Pregnancy

The Transition to Fatherhood: Pregnancy

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For many men, finding out that their partner is pregnant is the beginning of a roller coaster of feelings and an enormous amount of internal change. For those who welcome the pregnancy, first time fatherhood can represent the real marker of adulthood. And over the months of their partners’ pregnancies, these men often reevaluate their sense of self, their expectations of themselves, their values, their lifestyle and their priorities – and it’s not easy. (1)

They are in the process of a psychological overhaul.

Some men meet the news of the pregnancy with elation, some with mixed feelings and some with dread – but whatever their initial reactions, many men experience the perinatal period as the most stressful time of all in their transition to fatherhood. (2) 

First of all, they often feel a bit disconnected from the reality of the pregnancy. Some take a number of weeks to really accept that the pregnancy exists. Many feel cut off, being able to experience the pregnancy only by proxy. While their partners have the embodied experience of the physical changes of pregnancy, they must rely on second hand accounts. (3)

And in one study, performed by Jan Draper, many of the men found that the reality of their partner’s pregnancies was different than their expectations. Some felt that the reality of the pregnancy alternated with periods during which they went about their lives as usual without an ongoing awareness of the pregnancy: “Some men suggested that their lack of continuous physical experience meant that they were able almost to opt in and opt out of their involvement of the pregnancy; they had an element of choice that their partners did not. These men remained focussed on everyday life, frequently their paid work, rather than on the minutia of the progress of the pregnancy. The sometimes part-time nature of men’s involvement was a theme…James, for example… was committed to the concept of involved fatherhood and apologetically contrasted his choice of part-time involvement with the continuous involvement of his partner. Steve, a novice father, described how the pregnancy kept `drifting away’ and how he felt guilty about `forgetting’ he was a father” (4).

Some also felt surprised by their reactions to their  partners’ changing bodies. Some felt put off by the size of their partner’s bellies and some felt that the pregnant belly was actually a barrier between themselves and their partners.

Some just could not connect the pregnancy to the reality of a baby. One said, “I can see Julie pregnant and I can see her with a baby and the two don’t seem to go together and that’s a really odd feeling and I don’t know how to describe that. You see a pregnant lady and then you see someone with a baby and…. it seems two separate type things” (5)

But getting to see the scans of the fetus as they were happening or feeling the fetus move inside their partners bellies helped many of these men to connect more directly to the pregnancy. One father-to-be said, “It feels nice (feeling the baby’s movements). It does. I think it’s harder for me because I get frustrated that I can’t experience any of it physically at the moment, other than putting my hand on the outside and feeling the movement”. (6)

And all the men in Draper’s study valued and enjoyed the accounts given to them by their partners about the pregnancy and the fetus’s development. 

During their partner’s pregnancies, some men feel the need to take on new responsibilities – to take care of their partner and prepare for the baby’s arrival.  Some feel more protective of their partner and worried about the wellbeing of their unborn child.

But some fathers-to-be may find themselves in conflict – on the one hand, feeling much of the above, and, on the other hand, resenting the new demands and responsibilities – whether the pressure to take these on comes from their partner, from what they perceive as societal expectation or whether it come from within themselves.

Contributing to these feelings may be the fact that in recent years, fathers have been expected to be more hands-on and more involved during the pregnancy and more intimate with their babies and children once they arrive than in previous generations. Fathers are generally expected to take at least an equal role in parenting – a job for which they may feel ill-prepared.

Many men have very little – if any – experience with babies and small children. They may never have held an infant before they hold their own – and they may know almost nothing about child care or child development.

And, of course, it is also confusing – because what constitutes fatherhood is ever-evolving. The wishes and needs of fathers and mothers and the societal norms around parenthood are alway in being reconfigured.  

And then there are the physiological changes involved in impending fatherhood. For example, a study published in the Mayo Clinic Proceedings demonstrated that men go through significant hormonal changes alongside their pregnant partners and that these changes are most likely initiated by their partner’s pregnancy.  The evidence suggests that fathers have higher levels of estrogen, the well-known female sex hormone, than other men and that increase starts 30 days before birth and continues during at least the first 12 weeks after birth – and possibly much longer. Although estrogen is best known as a female sex hormone, it exists in small quantities in men, too. Animal studies show that estrogen can induce nurturing behavior in males. So, it seems increasingly clear that just as biology prepares women to be committed mothers, it prepares men to be dads as well (7).

Furthermore, the study showed that men’s cortisol levels rise in the week before their baby’s birth and their testosterone levels decrease in the week after birth.

And then there are historical considerations in preparing for fatherhood as well: many men reflect on how they themselves were fathered. Old feelings are often stirred up around childhood memories, whether these are fond or those which include deprivation, harsh parenting, and abuse. And for those men who had fathers who were excessively strict, depriving, or angry, there will be many questions about how to father differently than they were fathered. They may have to evaluate how to deal with their own anger in ways distinct from their fathers, how to be more emotionally available than their own fathers, how to be more open than their own fathers, how to be less judgemental than their own fathers and/or how to be more generous than their own fathers 

Fathers-to-be have to consider what they want to take from their own experience of being parented and what they do not. They have to think about what kind of father they want to be and how to separate themselves from automatically fathering as they were fathered. 


And these thoughts can lead to potent feelings of uncertainty. In a study done by Meleagrou-Hutchins, the fathers studied anticipated various profound changes to their personal and professional lives beyond the birth of their baby.  And they worried about their ability to cope with the demands of fatherhood. They were all planning ahead and preparing, to varying degrees, so as to manage, or minimize, the disruption that fatherhood would cause in their lives.

They also felt invisible. Many felt their partners were getting more attention than they were in regard to the upcoming birth and that their health and wellbeing was being overlooked. Some felt sidelined, ignored during medical appointments – and at the same time many wondered whether they were really entitled to support.  Some also felt that they lacked a concrete goal during the pregnancy leading to feelings of powerlessness and frustration (8).

Many of these fathers reported feeling insufficiently supported as they worked to prepare themselves for fatherhood. Many felt their partner was their main source of support and yet they regretted putting further burden on her by needing this from her (9).

Preparing for fatherhood is a complex physiological and psychological process and clearly, men require more support in understanding their own experience as well as more institutional and societal support as they do so.

This is the first in a series on this subject.

Footnotes

1 Meleagrou-Hitchens 2020

2 Genesoni and Talandini, 2009.  

3. Draper

4. Draper, pg 132

5. Draper, p. 132

6. Draper, p 134

7. Berg, 2001

8. Draper, 2000, pg 132

9. Ibid, p. 133

References

Sandra J. Berg, MSc ∙ Katherine E. Wynne Edwards, PhD, Mayo Clinic Proceedings, Changes in Testosterone, Cortisol and Estradiol Levels in Men Becoming Fathers (2001). Vol 7, Issue 6, P582-592June 2001.

Draper, J. (2000). Fathers in the making : men, bodies and babies. (Thesis). University of Hull. Retrieved from https://hull-repository.worktribe.com/output/4211054

Genesoni, L. and Talandini, M., (2009). Men’s Psychological Transition to Fatherhood: A Review of The Literature, Birth, Dec;36(4):305-18. doi: 10.1111/j.1523-536X.2009.00358.x.

Meleagrou-Hitchens, L., Carla Willig (2022). Mens’s experience of their transition to first time fatherhood…. Department of Psychology, School of Arts and Social Sciences, City University London, EC1V 0HB London, UKDOI: 10.31083/jomh.2021.102 Vol.18,Issue 1,January 2022 pp.1-11.

Mombrain: Myth or Real?

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This is the seventh post in a series on The Transition to Motherhood.

In her book, Matrescence, Lucy Jones discusses the idea that society — and women themselves — often feel that childbirth and caring for young children diminish their memory and cognitive capacity. While they are pregnant and after they give birth, women often complain of not being able to remember anything, being scatterbrained, or feeling stupid.

But when looking at the research, Jones found the opposite!

In fact, it seems that having a baby concentrates the mind. Brain structure and the neurochemistry of the brain actually change during and after pregnancy in order to aid the mother to tune into her baby and her baby’s needs. It may be that some of the old things the mother used to think about are less the focus of her attention after her baby arrives and she may feel less capable of concentrating on them — but this is far different from being “stupid.”

In fact, Bridget Callahan, a researcher at UCLA, found evidence of enhanced learning, memory, and cognitive capacity after childbirth (Callahan, et al, 2022).

Of course, this makes sense, because new mothers need to expand their ability to tune in to their babies, to learn what helps and doesn’t help their babies to feel comfortable, and to learn how to solve the many problems of everyday childcare.

In fact, in reviewing the literature, researchers Erika Barba-Müller et al found that there are structural and functional changes in the woman’s brain both during pregnancy and following delivery which stimulate her to progress from being an individual with self directed needs to being responsible for her baby. These changes are highly adaptive and aid in the woman’s transition to motherhood.

Similarly, in a review of the literature, Winnie Orchard found that there is evidence that the brains of pregnant women become more flexible, efficient, and responsive.

Minor difficulties in word finding and short-term memory often make women feel less competent during pregnancy and early motherhood — but this is not all that is going on.

Referring to Orchard again, Lucy Jones says that the lifetime impact of motherhood on cognition and the brain may be positive and that the cognitive load of adapting and adjusting to one or more growing children may help the brain to be resilient.

Think about it: So many people have started doing the daily word puzzles put out by the New York Times — as well as doing all sorts of gaming apps on their phones — in order to preserve and enhance their cognition. But these do not provide even a portion of the challenge that comes up in a day for the parent of a newborn or child of any age!

For a first-time mother — and her partner — the day they come home from the hospital is often a terrifying day. Suddenly, they realize that it is up to them to figure out how to care for their new baby and to keep them alive. Soon it is clear that caring for a newborn requires a completely new set of skills. And there is a great deal of trial and error. Every day new problems need to be solved. So much has to be learned — not just about babies in general — but about this particular baby, her sensitivities, and her preferences. And then, just as the parents are getting the hang of it, the baby starts a new sleep pattern, develops new feeding preferences, or enters a new developmental stage. And learning how to deal with these things requires a great deal more problem-solving.

So as for “Mom Brain” — yes, there is such a thing, but it is not what we often think it is. The Mom Brain is a more flexible, more competent, more resilient brain than the non-mom brain.

References

Barba-Müller, et al (2019). Brain plasticity in pregnancy and the postpartum period: links to maternal caregiving and mental health. Arch Womens Ment Health. 2019; 22(2): 289–299. Published online 2018 Jul 14. doi: 10.1007/s00737-018-0889-z

Callaghan, B. et al., (2022) “Evidence for cognitive plasticity during pregnancy via enhanced learning and memory”, Memory 30(5) , p. 519-536.

Jones, Lucy (2023). Matrescence.

Orchard, E. R., et al., (2022) “The maternal brain is more flexible and responsive at rest: Effective connectivity of the parental caregiving network in postpartum mothers”, bioRxiv

The Transition to Motherhood: Pregnancy

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Part 5 in a series

In her book, Matresence, Lucy Jones says that pregnancy is a metamorphosis. Like a caterpillar that becomes a butterfly, the woman’s previous identity must melt away in order for her new identity and concept of self to emerge.

And during her own first pregnancy, Jones found this process very disturbing. She says, unlike other stages of life for which there are parties and ceremonies to mark the transition of one stage of life to another, during pregnancy, for which there are no ceremonies in our culture which celebrate the mother, the woman can feel profoundly awkward and alone.

Jones talks about how, during adolescence, she felt similarly awkward. She felt like she didn’t know what was going to happen next or how to be; she felt unsettled by the changes in her body.

But, she says, she had friends going through the same thing and films and articles and music which addressed the strangeness and alienation of adolescence, so she didn’t feel completely alone.

But as she went through her pregnancy, she did not feel accompanied. Part of this may have been because she, herself, did not understand what was happening to her mind, her body, or her self — and therefore she could not really talk about it with others.

She says that missing from pregnancy books or health apps was information about how pregnancy affects a woman’s mind – and her actual brain. She quotes Rosemary Balsam from the Western New England Psychoanalytic Society as calling this the “vanished pregnant body.”

She suggests that the very idea of the pregnant woman, of being two people in one, may make other people uncomfortable.

For example, there’s the the story of the runner, Allyson Felix. Felix was an Olympic medalist and many time US National Champion when she became pregnant. One of her sponsors, Nike, cut her pay by 70% and refused to offer her reasonable pay protection during her postpartum period. Felix reports being told “runners should just run” – in other words, women runners should not be pregnant.

Clearly having a premier spokesperson be pregnant was uncomfortable for Nike. And Jones talks about how it was uncomfortable for her – as it is for so many women — and not just because of the bodily changes, but also because of the emotional disequilibrium she felt and because of the changes in the way she perceived others as seeing her.

Experiencing this was hard for Jones because she felt external pressure to “pretend that pregnancy was a less dramatic and drastic event” than what she felt it to be.

And it is a dramatic and drastic event. For all women.

Thank goodness for Lucy Jones for saying so and letting us all heave a sigh of relief. We didn’t have to say it. But she did.

Toward the end of her pregnancy, Jones describes bowing out of work and not feeling guilty. She realized this was not typical of her — but she felt that she wanted to be at home and she didn’t mind being alone. She says that she felt “calm and placid, pleasantly vague, like nothing could touch me”.

Later she found out that this is normal — that there are physiological changes that accompany each of the many stages of pregnancy and that at the end of pregnancy, the reactivity to stress hormones is dampened. No wonder she didn’t feel the normal pressure to work and perform and please her boss. And luckily for her, she had the ability to step away.

The biology and neurobiological literature supports Jones. When she reports that she felt that her brain was changing during her pregnancies, she was right. In one study by Niu et all (2024), ten pregnant women were followed over the course of their pregnancies. Changes in brain structure were charted. Reductions in gray matter volume were found over the course of pregnancy. In other words — the pregnant woman’s brain actually shrinks! Their conclusion? There are profound neurobiological changes during pregnancy.

Moreover, in a review of the literature, Esel (2010) found evidence that the brains of pregnant women and women with children are very different from the brains of women who have not had children who are within the same age range. Moreover, Esel found ample evidence of neurobiological and hormonal influences on women and their feelings and behavior. She says that maternal behavior develops over the course of a woman’s life, including during pregnancy. This happens through the development of special neural networks, which are cooperatively developed by genetic, environmental, and hormonal factors.

In fact, the biology is fascinating. Esel points out the importance of hormonal influences in preparing women for motherhood. She says that estrogen, prolactin, and oxytocin stimulate maternal behavior after birth — and that the stimulation of the vagina during birth initiates the release of oxytocin, so important for the initiation of maternal behavior as well as milk production. She also discusses the finding that women are prepared to become mothers from their own birth. She says that early exposure to estrogen during the perinatal period in their own early lives may be responsible for women’s greater interest in and facility with social relationships over that of men. She suggests that this capacity primes women to be interested in and to relate to their infants once they become mothers. Then, during pregnancy the capacity for relating to their own infants is further primed by the high levels of progesterone and estrogen which are secreted. Furthermore, she says that the hormonal exposure of the brain during pregnancy plays an important role in the development of maternal neural networks and systems.

In the same vein Esel says that in humans, the ability to establish social relationships is inversely related to levels of fetal testosterone both in females and males — so in other words, men, from birth, are less primed to establish social relationships.

No wonder women feel different when they are pregnant — and no wonder they feel a shift in both body and identity. The hormonal influences on their brains, their bodies, their feelings and their behavior are powerful.

I look forward to reading the rest of Jones’s book to find out more about the research on the physiological and psychological changes that come about during pregnancy. I know too little about this.

In fact, most of us know too little about this.

Scientists are looking at aspects of the woman’s experience during pregnancy in a way that they might not have considered doing years ago, even though we have needed this information for a long time. But perhaps, as Jones suggests, science waited until there were enough women in the field to make this a priority.

References

Esel, Ertugrul (2010). Neurobiology of Motherhood. Turkish Journal of Psychiatry. https://www.turkpsikiyatri.com/Data/UnpublishedArticles/3uydyp.pdf

Jones, Lucy. Matrescence.

Yanbin Niu, Benjamin N. Conrad, M. Catalina Camacho, Sanjana Ravi, Hannah A. Piersiak, Lauren G. Bailes, Whitney Barnett, Mary Kate Manhard, David A. Cole, Ellen Wright Clayton, Sarah S. Osmundson, Seth A. Smith, Autumn Kujawa, Kathryn L. Humphreys (2024). Neurobiological Changes Across Pregnancy: A Longitudinal Investigation, bioRxiv, The Preprint Server for Biology doi: https://doi.org/10.1101/2024.03.08.584178

A Deeper Dive into the Transition to Motherhood

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More on matrescence – part 4 in a series

Posted July 20, 2024

Let’s take a deeper dive into the transition to motherhood in this, the fourth post in a series on this subject.

In the Introduction to her beautiful book, Matrescence, Lucy Jones says, “Pregnancy, then birth, and then – big time – early motherhood, simply did not match up with the cultural, social, and philosophical narratives I had grown up with…I started to realize that that my mind had been colonized by inadequate ideas about womanhood, about motherhood, about value, even love… A sense that I had been fundamentally misinformed about the female body and maternal experience set in fast” (p. 9, 10).

She describes how, during her pregnancy she noticed changes in herself which she had no language to describe – but she noticed that her “consciousness felt different: restructured or rewired” (p. 10).

She says, “I thought the baby would grow inside my body, …that I would still be the same person. But that didn’t seem to be the case” (p. 10).

I think that many if not most women feel all of these things. But do they have the language to speak about them? Or do they feel permitted to speak about them?

I suspect not.

Jones talks about how ill prepared she was for motherhood – how she had never changed a diaper and knew nothing about what it took to raise and take care of another human.

And I think many women feel this way – especially with their first babies.

Jones speaks about her guilt if she tried to do anything just for herself during those first months of motherhood.

She also writes about the idea that women are supposed to have a built in maternal instinct and how this works against the acknowledgement that motherhood absolutely requires the acquisition of knowledge and skills about babies, children and mothering.

And in saying this, I think Jones puts her finger squarely on the shame and embarrassment many mothers feel when they don’t know what the right thing is to do for their baby – whether it is something as simple as whether to put them down for a nap or something as complex and important as when to call the pediatrician.

As she says, “this is a set up in which mothers (are) destined to fail” (p. 11).

She says, “I thought early motherhood would be gentle, beatific, pacific, tranquil, bathed in a soft light. But actually it was hard core, edgy, gnarly” (p. 14).

Finally, we have someone who tells the truth about motherhood.

We have needed a Lucy Jones for a long time.

Women feel that they are not allowed to talk about the utter fatigue, boredom, tedium, panic and downright hardship of childcare. Yes, the difficulty of juggling work and child care is talked about. And the under valuation of parenting work is mentioned now and then. But as a society? We do not have much of a discussion around many of these issues – and we certainly have not made changing any of them a priority – in our own minds, with our partners and friends, or at the ballot box.

There is still pressure to put on a good face as a mother, to treat the work we do as joyous and to present that point of view to anyone other than our closest and most trusted friends and fellow parents.

Jones calls this “cultural apathy”. And she says that many women feel that they themselves are to blame for the extent of their troubles as new mothers. However, the fact is that a majority of women feel anxious after having a baby, at least 45% report feeling low, and at least 35% describe themselves as depressed. One in five mothers do not tell anyone about their feelings and over half report not feeling supported by their families. Almost half say they feel like they have to handle everything alone.

But there is hope. Jones writes about a burgeoning field of neurobiology that is looking at the changes in the brains of pregnant women and those who care for young infants. And she quotes Alexandra Sacks, a psychiatrist interested in this subject, as saying that simply by talking about the difficulties inherent in transitioning to motherhood, many women will feel relief.

And this is why, Jones says, she wrote her book: as an invitation to start talking about the process of becoming and being a mother.

And this is why I am writing this series.

Stay tuned for more.

References

Jones, Lucy. Matrescence

Matresence: The Transition to Motherhood – Isolation and Identity Shift

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A while back I wrote a post on matrescense, or the transition to motherhood, which seems to have struck a chord. This post is the second in a series on this subject.

To give some background, matrescence is a terms that was coined in the 1970’s by medical anthropologist, Dana Rafael, in her book, Being Female: Reproduction, Power and Change. More recently, the term was brought back to our attnetion by Aurelie Athan, a reproductive psychologist at Columbia University.

Athan notes that Rafael “pointed out that in many cultures, the birth of a new baby is announced by saying, “a woman has given birth.” Athan’s point is that the focus is on the mother and what she has done. And that emphasis is important. The mother is given credit for what she has accomplished. This is symbolic of the meaning the culture gives to the event and how it is handled. In cultures other than our own, mothers are often more supported after the birth of a baby, and more taken care of.

For example, in South Korea, it is common for mothers to go to a retreat for the first 21 days after they give birth. There, fresh meals are delivered three times a day, they can receive massages and facials and attend childcare classes, and there are nurses available to watch over the baby if the mother needs a rest.

There is a special soup to drink, traditional in South Korea during the postpartum period, lactation consultants and exercise routines to help with recovery, and body realignment to help new mothers get back in touch with their bodies.

In South Korea, eight out of ten mothers go to such a spa after giving birth.

This is the kind of thing that mothers in the United States can only dream about.

Here, mothers are often isolated in their own apartments or homes after their babies are born. During their leave from work, they often struggle with feelings of loneliness and anxiety. And this is especially true for first time moms who are not entirely sure what they are doing.

For example, a New York Times article profiled Alicia Robbins. When she had her first two children, she, like almost every woman who has birthed a child before her in this country, felt overwhelmed upon leaving the hospital. Never mind that she herself is an obstetrician and gynecologist. She said, having a child “was way harder than I expected. I kept wondering if it was OK that breastfeeding was so difficult or that I felt anxious. I kept asking myself, ‘Is this really my new normal?’”

Her mother came to help her, “but she kind of froze,” Dr. Robbins said. “I love her, God bless her, but we had fights over things like whether you need to sterilize the breast pump for three hours.”

In this country, as Aurelie Athan says, we talk about the baby, not the mother. We pay attention to the infant, give gifts to the infant, visit the infant….and we don’t talk so much about what the mother has accomplished and what we can do for her.

But the process of becoming a mother is something that we, in our culture, need to pay more attention to. As Daniel Stern said in his two books, The Motherhood Constellation and Becoming a Mother, giving birth to a new identity may be as hard, or even harder than the act of giving birth to the actual baby.

Becoming a mother changes who a woman feels herself to be. It expands her identity — but, as with many changes, this expansion can be fraught with uncertainty and anxiety. Who am I now? Do I know how to be a mother? Am I doing the right thing? What kind of mother do I want to be? Can I ever get back to doing the things I used to like to do? And if I do, will I be neglecting my baby? Can I still work? How much should I work? Can I still be good at my job?

The questions are endless.

Additionally, becoming a mother changes a woman’s identity as a partner. And this is not always easy. Sometimes a woman wonders if she still has room in her emotional repertoire for her partner. Sometimes the partner is jealous of the time a woman spends with her baby. Sometimes a woman feels she can only share her body with one person at a time and she feels resentful of other demands being made on her or torn about who that person should be — the baby or the partner? Often, a mother and her partner differ on how they each feel caring for the child should be handled. Conflicts come up over sleep training or how much of a schedule the baby really needs. And the energy for talking through these conflicts can be in short supply. Women often feel they carry more of the mental load for making doctor’s appointments, reading up on child development, and thinking about what the baby needs.

This identity shift is especially difficult, as a new mother needs her partner for support, and any resentment, difference of opinion, or outright conflict can get in the way of feeling supported.

The identity shift a woman faces after giving birth is hard. Like shedding a skin that no longer fits, the woman must say goodbye to aspects of herself and ways of being and doing that were part of her previous self, and she must grow into her new role as she works out what that will be.

Just knowing that all women experience this, that having a hard time with this shift is normal, and that it can be named and learned about — and even, in some cases, talked about with other mothers — can be helpful to new mothers.

I recommend that anyone suffering from this transition reach out — whether to friends, other new mothers, more experienced mothers, or even to a therapist who can discuss these issues openly.

After my last post, one such mother reached out to me and said that she felt less alone just knowing that what she was feeling was not unique to her.

****************************

For more good discussion of this subject, see the references section below and watch this blog for part 3 of this series.

To find a therapist, visit the Psychology Today Therapy Directory.

References

Jones, Lucy. Matresence

Rafael, Dana. Being Female: Reproduction, Power and Change

Stern, Daniel. Becoming a Mother

Stern, Daniel, The Motherhood Constellation