Maternity services need to educate parents-to-be on how pregnancy will affect their brain - their life could depend on it, says Helen Thomson.
When I was expecting my first child, I knew what to expect. An expanding belly, a bout of morning sickness, perhaps a little sciatica. I’d been to birthing classes, I knew how to change a diaper and I was fully prepared for imminent exhaustion.
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| “There are barely any areas of the brain that go untouched by pregnancy” Jecapix/Getty Images |
Except I wasn’t prepared. I was missing one vital piece of information: that pregnancy would change the structure and function of my brain – perhaps irreversibly.
No doctor or midwife mentioned it. Yet evidence has been building for years to show how significantly pregnancy affects the brain. This week, research by Emily Jacobs at the University of California, Santa Barbara, and her colleagues cemented this idea, showing that the brain experiences wide-sweeping changes throughout the whole of pregnancy and beyond.
I had no idea that while my baby-to-be was growing, part of my brain was shrinking. My grey matter, the wrinkly regions that contain cell bodies and synapses, was getting smaller, albeit better connected. Meanwhile, my white matter – containing axons that transmit messages between brain regions – was expanding.
“There are barely any areas of the brain that go untouched by pregnancy,” says Jacobs. Yet I was oblivious as to the impact they might have on my future.
While Jacobs’s team didn’t attempt to link these changes to behaviours, studies suggest they are an evolutionary adaptation that helped me and others during pregnancy to become better parents, influencing everything from how we respond to our children’s screams to the strength of our attachment. Many of these changes persist for at least six years after birth.
This remodelling of my neural architecture meant that when my baby cried, the sound would feel deafening, quickening my heart rate and moving my body towards her as if propelled by some invisible force. The seconds I took to respond felt like an eternity. “Don’t worry, it sounds much worse to you than everybody else,” a lady once said to me, noticing my anguish as my baby’s screams echoed around the bus.
Would it have helped to know that this sensory superpower was down to an evolutionary refinement of my brain’s anatomy? I believe it would have, and I’m not alone. “Women have been in the dark about these things for too long,” says Jacobs. “The more we equip women with basic knowledge of how the brain changes during this major transition, the better.”
There could be serious benefits. For instance, while “synaptic pruning” of grey matter is linked with many positive parental behaviours, it may also be behind mood disorders such as postpartum depression and anxiety – the most common mental health problems associated with pregnancy.
Simone Vigod at the University of Toronto in Canada, who studies these links, has advocated for people receiving more education on the potential reasons for postnatal mood disorders. Indeed, evidence suggests that attitudes towards and awareness of pregnancy-related depression can influence a person’s ability to seek support. This is more pressing than ever – in the UK, suicide is a leading cause of maternal death during pregnancy and the year after birth.
It is also the perfect time to make changes. Maternity services are in bad shape – a government-led inquiry published in May called for an overhaul of the UK’s maternity and postnatal care systems after numerous failures were discovered.
As those improvements are implemented, repairing and rebuilding the UK’s maternity systems, it is important to give as much thought to changes in the brain as to the more widely recognised physical alterations that pregnancy causes to the rest of the body.
Jacobs is hopeful that, in this respect, we are making progress. “Change is coming,” she says. I certainly hope that is true – nothing is quite the same after birth, let’s make sure new parents know that includes their brain.