Enf.ª Patrícia Sancho

Specialist in Maternal 
and Obstetric Health
Head of Nursing Services Gynaecology/Obstetrics Unit
Doctorate in Educational Sciences

Enf. Tito Manuel Félix

Specialist Nurse
in Obstetrics and Maternal Health

Women's brain:

Adaptive changes for motherhood

HPA Magazine 21 // 2024

With motherhood, women feel that their brains have changed. One of the common complaints, around 80%, is that they feel more forgetful. However, this forgetfulness, with some selectivity, has a good reason: to support the woman in the transition to motherhood.

We know that pregnancy brings, among other changes, various organic readjustments: the brains of pregnant women are no exception. In such a way, a reorganization of brain connections is triggered, preparing the woman for the care and relationship with her baby. This distinct neural plasticity stimulates the woman in responding to the needs of her baby, ensuring its survival.
There are even specific neural circuits that are activated in response to the crying and facial expressions of babies. 
A study conducted among women who had become mothers, compared to those who had never had a baby, showed brain activations in different regions. Thus, it was concluded that motherhood leads to a response to various facial expressions of babies, including a sad face or a smile. Brain areas related to social skills, such as empathic and caregiving processing, are also activated. Breastfeeding enhances greater sensitivity and response to the baby's signals, activating brain regions involved in empathy and bonding.
The baby's cry triggers the mother's brain to maintain attention and encourages care, also activating the neural circuit that prepares the mother's body to breastfeed through the release of the hormone oxytocin.
Adults have a preference for infant faces characterized by large eyes and foreheads, and small noses and mouths. However, findings indicate that a mother has distinct brain activation when looking at her baby's face compared to the face of other children. This recognition can influence various processes, from attention, memory, and learning directed towards identifying and recognizing the child's needs, as well as the development of motivation/reward and bonding that modulate behavior. All to ensure care and dedication to their child.
Another phenomenon that occurs in the mother's brain is the loss of brain mass volume: areas where the loss is more significant have been detected, considered a mechanism of maturation and specialization. 
This loss is evident in areas involved in processing social responses. This may indicate that maternal brains are more effectively connected to areas that allow reading the desires and intentions of others from faces and emotions, as well as being more alert to detecting threats and activating a protective response.
The loss of brain mass volume persists for at least the first two years of the baby's life, and it is speculated that this loss confers an adaptive advantage somewhat similar to what happens in adolescence. During this period, neural networks also undergo adaptation for greater efficiency in more specialized functions. Simultaneously, there is a need for adjustment in the regulation of emotions and dealing with new demands.
 

The plasticity of mothers' brains supports them not only in managing the new tasks of parenthood but also in bonding with their baby. However, this high plasticity can confer a high responsiveness to both negative and positive experiences. Thus, some higher stress factors can increase the vulnerability of mothers and compromise these natural changes in the maternal brain. Evidence has been found that deficiencies in these neuroplasticity processes may be associated with depression and other psychiatric disorders. 
Therefore, just as obstetric monitoring is carried out for these women, mental health assessment would also be relevant, as it would more effectively identify risk situations for mothers and babies.
To the relief of many women, these brain changes, such as memory loss and even the feeling that the brain is not functioning at full capacity, are not scientifically proven. 
Thus, with the transition to motherhood, these changes should be understood as an adaptation to the new role and not as a deficit in the woman's brain function. 
This is because a recent study demonstrated an increase in learning in subjects related to the baby and an improvement in long-term memory, compared to non-pregnant women. In this way, by changing the paradigm of understanding the maternal brain, the result is the recognition of the importance of care.
At the same time, understanding the adaptive needs of the maternal brain leads to a comprehensive understanding of the mother's brain function, which can to some extent provide new targets for the treatment of psychiatric disorders that affect 1 in 5 women in motherhood.
The narrative that a woman's brain with motherhood presents some dysfunction has prevailed over the years, even denoting an undervaluation of the work performed by women in caring for their children. For centuries, in Western culture, there has been a devaluation of women, seen and treated as the weaker sex, not as intelligent, with little intellectual capacity, with reproductive and caregiving abilities being the most highlighted. 
We are not only facing an undervaluation of women's intellectual function, but also a devaluation of the caregiver role, as if the brain had to function fully to take care of someone.
Currently, we witness the culture of the ideal and perfection: another demand on women's brains. There is a significant mental burden related to motherhood, translating into high personal, family, and social expectations that are almost always unattainable, inevitably leading to multiple inner struggles and even frustrations in this critical phase. This process should not be normalized and minimized as "just a phase" but should be the subject of adaptation support strategies for motherhood/parenthood.
In summary, society should prioritize strategies, protection, and support for women/couples to empower them, provide them with resources and internal mechanisms to fully and autonomously fulfill their parenthood, within a framework of realistic expectations. 
Because this performance, dedication, and focus have implications for their own health and for everyone in future generations.