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Alexandra Sacks M.D.
Alexandra Sacks M.D.
Postpartum Depression

Matrescence: The Developmental Transition to Motherhood

A body, mind, and hormone shift that sounds like "adolescence."

Though many of us have tried to block it out, we all remember puberty. First came the pimples and stretch marks. And next, feeling euphoric, awkward, and disoriented about growing from one life stage to the next.

Science and culture keep us well informed about the physical and psychological changes adolescents experience in their bodies, hormones, relationships, and identities. But women also go through a radical transformation in each of these dimensions when they are having a baby.

My work on the developmental transition to motherhood explores “matrescence,” a term coined in 1973 by Dana Raphael, a medical anthropologist who also popularized the phrase “doula.” Over the decades, other academics and clinicians have expanded on her research, but I've noticed that the term is not yet "out there" in popular culture and conversation. I’m a reproductive psychiatrist who works with pregnant and postpartum women, and my work and this blog are motivated by the mission to change that.

Over the past decade that I’ve been working in this field, I’ve observed a pattern. Women regularly call me to ask if they have postpartum depression. Though they may not meet diagnostic criteria for this condition, postpartum depression seems to be the most familiar term they have on hand to frame their distress. Here’s what many of them describe:

  • “I love my baby but I don’t have the right maternal instincts.”
  • “I’m not enjoying this, mostly I feel tired.”
  • “I feel so guilty because I wanted a baby more than anything, but sometimes I find myself feeling bored and even resentful.”

These descriptions of discomfort are natural to matrescence and not diagnostic of any specific disease. It’s no 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 familiar medical vocabulary, it’s being confused with a serious condition (that deserves its own expanded outreach, research, and advocacy) called postpartum depression. (More recently, postpartum depression clinical terminology is expanding to the more inclusive "perinatal mood and anxiety disorders," or PMADs.)

There is so much love in matrescence. The bonding hormone oxytocin circulates through your body, and you become attached to your baby at the most basic cellular level. But, because you’re still human, your brain and body continue to send you the usual cues to take care of yourself: to sleep, to eat, to go to the bathroom. Not to mention to exercise, have sex, socialize, continue your professional, spiritual and intellectual life, and nurture your relationship. Many new moms find themselves feeling like they are in a push and pull, an emotional tug of war, as they try to figure out how to care for themselves and their baby’s needs at the same time.

Many people find early motherhood to be both pleasurable as well as challenging, and at times fear and anger-inducing, and this is mediated by psychological as well as physiological factors (ranging from hormonal shifts to sleep deprivation.)

Rather than feeling like something is “wrong with them,” let’s encourage mothers to speak more openly with each other so that the beautifully messy challenges and joys of matrescence are as accepted in our culture as the ups and downs of adolescence. My hope is that if more women understood the natural progression of matrescence, they might feel less alone, they might feel less stigmatized, and this might even reduce rates of postpartum depression.

There are so many ways to normalize matrescence and break down this cycle of shame. I encourage moms to share more authentic images and stories on social media under the hashtag #motherhoodunfiltered.

References

Athan, A.M., and Reel, H.L. “Maternal Psychology: Reflections on the 20th Anniversary of Deconstructing Developmental Psychology,” Feminism & Psychology, 25:3 (2015), 311–25.

Athan, A.M. “Maternal Flourishing: Motherhood as Potential for Positive Growth and Self-development,” Lecture Presented at the Women's Mental Health Consortium Quarterly Meeting, October 2016.

Athan, A.M. Reviving Matrescence: The Developmental Transition to Motherhood. Unpublished Manuscript, Teachers College, Columbia University, New York, NY, (2018).

Raphael, Dana. Being Female: Reproduction, Power, and Change. Chicago: Mouton Publishers, 1975.

Sacks, Alexandra. "The Birth of a Mother," The New York Times, May 8, 2017.

Sacks, Alexandra. “A New Way to Think About the Transition to Motherhood,” TED Talk, May 31, 2018, https://www.ted.com/talks/alexandra_sacks_a_new_way_to_think_about_the_….

Stern, Daniel N., Nadia Bruschweiler-Stern, and Alison Freeland. The Birth of a Mother: How The Motherhood Experience Changes You Forever. New York: Basic Books, 1998.

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About the Author
Alexandra Sacks M.D.

Alexandra Sacks, M.D., is a reproductive psychiatrist and leading expert on matrescence, the transition into motherhood. She hosts the Motherhood Sessions podcast and coauthored What No One Tells You.

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