“Do you remember a time when you felt hormonal and moody? Your skin was breaking out and your body was growing in strange places and very fast? And at the same time people were expecting you to be grown up in this new way.”
This is the beginning a TED talk by New York-based psychiatrist Alexandra Sacks. In answer to her questions, I immediately thought about my teenage years: adolescence. She continues, “These same changes happen to a woman when she’s having a baby. We know that it’s normal for teenagers to feel all over the place, so why don’t we talk about pregnancy in the same way?”
After running a support group for mothers for several years, it has become apparent to me that while not all mothers develop Peri-Natal Distress (previously known as Postnatal Depression), all mothers do seem to battle in one way or another with the transition from woman to mother. This transition, and all the idiosyncrasies that go with it, was not something I had ever consciously considered. There are hundreds of books about the transition from child to adult. Adolescence is talked about in our culture; it is recognised as an awkward time in one’s life. Despite the obvious similarities, the same cannot be said for the transition from woman to mother. Even in the medical community, most of the focus is on a baby’s health rather than a mother’s, even less so her mental health.
Many women post birth or adoption will seek psychiatric help, thinking that they might have PND. Dr Sacks has spoken with countless new mothers who tell her that they are battling. This is what she hears repeatedly from her patients: The women thought motherhood would make them feel whole and happy; they thought a maternal instinct would tell them what to do; they expected to want to put the baby first. These mothers did not know that these expectations were unrealistic. Because they were not living up to these expectations, they thought something was wrong with them. They thought that their feelings were unnatural, and that perhaps it was PND.
The women were experiencing a sort of cognitive discomfort, but not the clinical signs of mental illness. They did not have PND. Dr Sacks struggled to put a name to what this phenomenon was. Then she found an old academic paper from 1973. Anthropologist Dana Raphael (who created the profession of a mother supporter: the doula) had coined the term ‘Matrescence’. Yes, this word sounds like adolescence. Both are times when the body changes and hormones shift, leading to emotional upheaval. Matrescence is not a disease, but doctors are not educated about the impact of matrescence on a woman’s life, and it consequently becomes confused with PND. In reality, it is not a simple case of either you have PND, or you feel absolutely perfect. Most mothers will struggle through the transition.
Matrescence is not only about the physical changes that happen to a woman’s body whilst becoming a mother. This is how ALL mothers, both natural and adoptive, go through matrescence. Psychiatrist Dr Daniel Stern describes becoming a mother as a massive identity shift. Being aware of this is important because a mother who understands it will have more control over her behaviours, which in turn leads to better parenting. In addition, if a mum is in touch with her own emotions, then she can be more empathetic to her children’s emotions.
What is it that makes matrescence so uncomfortable? Dr Sacks describes it as an emotional tug-of-war; a push and pull on a woman’s feelings. Human babies are very dependent on their mothers, and the hormone oxytocin helps a mother’s brain to ‘pull in’ to her baby. However, her mind is pushing away. There are other parts to her identity, such as relationships, work, hobbies, intellectual pursuits, etc. Then there are her physical needs: sleeping, eating, exercise, sex, and going to the toilet alone!
This feeling of ambivalence, of wanting their child close but also craving space – is uncomfortable. Mothers are experiencing two opposing feelings at the same time. Realistically the experiences of motherhood are a mix of good and bad. Women have the unattainable image of “the ideal mother” in their minds. It sets them up to feel shame and guilt for not meeting this impossible standard. Mothers are too ashamed to speak about their ambivalent feelings for fear of being judged. That can be a trigger for developing PND.
Motherhood is a natural progression. Most mothers find it hard. Ambivalence is normal and there is no reason to feel ashamed. If this were more widely talked about, mothers would feel less alone and stigmatised. It may even reduce the prevalence of PND.
Women need to talk to each other to change the way our cultures understand this complex transition. Talk to other mothers, friends, other women! There is nothing wrong with a woman keeping a part of herself separate to being a mother. In fact, it is healthy and normal.
Dr Sacks wrote in a New York Times article in 2017: “Knowing the causes of distress and feeling comfortable talking about them with others is critical to growing into a well-adjusted mother.” This, she says, will help new mothers and those around them to acknowledge that while PND is an extreme manifestation of the transition to motherhood, even those who do not experience it undergo a significant transformation. “When a baby is born,” she says, “so too is a mother; each unsteady in their own way.”