New mothers have a range of experiences in the months after childbirth. These experiences vary from being joyful, exhausting, miraculous, stressful or a combination of them all. One area of postpartum life that is meaningful to all new moms is their health and wellness.
After giving birth, child bearers don’t often feel as if they have much time to focus on themselves. Ask any new mother to describe postpartum experiences, and most will mention sleep—often the lack of restorative rest—and researchers are finding that sleep and sleep-related behaviors may have significant effects on child bearers’ current and future health and wellness.
Sleep health is one of the pillars of overall health and wellness. People’s sleep-wake cycles are regulated by an internal process called the circadian rhythm. Biological functions, even at the cellular level, operate on a timing system throughout the day. This rhythm that keeps the body functioning is affected by exposures, like light, and also by behaviors, like diet and physical activity. Sleep is both affected by this internal rhythm and also helps to regulate it. When people don’t get the right amount of sleep, at the right time, on a regular basis, their biological functions are disrupted, which can eventually lead to disease development.
For instance, take postpartum depression, a persistent condition that the Centers for Disease Control and Prevention approximates as many as one in eight new mothers experience. Researchers know that sleep deprivation and postpartum depression feed each other. In fact, when diagnosing postpartum depression, fatigue is one of the factors health care providers consider. The relationship between sleep and depression may seem obvious, but researchers are trying to pull apart that connection to understand it—and sleep during the postpartum period in general—to better inform care for child bearers.
Marquis Hawkins, PhD
Marquis Hawkins, PhD, assistant professor of epidemiology at the University of Pittsburgh’s Graduate School of Public Health, has designed the SLEPT study to examine how sleep and physical activity affect postpartum health.
“We know that sleep and sleep behaviors change after childbirth,” says Dr. Hawkins. “But we don’t really have documented information about those changes. Our goal with the SLEPT study is to characterize sleep after childbirth more comprehensively to identify specific targets for intervention.”
In the SLEPT study, Dr. Hawkins is looking at more than just duration of sleep, the sole factor by which many people evaluate their sleep. In addition to duration, he describes looking at sleep health as “a multidimensional behavior characterized by alertness, the ability to move through the day, regularity/consistent sleep patterns, personal satisfaction, the timing of sleep (sleeping at night as much as possible) and efficiency (whether people are able to sleep when they are trying to sleep).” The study also measures sleep behaviors, which include sleep hygiene, the daily routines and the environment in which people sleep. These behaviors also affect other health behaviors, like weight and depression, that are also important to health. Dr. Hawkins wants to understand how all those factors affect child bearers’ health.
In his research, Dr. Hawkins has interviewed many mothers. These people often discuss how the focus on their health during pregnancy and shortly after childbirth shifts to the health of the infant and going to well-child visits.
“Well-child visits are obviously important and necessary,” he says. “But child bearers still need attention and focus on their health. Symptoms for conditions like postpartum depression may not show up within the first six weeks after childbirth, the typical time for a postpartum checkup. After this checkup, child bearers may not have another check-in with their health care provider for at least another year. So many things change in people’s lives after giving birth, and they’re often overlooked.
“With sleep, we often expect that no one sleeps after a child is born; that it’s difficult, but it gets better. It’s important to promote the idea that sleep issues after childbirth can be neither transient nor do they go away on their own. Poor sleep in the postpartum period is associated with developing depression, weight retention and other long-term trajectories of health that may increase the risk of disease development in the decades to come.”
With the SLEPT study, focus returns to child bearers and how best to support their health and wellness in the postpartum period. To learn more about the SLEPT study, visit https://pittplusme.org/studyarms/publicdetails?guid=c5987916-6b65-41ef-b1a2-cd68a3a4a993 or email marquis.hawkins@pitt.edu.
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