17 votes

Motherhood brings the most dramatic brain changes of a woman's life. So why does prenatal care ignore the topic altogether?

19 comments

  1. [2]
    DonQuixote
    Link
    Thanks for the well thought out article. Of course the fact that it's behind a subscription wall doesn't help getting the word out. For those who don't have access, a few points:

    Thanks for the well thought out article. Of course the fact that it's behind a subscription wall doesn't help getting the word out. For those who don't have access, a few points:

    Entering into motherhood is “a major event” for the brain, says Jodi Pawluski, a researcher at University of Rennes 1 in France who focuses on what she and her colleagues call the “neglected neurobiology” of the maternal brain. “It’s one of the most significant biological events, I would say, you would have in your life.”

    Women experience a flood of hormones during pregnancy, childbirth, and breast-feeding that primes the brain for dramatic change in regions thought to make up the maternal circuit. Affected brain regions include those that enable a mother to multitask to meet baby’s needs, help her to empathize with her infant’s pain and emotions, and regulate how she responds to positive stimuli (such as baby’s coo) or to perceived threats. In the newborn months, a mother’s interaction with her infant serves as further stimulus to link her brain quite tangibly to her baby’s.

    Some effects of those brain changes may moderate over time. Researchers have found that the anxiety or hypervigilance that many new mothers feel, for example, peaks in the first month postpartum and then diminishes. But they suspect that other effects linger, shaping mothers even well past their child-rearing years and even influencing their relationships with future grandchildren.

    7 votes
    1. Deimos
      (edited )
      Link Parent
      Oh, it is? Sorry about that, it works fine for me, but maybe it's because I have javascript disabled and it's preventing their wall from working. Here's an Outline link that should work for anyone...

      Of course the fact that it's behind a subscription wall doesn't help getting the word out.

      Oh, it is? Sorry about that, it works fine for me, but maybe it's because I have javascript disabled and it's preventing their wall from working.

      Here's an Outline link that should work for anyone that can't access it: https://outline.com/Sfh93C

      7 votes
  2. [4]
    mat
    Link
    Literally just today I went to an ante-natal class where PPD and PPA and other mental health issues were discussed. Neurological changes were mentioned, although not in great depth, because there...

    Literally just today I went to an ante-natal class where PPD and PPA and other mental health issues were discussed. Neurological changes were mentioned, although not in great depth, because there was a lot of stuff to cover. This wasn't a special class that costs lots of money, it was the free NHS class (this was class 4 of 4, 2 hours per class) on offer to everyone in the UK. Things were explained and talked about, questions were asked and so on. Lots and lots of information was offered regarding support networks and how to use them - and there were a LOT of support options available. It was made clear that post-natal health visitors and parent-and-baby groups would be on the lookout for maternal (and paternal!) mental health just as much as infant physical health.

    I was genuinely impressed.

    5 votes
    1. [2]
      Cyhchan
      Link Parent
      That's really awesome to hear! I hope we can take a page out of the NHS book and have something similar someday. The class that I took was ten sessions, not nearly that comprehensive regarding...

      That's really awesome to hear! I hope we can take a page out of the NHS book and have something similar someday. The class that I took was ten sessions, not nearly that comprehensive regarding mental health and it cost a fair bit of money to attend.

      2 votes
      1. mat
        Link Parent
        Apart from the obvious fact that looking after people's health (mental or otherwise) is just the humane and decent thing to do, this sort of pre-care is just basic business sense - as the old...

        Apart from the obvious fact that looking after people's health (mental or otherwise) is just the humane and decent thing to do, this sort of pre-care is just basic business sense - as the old saying goes: "a gram of protection is worth a kilogram of cure" (I know it's ounce/pound but I refuse to use Victorian units). It's a lot cheaper and more effective to deal with a problem before it happens than later down the line. Spending taxpayer's money wisely and keeping people healthier at the same time.

        2 votes
    2. Catt
      Link Parent
      That's great! Would love to see more of that here in Canada.

      That's great! Would love to see more of that here in Canada.

  3. [13]
    acr
    Link
    I don't think the topic gets ignored at all. This subject is very widely covered. They even portray it on television and in the movies. There are always discussions / debates on it. I feel like it...

    I don't think the topic gets ignored at all. This subject is very widely covered. They even portray it on television and in the movies. There are always discussions / debates on it. I feel like it is pretty well addressed. Not saying we shouldn't keep addressing it.

    Look at all of the mothers who go on maturity leave and then just don't go back to work. It's pretty common making this topic even more wide spread.

    1. [5]
      Cyhchan
      Link Parent
      I find the topic is largely ignored or, when discussed, it is fairly vague. The way it is portrayed on television and movies usually show women being super emotional and unreasonable, usually for...

      I find the topic is largely ignored or, when discussed, it is fairly vague. The way it is portrayed on television and movies usually show women being super emotional and unreasonable, usually for comedic effect. That is not the same as treating the issue with the seriousness it deserves.

      I live in Canada and the way I was taken care of while pregnant was pretty amazing in terms of checking up on how my baby and I were doing physically. When it came to how I was doing mentally and emotionally, there was just a checklist that I filled out asking if I was sad or anxious. I was feeling pretty awesome during my pregnancy, so the doctors and I never had any conversations about how I could be an emotional mess postpartum. The birth and babies classes I attended focused largely on labour and delivery and care for the baby after it was born. We discussed recovery in terms of the amount of bleeding to be expected, how to deal with soreness, but the topic of postpartum depression was largely glossed over.

      I think there is still a perception in our society that women who face PPD or PPA are simply mentally ill or just unable to cope with a huge life transition. No one really go into the fact that the brain itself undergoes huge changes that can leave mothers feeling like they aren't themselves anymore. From my own personal experience (which I know doesn't mean much), I was largely unprepared for just how different I was going to be after having a baby. Most people will say, "Of course! What did you expect? Having a baby is an enormous life change!" What I would say is that I didn't even really feel like myself anymore. I knew that I would be sleep-deprived and all that, but I didn't know that I would never be able to shut my brain off, or that I would constantly be anxious with worry that I would screw up my baby, or that emotions that I had always been able to keep in check would suddenly always be impossible to contain. To have known that there was something neurologically different in me would have gone a longs ways towards helping me come to terms with the fact that I felt different because I was different.

      What we know about the maternal brain so far demands more investigation, Mittal says. But she and other clinicians I spoke with were less convinced that a routine discussion about typical brain development is warranted during prenatal care. One worried about women who feel the pressure to do everything just right during pregnancy, and how learning about how a woman’s neurobiology connects with infant bonding might add to that pressure.

      I don't believe that it is up to others to decide what information people can handle about their own bodies. Deciding how best to disseminate it is one thing, withholding it is another entirely.

      11 votes
      1. [5]
        Comment deleted by author
        Link Parent
        1. [2]
          Catt
          Link Parent
          My two-cents - a TV portrayal in a comedic sense is definitely not discussing the topic to the point that phrasing it as ignoring the topic still stands.

          My two-cents - a TV portrayal in a comedic sense is definitely not discussing the topic to the point that phrasing it as ignoring the topic still stands.

          3 votes
          1. [2]
            Comment deleted by author
            Link Parent
            1. Catt
              Link Parent
              I'm not trying to break down and misrepresent your comment. I'm disagreeing. Any portrayal I've seen in movies and TV has not communicated to me that this is a common concept. In fact, I would say...

              My entire point about movies and television, was that this topic is so wide spread, they even portray it there because it is such a common concept.

              I'm not trying to break down and misrepresent your comment. I'm disagreeing. Any portrayal I've seen in movies and TV has not communicated to me that this is a common concept. In fact, I would say portray in movies and TV suggest the opposite - that it is poorly understood at best.

              2 votes
        2. [2]
          Cyhchan
          Link Parent
          Okay, but the article is talking about neurobiological changes in the brain, and that is ignored completely on tv and in movies. Dismissing the biological effects of becoming a mother and just...

          But we're talking about ignoring the topic all together. Ignoring it and not treating it seriously are two different things.

          Okay, but the article is talking about neurobiological changes in the brain, and that is ignored completely on tv and in movies. Dismissing the biological effects of becoming a mother and just saying she is crazy is ignoring what is actually going on. You also went on to say that it was well discussed and I disagree with that as well.

          I missed this. I feel like this is a feel good statement. It doesn't really address my comment that you are responding to. It is you stating an opinion I never touched on, and kind of paints it as if I had said the opposite

          I addressed your comment earlier when I argued that the topic was largely ignored. I believe it was my first sentence and I went on to explain all the ways in which it was not discussed. My last paragraph was clearly in response to a part of the article that I disagreed with (which I quoted). I didn't think there was a point in making a separate post.

          3 votes
          1. [2]
            Comment deleted by author
            Link Parent
            1. Cyhchan
              Link Parent
              I honestly don't even know what you are talking about. Who's even agreeing with me? Everyone else responding is responding directly to you and what you wrote, not me. And I don't think I'm making...

              I never said that wasn't the case though. This is kind of a cheap feel good statement peppered in to get more agreement. Kind of like, Oh I agree with that one piece so I must agree with all of it

              I honestly don't even know what you are talking about. Who's even agreeing with me? Everyone else responding is responding directly to you and what you wrote, not me. And I don't think I'm making cheap statements. Name one show that you've seen that talks about permanent neurobiological changes in the brain for mothers.

              All I can say is that, from my own experience, at no point (prior to reading this article) did I ever know that this change would take place after having a baby. Not from TV, not from friends, other mothers, doctors, nurses, etc.

              3 votes
    2. [4]
      phedre
      Link Parent
      It's actually not, though. The actual physical and mental changes women go through post childbirth are glossed over or ignored by everyone, including women themselves. It's honestly quite...

      It's actually not, though. The actual physical and mental changes women go through post childbirth are glossed over or ignored by everyone, including women themselves. It's honestly quite frightening.

      What's shown in television and movies is not reality for new mothers, any more than Fast and the Furious is the reality for race car drivers.

      This is an interesting look into some of it:

      https://www.motherjones.com/politics/2017/01/childbirth-injuries-prolapse-cesarean-section-natural-childbirth/

      4 votes
      1. [4]
        Comment deleted by author
        Link Parent
        1. [3]
          phedre
          Link Parent
          No, I'm really not. I have done a lot of research when it came to my choice to have kids or not, and one of the things on my "cons" list was the fact that the way a woman's life changes after...

          No, I'm really not. I have done a lot of research when it came to my choice to have kids or not, and one of the things on my "cons" list was the fact that the way a woman's life changes after childbirth, physically, mentally, emotionally... is downplayed by society.

          Women don't know what they're in for when it comes to childbirth, that is a fact, plain and simple. Doctors don't discuss it, other women down play it or ignore it, and society as a whole just hand waves it. "Baby blues", "the stress of being a new mother". It's just not taken seriously when there are real, life long changes that happen to a woman's body (including her brain) after childbirth.

          There's a real stigma in society when it comes to telling the unvarnished truth about childbirth, that it comes with real risks and consequences for mothers, because we don't want to discourage them from having children. Or we think we're scaring them unnecessarily, or that they can't handle the information.

          Saying that it's widely talked about because pregnancy and childbirth is shown TV is just not the case, and missing the point behind the article.

          4 votes
          1. [3]
            Comment deleted by author
            Link Parent
            1. phedre
              Link Parent
              I've done research, that does not mean I am biased, it means I am informed. Your specific statement is: Showing women who are pregnant/have had children on TV and in the movies is not the same as...

              I've done research, that does not mean I am biased, it means I am informed.

              Your specific statement is:

              I don't think the topic gets ignored at all. This subject is very widely covered. They even portray it on television and in the movies. There are always discussions / debates on it. I feel like it is pretty well addressed. Not saying we shouldn't keep addressing it.

              Showing women who are pregnant/have had children on TV and in the movies is not the same as addressing the changes women go through when they are pregnant and have children. I will grant you that sometimes you can find discussion about the effects of motherhood on daytime talk shows that will touch on topics like post partum depression or functioning on no sleep, news pieces to some extent, but anything fiction based (like movies or tv shows) would not be a place I'd turn to for any kind of addressing the topic of how women change post partum.

              This article in particular addresses prenatal care. So picture a pregnant woman visiting her doctor to discuss the entire process of childbirth. There may be discussion on what the hospital will do in case of fetal distress, if she might require a c-section, who she wants in the delivery room with her, etc. All well and good.

              What won't be addressed is the specifics around how she'll change after childbirth, that her brain is actually going to be rewired to be anxious, stressed, and emotionally attached to this new baby. It's just not a part of the puzzle we have yet.

              4 votes
            2. Cyhchan
              (edited )
              Link Parent
              In what way does doing research mean that one has a bias?

              And there you have it. You have a bias.

              In what way does doing research mean that one has a bias?

              1 vote
    3. [3]
      Catt
      Link Parent
      I'm not sure there's correlation there. I know financial considerations are a huge reason for not going back to work. I'm sure it depends are where you are, but mental health in general is poorly...

      Look at all of the mothers who go on maturity leave and then just don't go back to work.

      I'm not sure there's correlation there. I know financial considerations are a huge reason for not going back to work.

      I'm sure it depends are where you are, but mental health in general is poorly covered in Canada.

      3 votes
      1. [3]
        Comment deleted by author
        Link Parent
        1. [2]
          Catt
          Link Parent
          I believe we may have read the article differently. For me, it was more saying that we don't scientifically study and quantify the physical changes in women's brains before, during and after...

          I believe we may have read the article differently.

          For me, it was more saying that we don't scientifically study and quantify the physical changes in women's brains before, during and after childbirth. I would say, mother's deciding to be SAHMs is anecdotal evidence, that shouldn't necessarily be disregarded, but the topic itself is still largely ignored by the scientific community.

          3 votes
          1. [2]
            Comment deleted by author
            Link Parent
            1. Catt
              Link Parent
              This is where we disagree. It is basically, if not literally 100% ignored. Far from "isn't as widely addressed." There maybe some hand-wavy talk about women becoming mothers, but before this,...

              This is where we disagree. It is basically, if not literally 100% ignored. Far from "isn't as widely addressed." There maybe some hand-wavy talk about women becoming mothers, but before this, never of permanent changes in the brain.

              2 votes