Widening the Narrative Around Pregnancy, Postpartum & Trauma Resolution
Pregnancy is not just about growing a baby. As women we go through immense psychological changes that to date have been wildly underexplored when it comes to the mainstream narrative of pregnancy and postpartum.
I published an article some years ago after the birth of my daughter in a mindful living magazine. In the article I speak to the challenging emotions that came up for me during pregnancy - what felt like a lack of or inability to connect with my own identity, the feeling of having my psyche hijacked at times, a complete lack of interest in things that would normally light me up, and then there were the darker emotions that seemed to rise out of nowhere like a child’s plastic boat bobbing to the surface of the bathtub. This was by no means a comprehensive picture of my pregnancy experience, but it did speak to the less pretty parts of my experience, which until that point, I had never heard anyone speak to in a raw and candid way.
At the time of my pregnancy I held a masters’ degree in global health and had worked in the field of reproductive health for almost a decade. I was a birth doula as well as a prenatal yoga teacher. With all of this as my back ground, I could still not help but feel ..well – slightly blown away by the metamorphic and at times cathartic experience of my own pregnancy and transformation as I traversed this journey from maiden to mother. In many ways even that term “maiden to mother” felt confining. This wasn´t just about me becoming a mother but rather an entirely different person. In many ways pregnancy for me felt like puberty on steroids, except I was thirty-six not sixteen.
I could not help but feel that somehow as a collective, the mainstream narrative of pregnancy seemed to have dumbed down and glossed over an entirely complex and sophisticated process. I also had the overwhelming sense that while not easy, every difficult emotion that was coming to the surface in my own experience, was happening for my growth. I felt that while my body was growing a child, I was equally undergoing a massive, almost inexplicable transformation and in many ways was unrecognizable to myself.
So much of what I was experiencing and what I would come to find out, other women were experiencing, seemed to be dismissed or disregarded as random or happenstance, especially when it came to more of the psychological aspects of pregnancy. The disparage between what I felt and what was being reflected back to me in the outside world of information, felt like a giant and gaping abyss in the narrative around pregnancy. While words likely will never be able to fully capture the experience of this transformation we go through, I knew there had to be more depth and substance to the psychological aspect of pregnancy than just writing off the changes and emotions as arbitrary and hormonal.
THE CURRENT LIMITED MAP OF THE PREGNANCY EXPERIENCE
Currently in my personal practice as a somatic practitioner in reproductive health one of the ways I support women to claim sovereignty over their bodies is by naming and mapping out the physiology of the body. If we don´t know or ignore parts of our body and what is happening in our bodies, it is to our own peril. There is a disassociation that occurs and then when something goes wrong or even right in those parts, we can´t feel it, let alone speak to it. We forfeit a level of autonomy over our own being.
In 2016 there was a study which found that 44 percent of women were unable to identify the vagina and 60 percent were unable to identify the vulva on an anatomical diagram. Given these findings, it then didn´t seem so far fetched that in 2021 we were still likely missing the mark quite a bit when it comes to mapping out the physiology and psychology of pregnancy.
Pregnant or not, as humans we want our brains to be in the practice of speaking to our bodies, but if we are unaware of aspects of our bodies or relegate parts of ourselves out of our conscious awareness (intentionally or otherwise), there is a level of disempowerment that occurs. In a way we forfeit our body sovereignty which is connected to our personal sovereignty in the world. In pregnancy as a collective narrative, it seems then, that we had relegated monumental amounts of body wisdom to the shadow, with entire systems left unexplored.
After the birth of my daughter in the spring of 2016, I would go on to spend the following years looking for scientific validation for the psychological aspects of what I experienced in pregnancy. I came to believe that this window of pregnancy is an invitation to all women to come into deeper connection with self, that it is a significant window in time where we as women are primed for profound transformation and healing, something that more indigenous cultures know and recognize. I also came to believe that unequivocally women need deep support during this time in order to allow for the level of transformation and healing to occur, to the extent which we are fully capable of.
But apart from more anecdotal studies that show women are more adept to making big changes in themselves during pregnancy, I found minimal scientific information, that supported my theory, that pregnancy is a time that naturally brings to the surface more dormant parts of ourselves that are ready to be shed.
While there does exist literature and studies about the sensitive time of postpartum and the way that postpartum is approached from a more holistic perspective in various more indigenous cultures, which emphasize the practice of social support for a more protracted postpartum period; there exists less literature on the well being of the mother throughout the prenatal period, except as she relates to the baby.
I remained in search of information to help bridge and support what indigenous cultures seemed to know and what I believe all women inherently know and understand but which has been eroded over primarily by modern lifestyles, more insular family units, a society that is largely disconnected from the body, and the medicalization of birth. By and large from a modern day and scientific lens, the support women require throughout pregnancy and postpartum are still seen and treated as ethereal niceties that can´t really be afforded or bothered with.
NEW DISCOVERIES IN THE BRAINS OF PREGNANT WOMEN
Since giving birth to my daughter five years ago, I went on to study in the fields of somatic psychology and trauma. I began my own practice working with women in these areas and work under the premise that everything that is taking place in our bodies is happening from a place of intelligence, that nothing is by accident or happenstance. It was also around this time that I finally came across a study that seemed to contextually support, as well as give weight and depth to my own psychological experience during pregnancy and postpartum.
In this recent study led by neuroscientist, Elseline Hoekzema it was discovered that there are two times in our lives where we lose significant amounts of grey matter in our brains. The first is during puberty. The second time is throughout pregnancy and up to at least two years postpartum. This study showed that not only are neuro pathways that are no longer needed pruned throughout this time, but it showed that there is a complete restructuring of the brain whereby brand new neuro pathways are also laid down.
This study showed that the anatomical changes in the brain were so dramatic that neuroscientists looking at hundreds of brain scans (of women that were pregnant, had recently given birth and women that had never been pregnant) were able to easily distinguish which brains belonged to pregnant women or women who had recently undergone birth just by looking at the brain scans and the level of grey matter in the brain.
In one article about this study, neuroscientist Hoekzema says “Most women undergo pregnancy at some point in their lives, but we have no idea what happens in the brain”. Yes! As a woman who felt major changes going on in my own brain and psyche during pregnancy, it was incredible to finally hear a neuroscientist speak to aspects of what I intuitively felt. This study seemed to widen the scope and give new vocabulary, to more accurately be able to describe the physiological and psychological experience of pregnancy. Suddenly that gaping abyss between the traditional narrative of pregnancy and what I experienced didn´t seem to be so wide. The map of the pregnancy experience started to feel more complete, with depth and nuanced textures. This study began to paint a more multidimensional picture of what often felt like a one dimensional view of pregnancy and postpartum.
THE POTENTIAL LINK BETWEEN TRAUMA RESOLUTION DURING PREGNANCY & POSTPARTUM
It was evident in this study that the areas of the brain, where the most pruning was taking place was in the region of the brain responsible for social cognitive development, which refers to how we process, interpret and respond to information and experiences.
As I took this study in, I also couldn´t help but begin to wonder how this information might connect with the somatic and trauma informed work I was doing with pregnant women. When working with trauma, the definition I like to use is “anything that is too much, too fast, too soon and the residue this leaves as a result of not being able to fully process or digest in our nervous systems what has occurred”. Another way of saying it is that trauma is in part what happens but more so how the individual interprets and responds to this experience.
For example, two different people may witness the same horrific car accident. One of the individuals might walk away from the experience completely unscathed and not think of it again, while the other individual might be completely traumatized and affected on a deep level. The difference here is in the ways in which each of the individuals interprets and responds to the experience.
The social brain circuit of the brain is divided into two main networks, the first is centered in the amygdala and is thought to process the emotional significance of social stimuli. It is also this same area that determines how resilient we are. In other words, the same part of the brain that undergoes targeted anatomical restructuring during pregnancy is the same region of the brain that is very much related to how one processes potentially traumatic experiences.
This region of the brain also plays a key role in a component of recovery after a potentially traumatic experience. In one study it was found that there was a consistently large deficit in social cognitive brain performance in PTSD groups relative to groups that had only been exposed to trauma and in completely healthy control groups.
POTENTIAL HYPOTHESES FOR FURTHER EXPLORATION AND STUDY
Hoekzema´s study then on the anatomical restructuring of women’s brains throughout pregnancy and postpartum was in fact incredibly exciting not just in that it seemed to be filling in and giving a fuller picture of the transformation we undergo as women who give birth. It also points to the following ideas which can be further explored and studied.
1) The brain is primed at a neurological level for transformation and healing during pregnancy and throughout postpartum. Women naturally shed aspects of themselves at the neurological level that are no longer useful. Knowing this we can then work more intelligently as well as intentionally with women and trauma resolution during this period in their lives.
2) This is a time when not only are we more capable of shedding thoughts, habits and belief systems that don´t serve us, we are also primed to produce and lay down new neuro pathways that are useful and will serve us. In other words, we can more intentionally work with restructuring of the brain.
3) This is not a momentary shift in our thinking and way of being but rather studies give compelling evidence that these changes are long term (as the study measured and confirmed these changes two years into post partum).
4) The fact that the main area of the brain that is affected during pregnancy is the social cognitive area and this is one area that is highly impacted and affected with trauma, points to some foundational pieces that lay the groundwork for advocating for and exploring the idea that working with the personal healing of ones trauma during pregnancy and postpartum is a time where the physiology of the body will support long term resolution and healing at the anatomical and neurological levels.
Even if one never chooses to intentionally work with their trauma at this time, just knowing what is taking place and having a fuller vision and understanding of the physiological and psychological processes that one is undergoing can be incredibly empowering. We also know from this study that the male partners of the pregnant women did not show any changes in the brain. This information can be helpful when couples are navigating the new and unfamiliar territory of this stage of life as new parents and as a couple. When we understand ourselves more we can also help others to understand us.
Not only do I believe that this knowledge will empower women, couples and professionals to navigate as well as work more intelligently with what the body is primed for at this time, it is also a potential opportunity for women to mitigate passing on intergenerational trauma in the family line.
While there is still much to be discovered and explored this information is revolutionary in the fields of reproductive health and mental health. It puts more ownership and power back into the experience of pregnancy and brings depth to the current more limited narrative of pregnancy and postpartum.
This information empowers women to walk around in a body that is more deeply aware of itself, that gives rise to greater self autonomy and liberates women in making more informed decisions for themselves and future generations. For myself it let me know that my instinct, that believed there was more to this process of pregnancy and birth was right on, that there was a deeper intelligence taking place even in the midst of what felt like chaos, and that I can continue to trust, that when it comes to the body, nothing is arbitrary.