Having just entered into the seventh month of my pregnancy, it seems a good time to write a little about the effects of pregnancy and the relationship to mental health.
Firstly, it's very important to know every pregnancy is different, even for the same woman, and even more so between different people. It's a highly personal and contextual experience.
That said, there are some universal themes, some of which I have been feeling keenly, that I want to touch on. The social discourse is so often full of glib and trite commentary about how amazing it all is and how lucky a pregnant woman is. It is amazing, and we are lucky, AND it is also a hugely impactful and transformative process after which we will be deeply changed, and its OK to acknowledge and be with that.
Lucy Jones's wonderful book Matrescence, published just last year, touches on many of the themes of the metamorphasis of pregnancy, birth and motherhood. Despite being a mother twice over already she taught me much I didn't know. For example, through the process of microchimerism did you know I carry cells that belong to my children in my body for decades, maybe forever. No wonder I am so well primed to tend to their every need! This is how the sex of a baby can be determined by a Non-invasive pre-natal (NIPT) blood test, does Mum's blood have male DNA in it or not?
In her excellent volume Eve, Cat Bohannon traces the way the female body has driven evolution over 200 million years. It is a fascinating read, and her turn of phrase often had me laughing out loud as I recognised many of the experiences she talked about. She notes that the extraordinary placenta, which is made up of tissue from both Mum and embryo, exchanges whatever needs to pass between the two, and that it prioritises the baby. In fact, she notes that pregnancy is an uneasy stand off between the needs of the baby and the needs of the mother to keep both alive; baby/placenta will unconsciously suck out all it can, and Mom will unconsciously temper what it taken to allow her to survive and deliver a live child or children. Yikes!
Another interesting fact Cat Bohannon highlighted is that a mother's brain shrinks in volume by as much as 5% during the third trimester of pregnancy, followed by a steady re-building in the early months of motherhood. She notes that the change in life circumstances is so vast that the brain re-wiring is similar to that of toddlerhood and teenage years, it is seismic. Previous experience tells me this is indeed the case, neither life nor I were or have been the same since becoming a mother. While this is something to embrace, it is also something to mourn, all change comes with loss after all. Being real about it and letting yourself tenderly experience it can ward off depression and the attendant anger as you adjust to life while pregnant, and afterwards.
So in real terms what does all of this feel like for me? As an older mum, this pregnancy has been different to my others. My energy is much, much lower. My default go to of exercising to manage both physical and mental health has not been a possibility, nor has getting out in nature for gentle walks, or playing musical instruments or singing with the intensity I prefer; getting through the day is more a realistic goal. Lower energy has meant lower activity in all sorts of ways, more giving up of things I like to do and that used to energise me. I'm working less, going out less, playing less. I'm eating very differently, managing the many digestive challenges of my digestive organs being displaced by the wonderfully active little person who is evolving in my abdomen. Sleep has become a luxury, snatched in the moments when lesser physical discomfort allow. Watching the impact of all this on the people I love has been difficult, bringing up feelings of guilt and shame to contend with through the fog of tiredness and my own frustration and anger.
There have been times when I have simply not felt like me at all. Jones speaks to this eloquently in Matrescence, the need to work out 'who am I now?'...and who am I now?...and who am I now? I know this is a process that will continue and that I will keep finding new answers. Approaching it as a voyage of discovery and letting go the old is of course a healthy way to be with it, but being real, that is not always possible, and the loss is quite something to process.
Another of the trite things you hear from those around you is how 'it will all be worth it' when you have your beautiful baby. For the vast majority of us, yes, thankfully we will have beautiful healthy babies that we can fall in love with, and survive an early babyhood with. And yet, do not minimise or disregard the personal transformation that happens along the way. Learning from it, healing from it, and finding different ways to be the essence of who you are because of it are all equally potent gifts that matrescence offers you. You matter. It is not all about the baby. The very selfless, personally expensive process and gift of giving life are worthy of deep respect and appreciation. We all need to remember that, every time we see a bump or a baby. Let's honour and give space to the parents, particularly the mothers, who are right in the thick of it.
If you are struggling with mental health through pregnancy or post-natally, please do reach out for help. It is a very common, normal experience, and there are services that can make a difference. Your mid-wife, health visitor or GP (whichever you have a rapport with and trust of) may be good starting points, and there are also private psychotherapists who are on hand to support you.
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