Cortisol: The stress hormone that follows us through pregnancy, postpartum and beyond

Cortisol is often labelled the “stress hormone”, but that description barely scratches the surface. Cortisol plays an essential role in regulating energy, inflammation, blood sugar and our sleep–wake cycle. In short bursts, it’s helpful. It keeps us alert and responsive.

The challenge arises when cortisol stays elevated for long periods of time.

For women moving through pregnancy, postpartum and motherhood, sustained high cortisol levels are incredibly common. Sleep disruption, physical recovery, hormonal shifts, mental load and constant responsiveness all contribute to a nervous system that rarely fully switches off.

And while cortisol isn’t something to fear, it is something to understand.

CORTISOL DURING PREGNANCY

During pregnancy, cortisol levels naturally rise as part of normal physiological changes. The body uses cortisol to support fetal development and energy regulation. However, when stress becomes chronic, cortisol can remain elevated beyond what the body easily balances.

Research suggests that prolonged stress during pregnancy may influence sleep quality, immune response and overall wellbeing. Many women notice changes in their skin as well. Increased sensitivity, dryness, flare-ups or slower healing are all common experiences during periods of sustained stress.

This doesn’t mean stress needs to be eliminated. That’s neither realistic nor necessary. But it does highlight the importance of nervous system support during pregnancy.

CORTISOL IN POSTPARTUM

Postpartum is often where cortisol becomes most noticeable. Sleep fragmentation alone has a significant impact on cortisol regulation. Add recovery from birth, feeding demands and emotional adjustment, and the body can remain in a heightened state for longer than intended.

Elevated cortisol in postpartum can show up as difficulty winding down, feeling “tired but wired”, muscle tension, slower physical recovery and increased skin reactivity. It can also interfere with the body’s natural repair processes, which are most active when we’re calm and rested.

This is why postpartum care shouldn’t focus solely on productivity or bouncing back. The nervous system needs time and signals of safety to recalibrate.

CORTISOL, THE SKIN AND BODY

Cortisol doesn’t just affect how we feel. It directly impacts the skin barrier. Studies have shown that elevated cortisol levels can slow lipid production in the skin, impairing barrier recovery and increasing trans-epidermal water loss. This can leave skin feeling dry, tight and more reactive.

Cortisol also influences inflammation pathways, which helps explain why stress often coincides with flare-ups, delayed healing or increased sensitivity.

Supporting cortisol regulation isn’t about forcing relaxation. It’s about creating conditions that allow the body to downshift naturally.

BEYOND PREGNANCY & POSTPARTUM

Cortisol doesn’t magically settle once babies grow. Many women continue to carry elevated stress levels well into motherhood. The body adapts, but it still benefits from regular signals of rest and recovery.

Even small rituals can make a difference. Gentle movement, warmth, slow breathing, consistent sleep cues and calming touch all play a role in nervous system regulation. These moments don’t need to be perfect or uninterrupted to be effective.

The goal isn’t to control cortisol. It’s to support the body so cortisol can return to baseline more easily. Care that respects the nervous system is long-term care.