
[4.] Dawson SJ, Leonhardt ND, Impett EA, Rosen NO. Associations Between Postpartum Depressive Symptoms and Couples’ Sexual Function and Sexual Distress Trajectories Across the Transition to Parenthood. Annals of Behavioral Medicine. Published online January 15, 2021. doi:https://doi.org/10.1093/abm/kaaa117
[5.] Dhiman, P., Pillai, R.R., Wilson, A.B. et al. Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women. BMC Pregnancy Childbirth 21, 146 (2021). https://doi.org/10.1186/s12884-021-03622-x
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[8.] Pérez-lópez FR. Iodine and thyroid hormones during pregnancy and postpartum. Gynecological Endocrinology. 2007;23(7):414-428. doi:https://doi.org/10.1080/09513590701464092
[9.] Jin X, Perrella SL, Lai CT, Taylor NL, Geddes DT. Causes of Low Milk Supply: The Roles of Estrogens, Progesterone, and Related External Factors. Adv Nutr. 2024 Jan;15(1):100129. doi: 10.1016/j.advnut.2023.10.002. Epub 2023 Oct 11. PMID: 37832920; PMCID: PMC10831895.
[10.] OXYTOCIN AND MILK EJECTION. Journal of the American Medical Association. 1954;155(15):1337. doi:https://doi.org/10.1001/jama.1954.03690330041012
[11.] Scarff JR. Postpartum Depression in Men. Innov Clin Neurosci. 2019 May 1;16(5-6):11-14. PMID: 31440396; PMCID: PMC6659987.
[12.] Issue Brief: Black Maternal Mental Health. Policy Center for Maternal Mental Health - Formerly 2020 Mom. Published December 11, 2023. https://www.2020mom.org/blog/issue-brief-black-maternal-mental-health
[13.] Njoku A, Evans M, Nimo-Sefah L, Bailey J. Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States. Healthcare (Basel). 2023 Feb 3;11(3):438. doi: 10.3390/healthcare11030438. PMID: 36767014; PMCID: PMC9914526.
[14.] Mulherin K, Miller YD, Barlow FK, Diedrichs PC, Thompson R. Weight stigma in maternity care: women's experiences and care providers' attitudes. BMC Pregnancy Childbirth. 2013 Jan 22;13:19. doi: 10.1186/1471-2393-13-19. PMID: 23339533; PMCID: PMC3577669.