A new way to think about the transition to motherhood Alexandra Sacks
Do you remember a time
when you felt hormonal and moody?
Your skin was breaking out,
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.
Teenagers, right?
Well, these same changes happen
to a woman when she’s having a baby.
And 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?
There are entire textbooks written about
the developmental arc of adolescence,
and we don’t even have a word
to describe the transition to motherhood.
We need one.
I’m a psychiatrist who works
with pregnant and postpartum women,
a reproductive psychiatrist,
and in the decade that I’ve been
working in this field,
I’ve noticed a pattern.
It goes something like this:
a woman calls me up,
she’s just had a baby,
and she’s concerned.
She says, “I’m not good at this.
I’m not enjoying this.
Do I have postpartum depression?”
So I go through the symptoms
of that diagnosis,
and it’s clear to me
that she’s not clinically depressed,
and I tell her that.
But she isn’t reassured.
“It isn’t supposed to feel
like this,” she insists.
So I say, “OK. What did you
expect it to feel like?”
She says, “I thought motherhood
would make feel whole and happy.
I thought my instincts
would naturally tell me what to do.
I thought I’d always want
to put the baby first.”
This – this is an unrealistic expectation
of what the transition
to motherhood feels like.
And it wasn’t just her.
I was getting calls with questions
like this from hundreds of women,
all concerned that something was wrong,
because they couldn’t measure up.
And I didn’t know how to help them,
because telling them
that they weren’t sick
wasn’t making them feel better.
I wanted to find a way
to normalize this transition,
to explain that discomfort is not always
the same thing as disease.
So I set out to learn more about
the psychology of motherhood.
But there actually wasn’t much
in the medical textbooks,
because doctors mostly
write about disease.
So I turned to anthropology.
And it took me two years,
but in an out-of-print essay
written in 1973 by Dana Raphael,
I finally found a helpful way
to frame this conversation:
matrescence.
It’s not a coincidence that “matrescence”
sounds like “adolescence.”
Both are times when body morphing
and hormone shifting
lead to an upheaval
in how a person feels emotionally
and how they fit into the world.
And like adolescence,
matrescence is not a disease,
but since it’s not
in the medical vocabulary,
since doctors aren’t
educating people about it,
it’s being confused
with a more serious condition
called postpartum depression.
I’ve been building on
the anthropology literature
and have been talking
about matrescence with my patients
using a concept called
the “push and pull.”
Here’s the pull part.
As humans, our babies
are uniquely dependent.
Unlike other animals,
our babies can’t walk,
they can’t feed themselves,
they’re very hard to take care of.
So evolution has helped us out
with this hormone called oxytocin.
It’s released around childbirth
and also during skin-to-skin touch,
so it rises even if you didn’t
give birth to the baby.
Oxytocin helps a human mother’s brain
zoom in, pulling her attention in,
so that the baby is now
at the center of her world.
But at the same time,
her mind is pushing away,
because she remembers there are
all these other parts to her identity –
other relationships,
her work,
hobbies,
a spiritual and intellectual life,
not to mention physical needs:
to sleep, to eat, to exercise,
to have sex,
to go to the bathroom,
alone –
(Laughter)
if possible.
This is the emotional
tug-of-war of matrescence.
This is the tension
the women calling me were feeling.
It’s why they thought they were sick.
If women understood the natural
progression of matrescence,
if they knew that most people found it
hard to live inside this push and pull,
if they knew that under
these circumstances,
ambivalence was normal
and nothing to be ashamed of,
they would feel less alone,
they would feel less stigmatized,
and I think it would even reduce
rates of postpartum depression.
I’d love to study that one day.
I’m a believer in talk therapy,
so if we’re going to change the way
our culture understands
this transition to motherhood,
women need to be talking to each other,
not just me.
So mothers, talk about your matrescence
with other mothers, with your friends,
and, if you have one, with your partner,
so that they can understand
their own transition
and better support you.
But it’s not just about
protecting your relationship.
When you preserve
a separate part of your identity,
you’re also leaving room
for your child to develop their own.
When a baby is born, so is a mother,
each unsteady in their own way.
Matrescence is profound,
but it’s also hard,
and that’s what makes it human.
Thank you.
(Applause)