New parents – especially moms – experience profound changes in the brain when they are expecting and welcoming a new baby.

Health journalist Chelsea Conaboy explains how the caricature of “mommy brain” and its cognitive fog has it all wrong – parenthood actually has a neuroprotective effect, as the brain adapts to meeting the needs of children.

It happens to all parents, not just mothers, but it’s most dramatic in gestating parents.

Plus… how it takes a troop to raise a monkey.

Phil Stieg: Hello I’d like to welcome Chelsea Conaboy, a health and science journalist and Pulitzer Prize-winner. Importantly for today’s topic, she is the mother of two boys. She has recently written, “Mother Brain: How Neuroscience is Rewriting the Story of Parenthood.” Today, we will explore the adventure of her own parenting and the neuroscience behind our understanding in this important field.

Chelsea, thanks so much for being with us today.

Chelsea Conaboy: It’s really my pleasure. Thanks for having me.

Phil Stieg: Why did you write the book?

Chelsea Conaboy: I didn’t set out to write this book. What happened was I became a mother myself in 2015, and I was struggling, and I felt like I didn’t have the words to describe what I was going through.

I’m a journalist. Information is how I cope in my life. And so I went looking for a description of my own experience, and really, I found that in the parental brain science. The more I read, the clearer it became to me that there was a story in the science that was really missing from prenatal education, and it helps me, and I thought it could help a lot of other people, too.

Phil Stieg: Can you give us a brief synopsis? What’s the story of the book? In a nutshell?

Chelsea Conaboy: I think the story of the book is that the process of becoming a parent is really a whole new stage of development in our lives. We have this story of parenthood and of motherhood in particular, that says we have a maternal instinct that clicks on when we have a baby and carries us through this time of life. And the science tells something very different.

It is a time of transition, really of upheaval for the brain, that is both grueling for many of us, and powerful, and adaptive, and it’s grounded in who we are already. But also through these really powerful processes to help us become the parents our children really need.

Phil Stieg: So it sounds to me like the expectations you had about being a parent were different than the reality of what you were experiencing. And so I guess I have to ask, what do you think those expectations were due to? Are they sociologic? Are they scientific? Are they both? Why did you come into these? Why did you come into parenthood with false expectations?

Chelsea Conaboy: It’s really a good question. I was a health and science journalist, so I was like pretty educated and also pretty capable. If you had asked me if I believed in a rigid maternal instinct that this thing was going to click on for me, I probably would have said, well, that’s silly. That’s a really old fashioned idea.

But it’s something that’s so ingrained in our cultural conversation of parenthood, the expectations we place on ourselves and on each other. So I think I just didn’t have the information I needed to really know that this was a time of deep change. Not just like lifestyle and sleep schedule and work logistics and learning how to swaddle and diaper a baby, but like my internal life, my sense of self was going to change too.

Phil Stieg: You refer to the term “mommy brain” in the book. Is that a false expectation or is that an incorrect way of expressing what actually changes after you give birth to a child?

Chelsea Conaboy: I think it’s a very limited and pejorative way of describing what happens to a person’s brain when they have a baby. So when we talk about “mommy brain,” we’re often talking about that kind of caricature of the forgetful, frazzled mother who maybe just can’t keep up cognitively as she once did. And the reality is, for many people, that forgetfulness is real.

Research shows especially during pregnancy, four out of five people report symptoms of forgetfulness or memory deficits. The problem is that’s all we talk about. If we talk about anything related to mothers and brains, that’s what we talk about. The bigger picture is that, yeah, that is probably part of the process of adaptation. It might be related to changes in the hippocampus, which is a really important part of the brain for memory, but it’s really one tiny sliver of a much bigger picture.

Phil Stieg: And you talked about the characteristics of motherhood, that flipping of the switch going to selflessness and to tenderness. Did you not find that?

Chelsea Conaboy: So, I felt deep love and awe for my son. It is a magical, beautiful process and it is inherently disorienting -and for many, many people, distressing. And I think all of that can be true. And that narrative of kind of the tender emotion that comes with maternal instinct kind of consuming you and overtaking everything in the early descriptions of maternal instinct.

Phil Stieg: Makes you perfect, you’re the perfect mother, or the expectation of being the perfect mother.

Chelsea Conaboy: Yeah, perfect, self-sacrificing. And that this idea that maternal instinct can even overcome fear itself. I was really fearful. I was worried about my capacity to take care of this tiny, tiny, vulnerable creature who I did love and who I did feel connected to, but I didn’t know how to do it. And then the more I worried, the more I worried about the worry. I thought that it was a sign that I was broken, or that this maternal instinct thing was missing in me, or just hadn’t developed properly or disrupted somehow in a way that was going to harm my son.

And the story that I found in this science instead, said that the brain really changes in ways that compel us powerfully to pay attention to our babies. There’s heightened activity in brain regions that are involved in motivation and in vigilance.

I started to recognize all that worry, not as problematic, but really as part of the process of adaptation. And yes, I needed to keep it in check and look at it, and think about it, and make sure that it wasn’t kind of becoming too much, but it also was something productive. That was really powerful.

What the research shows is that it changes our social cognition, our ability to read and respond to other people’s social cues. It sets us up to get better at that so that we can keep changing, we can keep working at that and changing as our babies change. And we know babies change from day to day. So we have to get good at that really quick.

Phil Stieg: Yeah. I wanted to touch upon the two components. And number one are the physical changes that occur within the brain and then touch more upon the environmental and emotional aspects that you write about and experience personally. So summarize the physical changes that are reported to occur. Let’s focus on the mother’s brain after childbirth.

Chelsea Conaboy: Yeah. So there’s changes that occur on kind of two tracks, structural and functional. That’s often how we talk about plasticity within the brain. And researchers have tracked increased activity in these brain regions related to motivation and vigilance and also meaning making salience. And then over time, it’s thought that really intense activity sort of shifts and becomes more aligned with brain regions related to social cognition. But at the same time, there are these really incredible studies looking at structural meaning anatomical changes in the brain.

Phil Stieg: So the first studies, the studies you’re just referring to, are from functional MRI studies looking at the transition that occurs in the mother’s brain pre and postpartum.

Chelsea Conaboy: Yes, there are some looking at pre and postpartum, and there are some comparing parents and non-parents or even changes within parents. A set of studies, that I think are going to become known as really landmark studies for this field, are looking at the changes in brain volume across time.

So this is a longitudinal study looking at the brains of women before they’re ever pregnant, immediately or very soon after they have babies. And then they’ve done follow up studies looking at two years out and now six years out, and they found significant volume losses or reductions from pre to post pregnancy.

And it’s really important here to note that volume loss is not a sign of neurodegeneration. The researchers compare this to time of adolescence where we know that there’s significant volume loss and that, that is a fine-tuning of the brain, a real adaptation, a strengthening of synapses that are needed and a pruning of those that aren’t.

Phil Stieg: I always remind patients as well that you only use 20% of your brain, so if you lost a little bit, it’s still not going to affect who you are. Does the science show that these changes that occur? Is that genetic? Is it environmental? Is it hormonal? What are the changes due to?

Chelsea Conaboy: All of the above, I guess, right? Everything that happens to us is grounded in genetics in some way or another. There are two things that really shape the parental brain. One is hormones, and the other is experience. And especially for pregnant people, we’re very aware of the dramatic hormonal shifts that happen through pregnancy and the postpartum period. And we’re used to talking about those things for how they shape the body, how they prepare us to carry a baby, how they sustain a pregnancy, how they propel childbirth and lactation.

But we don’t often talk about how those same hormones are neurotransmitters, I mean, how they’re acting neurochemicals, how they’re acting on the brain. And they are. The way researchers often talk about this is that those big hormonal shifts are kind of priming the brain to be ready to receive the cues of a baby. And babies, we know, are really powerful stimuli for the brain.

Phil Stieg: Going through the book, if you look at the end of it, you have about 30 pages of reference. So you’ve obviously done your homework in terms of creating this tome and you did an excellent job. Out of all of that, what did you find to be the most surprising factor?

Chelsea Conaboy: There’s a lot that is surprising to me. After I started reading this I would talk to my friends who are also moms and just say to them the brain changes, it changes for good. It’s permanently. And that idea and the fact that we weren’t talking about that felt really big.

There’s a set of studies that look at the brains of older adults and they compare the brains of parents and non parents. And these are people in their fifties, sixties, seventies. And what they found was that the brains of people who are parents look what the researchers describe as younger looking. What that term younger looking means really is like a slowed effects of aging. I mean, you’re still aging, of course, but there are sort of fewer natural degenerative signs of aging. And the why I love those studies so much is this indication that parenting is a kind of neuroprotective has a neuroprotective effect. And it makes sense when you think of it from the perspective of what kids do. They require us to constantly be changing and rising to these challenges, these very intense cognitive and social challenges, and to do it over and over again. And I love that that is such a counterpoint to this idea that we are compromised by our kids cognitively.

Phil Stieg: We’ll have to see about twelve months after the release of your book, whether there’s an increase in the birth rate.

Chelsea Conaboy: Yeah, that’s a whole other question. Yeah.

(Interstitial Theme Music)

Narrator: Parents of a new infant can often feel very isolated, struggling with lack of sleep, constant nursing, and getting to know this strange little person that has suddenly become the center of their world.

The exhaustion of new parents has a lot to do with the extended period of helplessness in human infants, which is why so many cultures throughout history have developed support systems for new parents.

It has a fancy scientific name — “Allomothering”— and it’s not just a human custom. There is a fascinating (and colorful) example to be found in the wild.

In Southeast Asia, female silvered leaf monkeys will cooperate to protect and nourish any babies in their troop. Juvenile females help carry babies as the troop moves about – helpful for a tree-dwelling species. Lactating females will even breastfeed other females’ babies.

While adult leaf monkeys have dark grey fur, their babies are born with bright orange fur, the color of a life jacket or a traffic cone. Scientists believe this makes them easier to spot in the trees, and easier for their allomothers to keep an eye on them.

Within a few months a baby’s orange fur turns medium grey, which is a signal to the troop that this “toddler” is now big enough to start striking out on its own and doesn’t need the protection of the allomothers.

One obvious advantage of allomothering is that the birth mom gets a needed postpartum break to rest, feed and regain her strength. And it strengthens the social bonds among the whole troop, ensuring the survival of the next generation.

Humans have a saying that it takes a village to raise a child. Our primate cousins might add that it takes a troop to raise a monkey.

(Interstitial Theme Music)

Phil Stieg: So you also suggest that the brain is not hardwired to do this. And I almost have to admit, I probably took a little bit of an issue with that.

Chelsea Conaboy: I think my issue with the word hardwired, you could say that we’re hardwired for everything that happens to us in our development over time, I suppose because we’re humans. But I think the reason why it’s frustrating to me in this context, is maybe the way that it’s become kind of embedded in our expectations of women.

There’s not a lot of things that we still use the notion of instinct, to describe when it comes to humans. We just have a much more complex understanding of human behavior. But we do maintain it for motherhood.

By definition, an instinct is like a fixed pattern of behavior. It’s a rigid idea. And the issue I have with it is it can keep us from acknowledging both the context of ourselves, what we bring, that this is a pattern of development that comes from the brains we already have. That’s shaped by our various strengths and challenges and also our social context, that it really matters the support that we have around us.

Phil Stieg: Well, we know that it’s not correct, but probably the word instinct was used back when we didn’t have functional MRI. You know, it’s a matter of semantics. And I think what’s important now is that we do understand that there are fundamental mechanisms in the human brain after you give birth to a child. You also briefly talk about the father’s brain, non-gestational parents, caregivers changes that go on in their brains as well. Can you summarize that?

Chelsea Conaboy: Yeah, and I guess here is one of the areas where I would say it’s really not just a matter of semantics when we’re talking about maternal instinct because it has had really profound impacts on what kinds of support we give to mothers. And also it’s led us to really underestimate whose biology can make them into really good caregivers.

And the truth is, fathers and other parents, non binary parents, adoptive parents, they are included in this biological story as well.

And first of all, overwhelming majority of the research has been done in gestational mothers. That’s the reality.

But what we have in fathers is really interesting and it’s growing. The same is true for them that hormones and experience shape the parental brain.

Researchers have described what they call a global parental caregiving circuitry. And the idea here is that there are different mechanisms for getting there. I would never try to deny the kind of unique, powerful experience of a pregnancy on the brain, but the mechanisms are different, the timelines are different and the intensity is different. But the outcome is remarkably similar for fathers, which is that they are also primed hormonally to be ready to receive the cues of a baby. And the outcome is a brain that is adapted to be better at reading the cues and meeting the needs of that child.

One really interesting example is that it’s thought that fathers, as they approach fatherhood when they’re expecting parents that they have a decline in testosterone and that’s thought to be a sign of commitment to their role as fathers. It’s really complex research. These differences are quite small and we attach like big narratives to them

Phil Stieg: – almost anecdotal.

Chelsea Conaboy: Yeah, but there is evidence of that. I mean, there have been large studies looking at testosterone changes across that time period. One study looked at testosterone changes or hormonal changes broadly in gay couples – lesbian couples and the non-gestational parents. And they expected to see the kind of the same hormonal changes to signal commitment to their role as expectant parents also. And they didn’t.

And one thing that they noted also in that study was that how those women reflected on their relationship, also didn’t change across time. And what they said was “well, we were looking at this wrong essentially because these women were already deeply committed to their relationships. Because if you’re a gay parent and you decide to have a baby, you have made really profound legal and financial investments in that decision that often isn’t present for heterosexual couples. It’s interesting how social context can really affect these changes in ways that we don’t see if we’re only studying it through a very heteronormative lens.

Phil Stieg: As we stated at the top, this is an incredibly important part of the human experience, and we need to understand it, because one of the things I believe in strongly is the answer to this is I think we need more parenting education in middle school. People think I’m just going to go have a family, and they have no real education on what it means to be a parent.

Chelsea Conaboy: It’s one of the things that I found, one of the most hopeful pieces of reporting for this book, is there’s a woman named O’Reilly Athin, who is a professor at Teacher’s College at Columbia University, and she trains sex educators, and part of that training is to say, let’s broaden the conversation by a lot.

Let’s not just say, here’s the sperm and here’s the egg, and this is how a baby is made. But do you want to have children? How do you want to have children? What would that look like in your life? How would it fit into the rest of your life plans? And to make it like something that people think about

Phil Stieg: Demystify the process.

Chelsea Conaboy: Yeah, demystify the process and introduce those questions early.

Phil Stieg: What do you think we should do? What should society How can we make the expectations more appropriate for the expecting mother?

Chelsea Conaboy: So I think there’s a couple of things to say here. One, we can start talking more honestly about what this transition really is for new parents and including some of this brain science. I mean, an expected parent doesn’t necessarily want to know the details of what’s going to happen to their hippocampus or their amygdala or their dopamine system. But I think that we can give them some basic information about how the brain changes and what that will mean for their psychological state after pregnancy.

And I think we can be more honest in sharing the struggles and the distress that we experience ourselves and helping to shape that narrative. And then I think there are also really deep, important systemic implications for the science that if it’s true that new parenthood is a distinct and really important developmental stage of life, then what do we need to be doing differently in our clinical care, which currently the standard of care is one six week postpartum appointment with very basic and limited screening for depression. And really, that’s it.

Phil Stieg: Reading through your book, it seems to me that postpartum I mean, you have joint pain, you have muscle pain, you have all these things, and that’s somewhat expected. Okay. But then people don’t seem to expect this emotional transition that goes on. For some reason, other people want to treat the brain differently. And the reason for this podcast is I want to demystify that. I want people to understand the brain just another organ that gets hurt, changes and modifies.

Chelsea Conaboy: Yeah, I mean, one thing I mentioned in the book is that the app that I used to track my pregnancy and that many other people use the details about how the baby is changing over time and details about how the woman’s body is changing over time. And it uses a model of a woman’s body that’s literally cut off at the neck. So it talked about all of the changes in your physiology, but not above your shoulders.

Phil Stieg: In the last chapter, I guess I’ll paraphrase you by saying you sounded a little bit angry, but I’ll actually quote you. You said, quote, pissed, end of quote. And understandably so. Is it because of this lack of science, the misleading of parents in terms of what the science actually said at the time? What are you most angry about?

Chelsea Conaboy: I got angrier as I wrote this book, for sure –

Phil Stieg: – that was evident (laugh).

Chelsea Conaboy: It’s a lot of things. It’s our failure to talk about this change. It’s our failure to adequately fund it, meaning funding the research. It’s our persistence in maintaining these outdated, unproven ideas of what this transition to parenthood is.

It’s our failure to do what our peer countries have done in terms of remaking clinical care across the perinatal period and providing more postpartum support.

It’s the fact that the United States is one of six countries in the world that doesn’t offer federally mandated paid leave for her new mothers. And that’s like a really deep, shameful fact. And that this science so clearly shows that it’s necessary.

And it’s just like our continued persistence that mothers do this work invisibly and go through this change without the support that they need.

Phil Stieg: So if you could list three to five things that you would like to change about the perinatal period, what would they be?

Chelsea Conaboy: Paid leave would be at the top of that. More integration of midwives, not only in the prenatal period, but across the postpartum period.

Midwives play a huge role in much of Europe, and providing in home and community based support to new parents. And it’s really critical.

Third, I could choose lots of different things, but I guess something I’ve been thinking about a lot is prevention of postpartum mood and anxiety disorders. We’ve done a lot of work of increasing awareness and reducing stigma, but there are steps we can take that are proven to actually prevent those things from happening by screening people for risk factors and providing them often with the particular kinds of psychotherapy or social supports that they need in order to have the best possible transition.

Phil Stieg: Flipping to the other side – male readers of your book. What do you want them to know other than understanding what their wife is going through with the process. What else can they take away from this book about themselves?

Chelsea Conaboy: I want them to know that this is their story too, that their brains change, and also that the best way for them to adapt to the role of fatherhood is to really engage in it early and that their brains change specifically through experience.

So experience really taking responsibility for their babies and engaging in the direct caregiving for them. And we often have this narrative that babies just need their mothers early on and there’s not much for fathers to do. That’s not really true.

There’s a lot that fathers can do in caring for their babies and caring for their partners and spending the time learning their baby’s cues and helping their brain to adapt in a way that’s going to be meaningful for them, the whole course of their lives.

Phil Stieg: Chelsea, it’s been a real honor and a pleasure to meet with you and talk with you about a subject that clearly needs to be transformed in terms of education, behavior, and paid leave for new mothers. And it’s also an education for fathers to understand what their wives are going through, and how their brains change. Thank you for making this all understandable for us.

Chelsea Conaboy: Thanks so much. It’s been a pleasure talking with you.

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