Can a Pregnant Woman’s Experience Influence Her Baby’s Temperament?

photo credit AlonzoDesign

photo credit AlonzoDesign

Thirty years ago, when my Indian mother-in-law first learned that I was pregnant, she had some advice: Eat a lot of ghee (clarified butter), think pleasant thoughts, and gaze upon beauty.

Charming, I thought. I had a full time job with a two-hour commute. Where was there any time for meditative reflection? Still, she planted a thought in my mind, and I began to wonder. Was there a connection between my internal state and the development of the baby growing within me?

Folk wisdom and cultural beliefs throughout history have maintained that a woman’s emotions affect the fetus. Animal studies have shown that maternal stress, especially, can affect offspring—but it’s not been clear exactly how relevant those findings are for humans. In the last 15 years, though, research on human mothers and babies has caught up to show that my mother-in-law was at least partly correct: A pregnant woman’s emotional state—especially her stress, anxiety, and depression—can change her child’s development with long-lasting consequences.

Yerkes and Dodson, 1908, in Diamond, DM et al. (2007).

Yerkes and Dodson, 1908, in Diamond, DM et al. (2007).

 Some stress is good.

When it comes to stress, psychologists often affirm the Goldilocks approach: too little is not good, as it makes us passive. And too much is not good because it can overwhelm us and contribute to emotional upheaval and physical disease. Along the spectrum, there’s a “just-right” amount of stress that helps us to function optimally in most situations.

The Goldilocks principle (called the Yerkes-Dodson law, in psychology) seems to be true in pregnancy, too. “The human brain requires sufficient, but not overwhelming, stress to promote optimal neural development both before and after birth,” writes researcher Janet DiPietro of Johns Hopkins University.

Pietro and colleagues studied pregnant women who were mentally healthy, well-educated, and had low-risk pregnancies. Midway through the pregnancies, Pietro measured the level of the mothers’ psychological distress (stress, anxiety, or depression). After the babies were born, she tested their development at six weeks and then again at the two-year point. She found that babies whose mothers had mild-to-moderate distress were more advanced in their physical and mental development. Another study showed that the babies’ brain development benefitted from a little prenatal stress, maturing a bit faster, with quicker connectivity among neurons.

Does that mean that women should welcome stress in order to boost their fetus’ development?

Absolutely not. According to DiPietro, the normal stresses of modern life are enough already. “The last thing a new mom needs is to head into newborn baby care stressed and exhausted.” In other words, healthy women leading reasonably normal lives can “stop worrying about worrying.”

But too much stress can be harmful.

On the other hand, when women experience severe stress during pregnancy, their babies can be at risk for serious problems. What kinds of stresses are harmful?

In studies on pregnant women, intense stress has been defined to include the following: the loss of a loved one; war; a major catastrophe like an earthquake, flood, fire, or terrorist attack; and interpersonal violence. These stresses have been linked to subsequent miscarriage, prematurity, or low birth weight in infants.[1] Stress that is chronic—like poverty, homelessness, racism, and discrimination—can also lead to low birth weight, as well as later physical and psychological problems. Babies whose mothers experienced these kinds of toxic levels of stress while pregnant are statistically more likely to have respiratory and digestive problems, irritability, or sleep problems in the first three years of life. They are also more apt to experience developmental problems, with cognitive, behavioral, social-emotional, and health issues that suggest neurodevelopmental changes that ripple into adolescence and adulthood. Many of the studies were careful to rule out other potentially confounding environmental factors in order to isolate the effects to the prenatal environment.

photo credit Ijubaphoto

photo credit Ijubaphoto

photo credit monkey business images

photo credit monkey business images

A woman who experiences depression is also cause for concern. Newborns of mothers who were depressed during pregnancy are four times more likely to have a low birth weight than babies born to mothers who are not depressed. When women are depressed during pregnancy, there’s also a greater likelihood that they’ll suffer postpartum depression, which can become a major challenge for the whole family. Not only does the mother suffer, but research shows that depression in the primary caregiver is one of the strongest predictors of poor developmental outcomes in children. These children simply do not receive the normal interpersonal attunement and feedback they need in order to grow in emotionally healthy ways.

Even anxiety about being pregnant can be cause for concern. Research shows that “pregnancy-related fears”—worrying about an unplanned pregnancy, a specific medical risk, the fetus’ health, labor and delivery, or your ability to be a good parent—can be problematic in high doses. Excessive levels of anxiety (as opposed to what you worry about) are correlated with a greater likelihood of having a preterm birth. Also, pregnant women’s high levels of anxiety are correlated with later problems in children, including a difficult temperament, behavioral and emotional problems, anxiety, problems with attention regulation, impulsivity and hyperactivity, immune functioning and autoimmune disease, cognitive problems, and stress regulation.

Fetal stress and infant temperament

Psychologists have long known that babies enter the world with different temperaments. Some babies seem easy and sociable; others are more reactive, difficult to soothe, and are more sensitive to their environment. Until recently, scientists thought babies were “just born that way,” with temperaments that were “constitutional,” part of their makeup, or “inherited” from parents.

But the new research on fetal development changes that notion, and our understanding has progressed toward an interplay between biology and environmental influences—even before birth.

Catherine Monk, Professor of Medical Psychology in Psychiatry and Obstetrics and Gynecology at Columbia University Irving Medical Center, and her colleagues study the long reach of prenatal influences, especially among women who suffer from depression, stress, and anxiety. They found that some fetuses register mothers’ stress, and that fetal reactivity correlates with infant temperament at four months.

Monk and her colleagues brought 50 pregnant women into the lab and monitored the fetal heart rate while the women completed the Stroop Test, a mildly stressful mental task. Fetuses of women who were clinically depressed or anxious showed they registered the performance stress of their mothers, by the changes in their heart rates during the task. Later, when the babies were four months old, researchers assessed their temperaments by watching how reactive they were to a range of new stimuli (sounds, sights, smells), and some important patterns emerged. In particular, fetuses who had greater heart rate changes during their mothers’ task were more likely to be highly reactive at four months of age.

Subsequent studies have shown while the heart’s reaction to stress is important, the recovery from the stressor—how soon the heart returns to baseline—is also predictive. A quicker heart-rate recovery in the fetal period predicts an easier temperament and even more prosocial behavior later in childhood.

The fetus’ response to stress and the ability to return to baseline, may be the earliest sign of a fetus’ emerging stress regulation system, which in turn is the foundation of temperament (reactivity and regulation). The stress regulation system involves complex processes throughout the brain and body, and its effects cascade through complicated pathways into all the other areas of development. In infancy, the stress regulation system affects babies’ ability to form an attachment with others, to explore and learn about their world, and to receive feedback from others that helps them grow. It also affects their health and immune systems. Even for adults, scientists find that over the entire lifespan, the ability to manage the ups and downs of our interior worlds—stress, emotions, energetic “arousal,” and positivity—affects our physical and mental health, relationship quality, decision-making, and even creativity. Some studies assert that stress regulation has consequences for education, employment, and overall life satisfaction.

But a baby isn’t born with a thermostat set to some ideal of normal. In utero, the fetus is programmed to listen for cues about their future environment and start adapting accordingly.

“Theoretically, it’s an elegant evolutionary adaptation,” Monk told me in a recent interview. “The pregnant female communicates to her offspring cues about what the postnatal world is like, and the adaptation starts in utero.” But problems arise when the fit between the stone-age brain and the modern world is misaligned. “It could be advantageous to be reactive and vigilant if you’re in a dangerous postnatal environment,” Monk explains. “But we’re not facing bears in the woods now, so maybe the system for prenatal adaptations made to anticipate adverse environments (the environments that are eliciting stress and anxiety in pregnant women) aren’t adaptive for our modern world.”

The stress regulation system operates much like a thermostat that sets the room temperature, increasing the heat or turning it down to achieve a desired range. When we perceive a threat, the sympathetic nervous system activates a fight-flight-or-freeze response throughout the body and brain. When we judge that the threat has subsided, the parasympathetic system turns on to try to bring the whole system back to a resting state.

Because the biological “hardware” is just forming during the fetal period and early infancy, these are crucial times for setting the stress baseline in each fetus and young baby.

How do mother’s feelings get through to the fetus?

Scientists are curious about how stress reaches a developing fetus. This research is just in its early stages, and much more needs to be learned. But so far, scientists are focusing on a few mechanisms which may operate together or independently:

  • One is cortisol, a stress hormone that’s a downstream product of the body’s stress response. Women with anxiety and depression have higher levels of cortisol. And there is some evidence that when the placenta registers higher levels of cortisol from the mother, it creates an epigenetic change—a molecular modification to the gene that changes how it functions—that allows more cortisol through to the growing fetus, which in turn affects the stress regulation system.

“The placenta is highly susceptible to maternal distress and a target of epigenetic dysregulation,” Monk and colleagues write.

  • Inflammation is another focus of investigation. The pro-inflammatory cytokines—proteins that impact the behavior of cells and resulting immunity—may play a role, but the research on the exact pathways involved is still in the early stages.

  • Scientists are also looking at the role of infection and the microbiome, but there is no conclusive evidence at this time.

There are other complications, too. For example, one gestational period doesn’t seem more sensitive than another, but the impact of stress might vary depending on which areas of the brain are developing when the stress occurs. And while both sexes are affected, there are hints that male and female fetuses might react differently. For example, some research shows that female fetuses are more reactive to stress in utero, but other studies suggest males and females react similarly, but that males recover more quickly.

How much control do pregnant women have?

It should be obvious that almost every source of major stress—war, the loss of a loved one, violence, poverty, homelessness, a demanding workload, etc.—is outside the control of the woman experiencing it. But given that we live in a culture that frequently blames mothers for whatever happens to their children, I was concerned that this new research might be wielded against women.

“Could this research be used as a new form of mother-blaming?” I asked Monk.

“I think about this a lot,” she replied. “I don’t want my research to be adding stress to a woman’s life.”

Monk pointed out several caveats to the findings:

First, she cautioned that the research is just beginning, and we have to consider that these are correlations, not cause-and-effect. The associations have been shown repeatedly by different researchers, but it is not possible to complete a scientifically controlled study of intense stress on humans that would sort that out.

Second, Monk explained that a pregnant woman’s stress is just one of many “exposures.” There are numerous biological and environmental influences on development: The air a woman breathes, the water she drinks, the nutrition she ingests, and whether she exercises, gets sick, or is exposed to toxins. There are genetics. The father’s sperm quality matters, too, and is affected by his age, health and risk factors, and even frequency of physical exercise. Support from partners, families, and friends is important in mitigating stress.

Third, we should care for pregnant women more preventatively. “If we want to have a healthy population, a healthy workforce, then society is responsible,” Monk says. “So let’s take care of women and families early on with policies and programs that support them.”

Fourth, some stress is modifiable. “I see homeless women living in shelters, and I see busy medical doctors juggling family life with their practices,” says Monk. “One person can’t move the level of poverty in the country, but we can do something to help people cope with it. We really do know how to de-stress people and help them with depression and anxiety.”

And finally, stress hardware isn’t completely formed by birth. Once born, the quality of early caregiving continues to alter the epigenome that regulates stress, emotions, and behavior, dialing up or down the expression of genes that set the baseline for stress regulation. In many cases, good caregiving after birth can offset a rocky prenatal start.

How much stress is too much?

“How can women know if their stress levels are harmful or normal?” I asked Monk. “Are some kinds of stress worse than others?”

She replied, “Science is not at a place yet of saying that one kind of stress is worse than another. In our clinic, we see women in extreme stress, and what matters is how much, and what inner and outer resources they can bring to the experience.”

Monk listed some indicators of harmful stress:

  • When stressful feelings are chronic (symptoms might include an inability to get up in the morning, a continual low mood, not eating or sleeping)

  • When there’s prior exposure to trauma or abuse (which the anticipation of parenting might reactivate)

  • When a person’s life foundation is weakened by repetitive daily stresses (e.g., “Will I lose my job?” “Where’s my next meal coming from?” “Are we getting a divorce?”)

  • Or continual feelings of being overwhelmed

In addition, Monk and her colleagues use the Perceived Stress Scale to measure stress in their research subjects. They found that women in poorer mental health (comprising about 20% of their samples) score around a 26 or less on the scale. Items such as “I feel like I don’t have control,” “I often feel overwhelmed,” and “I feel like I can’t get things done,” are indicative.

Monk adds, though, that fewer psychologists are trying to measure a person’s amount of stress, and instead are looking at how they function across different areas of their lives. For example, a person might ask, “How am I functioning now compared to six months ago?” Or, “How am I functioning cognitively, physically, interpersonally, or emotionally?” This approach offers more useful information, Monk notes, allowing the person to leverage what is going well and to shore up what is not.

What helps?

Every person has unique vulnerabilities and strengths, and every situation is different. But research confirms that although we might not be able to control what happens to us, we have some control over how we react. And that matters. We can change our responses to stress through self-care (nutrition, sleep, and moderate physical activity); increasing our repertoire of emotion strategies for coping; having positive experiences; and seeking support from others. A strong support network of engaged partners, helpful family members, and good friends can buffer the ill effects of stress. Techniques like meditation and mindfulness have been shown to reduce stress and create better pregnancy outcomes and physical health.

As an example, Monk and her colleague Elizabeth Werner developed a four-session intervention that reduces the risk of depression in pregnant women by half. The PREPP program (Practical Resources for Effective Postpartum Parenting) reaches out to women through OB-GYN offices, and offers them education on three topics:

  1. Parenting skills (e.g., How to help babies sort out day-night cues; encouragement for carrying the baby when he’s not crying, etc.)

  2. Psychoeducation (e.g., What to expect about babies’ crying); and

  3. Mindfulness and self-reflection (e.g., Examining how you were parented)

This intervention reduced depression and anxiety in mothers, and their babies became better self-regulated as well.

“By learning more about handling their baby, a mother may literally be facilitating their baby’s regulation along with their own. Mothers and babies get onto a bidirectional, more positive cycle,” Monk says.

As for me, since this knowledge wasn’t around to confirm my mother-in-law’s advice during my pregnancies, I hedged my bets. I knew I carried high levels of stress from a turbulent childhood, so I took some extra care. I exercised, was thoughtful about my food, and took a prenatal yoga and meditation course. But by the second pregnancy, I was frequently overwhelmed with panic attacks at the prospect of managing work and two children. Already my energy was low, and I filled in with chocolate milkshakes when I should have rested. Fortunately, both daughters did fine in the long run and are well-adjusted adults. But many women face graver challenges, and as a society, it’s our responsibility to protect and support them. Many countries have made children a collective investment, but in America, tragically, we haven’t. It’s a big problem—and a big topic, which I’ll save for a future blog entry.

photo credit RusianDashinsky

photo credit RusianDashinsky

 

More Resources

How pregnant women’s emotions affect prenatal and child development:

Stress reduction in pregnancy:

  • Newman, K. M. (2016, August 17). “Four Reasons to Practice Mindfulness During Pregnancy,” Greater Good Magazine. Retrieved from https://greatergood.berkeley.edu/article/item/four_reasons_to_practice_mindfulness_during_pregnancy.

  • Bardacke, N. (2012). Mindful Birthing: Training the Mind, Body, and Heart for Childbirth and Beyond. New York, NY: HarperOne.

  • Mindful Birthing Network: Mindful birthing. (n.d.). Retrieved from http://www.mindfulbirthing.org/.

  • Hardwiring happiness: Zimmer, E. (2015, June 24). 082: Dr. Rick Hanson. The one you feed. Retrieved from http://www.oneyoufeed.net/rick-hanson/.

  • Introduction to mindfulness-based stress reduction:

    • Palouse Mindfulness. (2015, August 28). Mindfulness-Based Stress Reduction (UMass Medical School, Center for Mindfulness). Retrieved from https://www.youtube.com/watch?v=0TA7P-iCCcY.

    • Sega, A. (2016, August 22). Jon Kabat Zinn: Practical Stress Reduction. Retrieved from https://www.youtube.com/watch?v=3fjNPbErciU.

    • Kabat-Zinn, J. (2016). Mindfulness for Beginners: Reclaiming the Present Moment and Your Life. Boulder, CO: Sound True.

  • This is one of my favorite resources for self-development:

    • Hanson, R. (n.d.). Rick Hanson. Retrieved from http://www.rickhanson.net/rick-hanson/

 How to find out about, and advocate for paid leave from work:

  • Find out if your state has paid family and medical leave protection here:

    • National Partnership for Women and Families. (n.d.). Paid leave means a stronger nation. Retrieved from http://www.nationalpartnership.org/issues/work-family/paid-leave-means-map.html.

  • Quick economic statistics re: the costs to both employers and employees of NOT having paid leave: https://drive.google.com/file/d/1geQNdDBd2MDBvzvOMJg_YKdfVqSsduWZ/view.

  • Companies that offer paid leave, and their rationales for doing it:

    • National Partnership for Women and Families (2018, January). Companies with new or expanded paid leave policies (2015-2018). Retrieved from http://www.nationalpartnership.org/research-library/work-family/paid-leave/new-and-expanded-employer-paid-family-leave-policies.pdf

  • An article on how businesses can adopt paid leave:

    • Williams, J. C., & Massinger, K. (2015, November 23). “Need a Good Parental Leave Policy? Here It Is.” Harvard Business Review. https://hbr.org/2015/11/need-a-good-parental-leave-policy-here-it-is.

  • How to negotiate a leave, from the Harvard Business Review:

    • Gallo, A. (2012, October 25). “How to Negotiate Your Parental Leave,” Harvard Business Review. Retrieved from https://hbr.org/2012/10/how-to-negotiate-your-parental-leave.html.

  • The effects of paid leave on child health and employee retention:

    • National Partnership for Women and Families. (n.d.). Studies on the Effects of Paid Leave. Retrieved from http://go.nationalpartnership.org/site/PageServer?pagename=issues_work_library_paidleave_research#effect

Reference

Yerkes and Dodson, 1908, in Diamond, D.M., Campbell, A.M., Park, C.R., Halonen, J., & Zoladz, P.R. (2007). The temporal dynamics model of emotional memory processing: A synthesis on the Neurobiological basis of stress-induced amnesia, flashbulb and traumatic memories, and the Yerkes-Dodson law. Neural Plasticity, article ID 60803, 33pgs. doi:10.1155/2007/60803

Footnote

[1] Low birth weight, sometimes referred to as “small for gestational age,” occurs when the weight at birth is lower than expected for the length of the pregnancy. It is a risk factor for subsequent development. The U.S. has the one of the highest rates of babies born with low birth weight—about 1 in 13. Babies who are born very small for their gestational age are more likely to go on to develop problems, but most low-birth-weight babies who receive good nutrition and sensitive, affectionate care and stimulation, catch up and do just fine.

Additional Photo Credits

Top panel, left to right: MaxRiesgo, RapidEye, vm, DragonImages

Middle panel, left to right: FatCamera, photominus, Dean Mitchell, martinedoucet











The Transition to Parenthood: What Happened to Me?

photo by Sahil Merchant

photo by Sahil Merchant

"Tell me about the joys of being a new parent," I prompted my niece, whose little baby is five months old. She is 34, works full-time, and is married to my nephew.

The transition to parenthood is profound, as many parents already know. Developmental scientists consider it to be one of the most massive reorganizations in the lifespan, changing the brains, endocrine systems, behaviors, identities, relationships, and more, of everyone involved.

Kelly's answers had a quiet and whimsical grace.

"There is nothing more beautiful in this world than his smile," she said. "Or watching him discover something new. Last night he found the upper register of his voice, so he spent five minutes shrieking at a high pitch, playing around with the newfound note."

Kelly is a beautiful person, so I wasn't surprised to hear her speak appreciatively about her young son. And, in recent and evolving research, scientists are charting a "global parental caregiving network" that gets shaped in a new parent's brain to bring about some of the very thoughts, feelings, and behaviors that Kelly and other new parents experience.

In 2014, Ruth Feldman, a researcher in Israel and at the Yale School of Medicine, conducted an experiment with her colleagues. They went into the homes of 89 new parents, collected samples of oxytocin (the bonding hormone), and videotaped the parents interacting with their newborns. Later, the researchers put the parents in a functional-MRI machine and replayed their videos back to them, observing which parts of parents' brains "lit up" when they saw their own infants (versus videos of unrelated babies) .

The researchers found two main regions of the brain particularly active in new parents. The first is the "emotion-processing network." This is located centrally and developed earlier in evolution than the neocortex (see below). It involves the limbic, or feeling, circuitry and includes:

  • The amygdala, which makes us vigilant and highly focused on survival

  • The oxytocin-producing hypothalamus, which bonds us to our newborns

  • The dopamine system, which rewards us with a squirt of the feel-good hormone to make us motivated and enjoy parenting

All together, this network creates a heightened emotionality in parents in response to their babies. In fact, according to researchers Laura Glynn and Curt Sandman, the volume of gray matter (or number of neural cell bodies) increases in the above regions in new mothers and is associated with their positive feelings toward their infants. (See Glynn and Sandman's review article on brain changes in pregnant mothers.)

The second region is the "mentalizing network" that involves the higher cortex, or the more thinking regions of the brain. This area, along with additional superhighways that develop between the emotion and mentalizing systems, focuses attention and grounds in the present moment: Who couldn't stare at a new baby forever? It also facilitates the ability to "feel into" what a baby needs: Areas of the brain that involve cognitive empathy and the internal imaging of, or resonance with, a baby, light up. These regions help a parent read nonverbal signals, infer what a baby might be feeling and what he/she might need, and even plan for what might be needed later in the future (long-term goals). These regions are also associated with multitasking and better emotion regulation. In other words, parents' brains are remodeled to protect, attune with, and plan for their infants.

Other research has found that hormonal changes in pregnant women dampen their physical and psychological stress response, as if to make more space to tune in to their babies' needs.

But along with all these changes, there seems to be a collateral cognitive hit: In a meta-analysis of 17 studies, 80% of women reported impaired aspects of memory (recall and executive function) that began in pregnancy and persisted into the postpartum period.

photo by Kelly Merchant

photo by Kelly Merchant

Mothers aren't the only ones whose brains are remodeled. The brains of fathers, too, light up in ways that nonparents' brains don't. Feldman and her colleagues found that while the emotion processing network is most active in the biological mothers she studied, it is the mentalizing networks that are more active in the brains of fathers who are co-parenting alongside moms. The more fathers engage in caregiving tasks, the more oxytocin they produce, and the stronger the activation in the mentalizing areas of the brain.

Interestingly, in gay dads who are primary caregivers (half of Feldman's subjects), both emotion and mentalizing systems were highly activated by engaging in parenting. (For more on how parenting changes fathers' brains, I recommend the fun read, Do Fathers Matter? What Science is Telling Us about the Parent We've Overlooked, by Paul Raeburn.)

In other words, parenting is a very plastic and flexible process. While pregnancy prepares a mother's brain for parenting, the act of caregiving can produce upticks in oxytocin (the bonding hormone) and create neurological changes that support parenting in many adults--dads, adoptive parents, and other alloparents (any caregiving adults).

photo by Kelly Merchant

photo by Kelly Merchant

Kelly's husband Sahil is open about the new feelings he's having as a dad. "Winnie [short for Winter] is a curious, cheerful little person, and watching him develop and experience the world for the first time brings me endless amusement and joy. With Winnie, I've found new depths of love--it feels like a very biologically driven emotion."

While he is drinking in the sweet elixir of his baby, Sahil is also running his feelings through the thought circuitries. "Besides being afraid of the regular things--injury, illness, and such--I am also sad that his innocence will inevitably be eroded over time, and that he will inevitably experience all the various pains involved in growing into an adult."

Kelly admires her husband's changes and says that one of her greatest joys is "watching my husband develop into an incredibly loving, nurturing, and giving father."

Parents, naturally, continue to develop as individuals, and the arrival of a baby stimulates self-reflection. Observing Winnie moved Kelly to reflect on what must also have been the miracle of her own beginnings. "I'm fascinated by the fact that I, too, floated in a sack of amniotic fluid; that I, too, saw my hand for the first time and probably stared at it for 30 minutes straight, waving it in the air. Or that I, too, might have been startled by my own sneeze, or gas, or yawn."

Sahil says, "Having a child has given my life more meaning. For example, rather than working to earn money just for myself, to purchase various objects and experiences, I now have a great reason to do so. I'm more careful now, too. I have a child who depends on me, so I feel like I need to take better care of myself, so that I can be my best possible self to take care of Winnie."

Challenges

The joys of parenting are often felt more deeply than almost any other feeling humans are capable of having. But the challenges are great, too. "Every mom I knew was surprised by the impact of becoming a parent and wished she knew more about coping with it," writes Jan Hanson in Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships. Hanson is a nutritionist who co-authored the book with her husband, the neuropsychologist Rick Hanson, as well as OB/GYN Ricki Pollycove.

There are challenges to parents' physical health: recovery from pregnancy and delivery, the adjustment to breastfeeding, disturbed nutrition, fatigue, and insufficient sleep. As you would expect, Kelly reports that trying to stay rational, keep conflicts down, and drive safely are difficult on three hours' sleep and/or when she's been up, exhausted, since 4 A.M. She is experiencing what researchers know: That proper sleep is critical to health and well-being, including mood, decision-making, performance, and safety.

There are psychological adjustments to the new parenting role, too. Some parents need time to recover from a difficult or complicated birth process. For some, parenting demands can trigger strong unresolved feelings from childhood, especially if it was traumatic or troubled. Hormonal changes, along with sleeplessness and the constant demands of a new baby, can create surprising new feelings, too: anger, sadness, feeling trapped or isolated--even guilt, fear, and inadequacy. Some parents have to wrestle with having lost a previous child, or perhaps they are parenting a difficult or differently abled child. Kathleen Kendall-Tackett writes about these psychological challenges, and more, in The Hidden Feelings of Motherhood: Coping with Stress, Depression, and Burnout.

Having a new child introduces new challenges to the parents as a couple. Conflicts often increase in a relationship after the birth of a child, in part due to the "roommate hassles" of who will do what in the household as well as disagreements about parenting styles. Sometimes the sense of intimacy, closeness, and sexuality in a relationship can get derailed with the arrival of a little one. Couples are challenged to re-synchronize their relationship and develop a new sense of teamwork.

The couples who are most at risk for serious problems after the birth of a child, write parenting scholars Carolyn Pape Cowan and Philip Cowan in their book When Partners Become Parents, are those who were on the rocks before the child came along. Becoming a parent amplifies any pre-existing fissures in the relationship. Especially problematic are poor communication patterns--where one stonewalls, digs in, and/or refuses to budge, while the other escalates. In contrast, couples who have productive ways of working out new difficulties and challenges do the best adjusting.

After the arrival of a child, there are new logistics to deal with: new strains in managing a household, financial and legal concerns, when and how to go back to work, and figuring out childcare. Like many contemporary mothers, Kelly experiences the challenges as coming from both sides: the struggle to feel okay going back to work after three months versus the struggle to feel okay staying home without being criticized as a poor worker or an anti-feminist.

New parents also undergo a rearrangement of their social life, including how they interact with extended family and friends. Some friendship networks get reconfigured (not all childless people want to hang out with new parents). Kelly noticed that other people changed in their relationship to her as she became a parent. Many people offered unsolicited opinions, especially on the topics of sleep and clothing: "At times it felt that anyone who had once been a mother felt the need to say that my baby should put on more clothing. Even in 90-degree weather when he was sweating! And I was quite happy to be co-sleeping with Winter, but I was made to feel guilty about this on many occasions. Sleep is such a touchy topic, and many people tried to convince us to get Winter into a crib if we wanted what was best for him." Kelly found support from her sister who encouraged her to be firm about her internal compass in the face of many differing opinions: "Your only option is to learn to listen to yourself and know that you know your situation, and what works for your family, better than anyone else." Kelly adds that the most helpful exchanges are ones where she is encouraged to share how things are going, and in return hear a similar story and outcome. "Not only does it feel good to know I'm not alone in this, it educates me about what works much better than direct advice."

Rick and Jan Hanson and Ricki Polycove have seen so many thoroughly exhausted mothers in their practices that they identified a "depeleted mother syndrome," a condition where the mother's "outpouring, stresses, vulnerabilities, and low resources" are so overwhelming as to "drain and dysregulate her body."

The solution they recommend is threefold, focusing on lowering parenting demands, increasing supportive resources, and building resilience. Rick Hanson is a thorough, compassionate, skilled, and practical therapist, and Mother Nurture is therapy in a book: From one-minute soothers, to resolving childhood issues, there is much help in the way of cognitive, neurological, and commonsense approaches. Among other things, he provides suggestions for :

  • taking care of your body

  • small daily practices to improve outlook

  • reframing circumstances

  • concrete problem solving approaches

  • transforming painful emotions from the past

  • problem-solving sleep

  • vitamins to help with the nervous system

  • assessing neurotransmitters

  • staying connected to your partner with empathy

  • sharing the load

  • maintaining intimacy

  • healing hurt feelings

photo by Crystal Hanson

photo by Crystal Hanson

Kelly noticed that just as her identity started changing as a parent, there was a tendency for people to converse with her exclusively about motherhood. She was naturally thrilled that her loved ones were excited about Winnie, yet she longed for relationships that also nurtured her individual identity as a painter, a counselor, yoga enthusiast, and traveller. 

As an American, Kelly is not alone in this experience. Kathleen Kendall-Tackett writes that in many non-industrialized countries, the postpartum period is a special time of "mothering the mother." New mothers are considered especially vulnerable so their activities are limited, they're relieved of normal work, and they stay relatively secluded with their babies while other relatives take care of them. Along with that extra care, there are special rituals and gifts that mark this as an important period. American mothers, in contrast, are quickly released from the hospital and are often even expected to entertain guests who come to visit the new baby. That difference in support, Kendall-Tackett says, is why in industrialized countries about 50-80% of new mothers experience the "baby blues," and another 15-25% have full-blown postpartum depression. In more traditional cultures where new mothers are exclusively nurtured, postpartum depression is "virtually non-existent."

Kelly agrees: "A mother needs to be nurtured and cared for because she is doing nothing for herself at this point. Everything is being given to the baby and I find little time to do things like even wash my hair or take a bath. Or connect with a friend. Even getting a hug from my husband can be hard in those times when a baby is especially demanding. When I do get that hug, I need it more than ever before."

The transition to parenthood is a huge transformation. And America, with no comprehensive child-family policy and no federal paid family leave policy--is a particularly unsupportive place to have a child. But the accumulating research is pointing to just how sensitive and important this period is for families. With a little knowledge and some foresight, parents-to-be, and their loved ones, can better plan for the transition. The rise in popularity of the postpartum doula (a person, usually a woman, who is trained to help new families in the home) is a step in the right direction.

Rick Hanson encourages new mothers--and fathers--to insist that others take their needs seriously. "Treat yourself like you matter," he says.

 

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Further reading (some of these are oldies but still goodies):

On coping with the challenging feelings of becoming a new parent:

On becoming a father:

Family Stress: It's Not All in Your Head

For most of my kids' childhoods, I felt that my ability to guide my family faced direct competition from school, and many forces beyond.

In elementary school, heavy backpacks bent my kids' soft little backs. Homework intruded into playtime, even though research has shown that play is important for cognitive and social development. In middle school, more homework and big projects hijacked precious family weekends--just when my kids needed more sleep, more time to adjust to their rapidly changing brains, and more healthy time with friends, and when my husband and I needed some rest. By high school, the downward pressure from looming college applications threatened to torque my kids' developmental arc.

"Don't do anything for a college resume," I warned. "Make choices because they make sense to you."

As the tsunami of outside competition flooded toward us, I felt like a little mushroom field trying to filter toxins out of a roaring river. The competition over messaging added even more pressure: media was saturated with hypersexualized images, dysfunctional interactions, unrealistic problem-solving, violence, and more. It was hard to stay on top of it all, to teach my kids the difference between our values inside our family versus values in the outside world. This on top of our own adult pressures to manage childcare, two jobs, meals, paychecks, health care and sick days, quality time, extended family, and maybe a few friends.

Adults are stressed, but our kids are stressed, too. A recent survey found that in the United States, teens' stress has now surpassed that of adults. Many young people say that they are overwhelmed, depressed, and sad because of the stress that they, themselves, gauge to be unhealthy. And the mental health of teenagers in this country is declining over time. Many parents are frantic, reaching for whatever levers they can put their hands on: hiring therapists, looking to medications, and trying ancient practices to calm everyone down. If only we could find the right key, we parents think, we can unlock the stress, and our child will thrive. 

photo by  Elvin

photo by Elvin

But when the number of kids and families struggling is so large, we have to start asking questions about the systems beyond ourselves. We parents love our children wildly, and ultimately, they're our responsibility. But our ability to care for them successfully also depends in large part on how the wider culture, policies, and values support childrearing. And on that score, America is not doing very well, especially compared to other countries. Last week I published an op-ed in The Washington Post exploring that theme. One of the comments was provocative: "America hates children," it read.

"Just because you're paranoid doesn't mean they're not out to get you," goes the saying. And I'm here to affirm: The stress that you and your kids feel is not all manufactured inside your family. Self-help goes only so far, and sometimes it even deludes us into accommodating to a maladaptive situation. A new election cycle will roll around soon, and it's time to start asking when America will put children first.

How Can Parents Help Prevent Bullying in Middle School?

Bullying Prevention Awareness Month is over, and unfortunately it had a horrific run of high-profile tragedies: two teacher fatalities at the hands of students, several bullying-related suicides and attempted suicides, two Florida bullies charged with felonies, and a 14-year-old shooter charged as an adult. Once again, we’re left to face the grim reality that bullying is alive and well in our culture.

But there’s something that all of these cases had in common—and that the news media didn’t notice. All of the kids involved in these events were 12-14 years old.

No surprise, from a developmental perspective. The onset of puberty remodels the developing brain—both for humans and for many animal species—in a way that makes young adolescents especially sensitive to their social world. The reason for this can be understood through an evolutionary lens: Reproduction requires social skills—mating, parenting, fitting in to the social niche, coordinating to secure resources, taking care of the community, etc. So it would make sense that while bodies are being reshaped to produce offspring, brains would also simultaneously change to make us more socially receptive and active at that time.

How does puberty make teens more susceptible to bullying?

Recent research on the teen brain shows that adolescents, compared to both children and adults, are exceptionally sensitive to social dynamics. In brain-imaging studies, teen brains show more activation in regions that process rewards, motivations and emotions (the socioaffective circuitry in the subcortical, limbic regions) compared to children and adults. As a result, teens can feel more intensely, especially about social interactions. They more easily feel judged, threatened, and evaluated by others.

 

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