We talk a lot about what pregnancy does to the body. We talk much less about what it does to a person’s identity. That transition has a name, matrescence, and while it can be a time of discovery and creation, it can also be a time of great struggle. In this two-part series we will dive into how the idea of matrescence, or becoming, happens both before birth and during the postpartum period and how you can navigate it without feeling alone.
What is Matrescence?
In 1966 anthropologist Dana Raphael completed her dissertation entitled The Tender Gift: Breastfeeding. In it, she coined a term to describe the profound developmental transition that pregnant people go through as they experience pregnancy, birth and the postpartum period. Raphael states “Childbirth brings about a series of very dramatic changes in the mother’s physical being, in her emotional life, in her status within the group, even in her own female identity. I distinguish this period of transition from others by terming it matrescence to emphasize the mother and to focus on her new lifestyle.” Traditionally this period of change has been set to the sidelines as more focus was placed on the baby than the pregnant person, but recently more attention is being given to this period of transition. As asserted by Raphael, this time is like adolescence, in that it is a natural but challenging part of development.
Both pregnancy and childbirth can have profound impacts on the body, the brain, and the spirit. Though much of our societal focus has been on the postpartum period, we’ll use this first part in my series to focus on what happens before birth. In other words, during pregnancy, what can we expect when we’re expecting?
This Is Your Brain on Pregnancy
Pregnancy is a period of intense hormonal and physiological changes, as anyone who’s witnessed or gone through it can confirm. Over approximately 40 weeks, the pregnant body adapts rapidly to support development and undergoes massive physiological adaptations that include alterations in immune regulation, metabolic rate, oxygen consumption and hormone production. In fact, there is a 100-fold to 1,000-fold increase in some hormones like estrogen and progesterone, both of which affect how the brain functions and adapts (Pritschet et al., 2024).
As it turns out, the brain is in major flux during this period. One of the observed changes includes extensive reductions in gray matter (the part of the brain that contains many neuronal cell bodies) during pregnancy, overlapping with the parts of the brain that form what’s known as the Theory of Mind network (Hoekzema et al., 2017). It is thought that these changes create flexibility in the brains of pregnant people, and depending on their experiences postpartum, that flexibility can lend itself to being more in tune with their baby and others’ emotions in general. The idea of losing gray matter may sound upsetting, but there are many periods where this kind of change is seen before other major periods of change. Sometimes, the brain seems to prune the “before” to make room for the creation of an “after.”
The Mental Ups and Downs of Pregnancy
As it turns out, all these shifts in the brain can have a profound impact on mental health during pregnancy. One potentially frustrating truth of this period is that it is highly individualized, and no two pregnant people – or even two pregnancies – are the same. Even in pregnancies where the pregnant person’s mental health is relatively positive, feelings of ambivalence are completely normal. But, sometimes, mental health takes a big hit during this time, and it’s important for us to recognize when we need help.
Many have heard of postpartum depression, but the antenatal (or before-birth) period can be a time of upheaval as well. Peripartum mood and anxiety disorders can begin during pregnancy and may include depression, anxiety or obsessive-compulsive symptoms. In rare cases, serious conditions involving psychosis can occur, although these are more common after childbirth.
It’s important to note that feelings of depression, hypervigilance or anxiety exist on a spectrum, and many of us feel these at one time or another as we transition to parenthood. Some amount of worry, irritability, or ambivalence is a normal response to the tremendous changes of pregnancy. After all, a pregnant person is contending not only with hormones and a changing body, but also with questions about birth, parenthood, relationships and the future. It is not always easy to tell where the understandable discomfort of a major transition ends and a mental health condition begins. One question to ask is: Are these feelings getting stronger, lasting longer, or making daily life harder? If anxiety, sadness or intrusive thoughts make it difficult to sleep, eat, work, attend appointments or connect with others, it may be time to ask for help.
Certain experiences can make this period more challenging. A previous history of anxiety or depression, pregnancy loss, infertility, medical complications, financial strain, or a lack of social support can all add weight to an already demanding transition. Pregnancy can also bring older experiences to the surface. A person may find themselves reconsidering how they were parented, what family means to them, or how safe they feel in a body that is changing beyond their complete control.
None of this means that a person is ungrateful for their pregnancy or that they’ll be a bad parent. The expectation that pregnancy should be a time of uninterrupted joy can make ordinary ambivalence feel shameful, and genuine distress harder to disclose. In reality, excitement and grief, confidence and fear, or gratitude and resentment can exist at the same time. Contradictory emotions do not represent a failure to bond with a baby. They may simply reflect the magnitude of what is taking place.
It is also worth remembering that help does not need to wait until after birth. Prenatal care can and should include conversations about mental health, particularly when symptoms are persistent or disruptive. Therapy, peer support and, when appropriate, medication can all be part of care. Hallucinations, delusions, severe confusion or thoughts of harming oneself or someone else require immediate professional help. Perinatal mental health conditions are treatable, and asking for support is not a failure to adapt; it is one way of responding to the transition with care.
Approaching Matrescence With Flexibility
If pregnancy is a developmental transition, it may help to prepare for it as one. This means paying attention to emotional health alongside blood pressure, nutrition and physical symptoms. It can be useful to notice patterns in mood, sleep and anxiety and to speak honestly with a healthcare provider when something feels difficult. People with a history of mental health concerns may also benefit from discussing a plan with their providers before symptoms arise or intensify.
From a philosophical and spiritual standpoint, some mental approaches to this period can help frame the transition differently. These can include:
- Investigate your values and your expectations. Are you putting a lot of pressure on yourself to be a certain way? Did you have a specific picture in your head for how pregnancy would go? It is hard to realize we don’t have as much control as we want to over pregnancy and how it impacts us. Gentle adjustments in our expectations can help us surrender to what we can’t control, while still putting effort into the things we value most.
- Talk to someone. If at any point in your pregnancy you feel overwhelmed with the process, it can be invaluable to seek regular support. This support might include a partner, family member, friend, therapist, medical provider or community group. One benefit of therapy, however, is the opportunity to work with someone who has experience helping others navigate this transition. For many, having that consistent support can prove vital as they move through the constant changes of pregnancy.
- Make room for opposing emotions. Excitement for what’s to come can coexist with grief over what has changed in your life. Gratitude can coexist with anxiety, discomfort or frustration. It can be soothing to gently remind yourself that none of the difficult emotions mean you will make a bad parent, they simply reflect the complexity of the transition (and of being human).
- Practice psychological flexibility. Psychological flexibility is the ability to stay grounded in the present moment, accept difficult thoughts or feelings without judgment, and take actions that match your personal values. With practice, this approach to our lives can bring fulfillment even in the most difficult situations. If you’re interested, learn more in books like The Happiness Trap by Dr. Russ Harris.
It’s important to note that rest, movement, nutrition, reflection and connection may support well-being, but they should not be treated as cures for every form of distress. A walk or a journal cannot compensate for inadequate healthcare, financial insecurity, discrimination, an unsafe relationship or the absence of meaningful support. Matrescence is a personal transformation, and it also unfolds within a social world. The conditions surrounding a new parent matter, and you deserve support wherever you are in that journey.
A Brain Preparing for Relationship
The changes occurring in the pregnant brain can sound alarming when described only as a loss of gray matter. It’s important to remember, however, that the brain often starts change by pruning away things that no longer serve its purposes. The pregnant brain is reorganizing during an unusually plastic period, potentially becoming more responsive to the demands of caring for and relating to an infant. In that sense, the changes may be less about losing something than about preparing to learn something new. Non-gestational parents, adoptive parents and other caregivers may also undergo major emotional, social and neurological adaptations as they take on the work of caring for a child.
Becoming While Expecting
Understanding pregnancy through the lens of matrescence helps place its uncertainty and emotional complexity in context. A person may sometimes feel as though they are losing themselves when, in fact, their sense of self is being reorganized around an enormous change. That process can be meaningful, uncomfortable and unfinished all at once.
Birth marks the arrival of the baby, but it does not mark the end of matrescence. In Part 2, we will look at what happens after birth, as the brain continues to adapt and a new parent navigates recovery, caregiving, bonding and the ongoing work of becoming.
References
Barba-Müller, E., Craddock, S., Carmona, S., & Hoekzema, E. (2019). Brain plasticity in pregnancy and the postpartum period: Links to maternal caregiving and mental health. Archives of Women’s Mental Health, 22, 289–299. https://doi.org/10.1007/s00737-018-0889-z
Harris, R. (2022). The happiness trap: How to stop struggling and start living (2nd ed.). Shambhala.
Hoekzema, E., Barba-Müller, E., Pozzobon, C., Picado, M., Lucco, F., García-García, D., Soliva, J. C., Tobeña, A., Desco, M., Crone, E. A., Ballesteros, A., Carmona, S., & Vilarroya, O. (2017). Pregnancy leads to long-lasting changes in human brain structure. Nature Neuroscience, 20(2), 287–296. https://doi.org/10.1038/nn.4458
Jones, L. (2023). Matrescence: On the metamorphosis of pregnancy, childbirth and motherhood. Allen Lane.
Martínez-García, M., Paternina-Die, M., Desco, M., Vilarroya, O., & Carmona, S. (2021). Characterizing the brain structural adaptations across the motherhood transition. Frontiers in Global Women’s Health, 2, Article 742775. https://doi.org/10.3389/fgwh.2021.742775
Pritschet, L., Taylor, C. M., Cossio, D., Faskowitz, J., Santander, T., Handwerker, D. A., Grotzinger, H., Layher, E., Chrastil, E. R., & Jacobs, E. G. (2024). Neuroanatomical changes observed over the course of a human pregnancy. Nature Neuroscience, 27, 2253–2260. https://doi.org/10.1038/s41593-024-01741-0
