Birthing the Mother
MATRESCENCE-INFORMED MENTAL HEALTH PRACTICE
INTRODUCTION
Unlike the one day-and-time event that is the child’s birth, the becoming of a mother takes years. Matrescence, this complex and meaningful human developmental stage, imposes physiological, emotional, psychological, social, cultural, and spiritual challenges, putting a woman’s ability to cope and adjust to the test. While much study has been dedicated to unveiling and ameliorating the child’s growth processes and the experience of being mothered, the mother’s growth processes and her experience of motherhood have been overlooked, with the mother’s health and wellbeing solely addressed in cases of maladaptation and mental illness.
In this article, we aim at exploring the current maternal care mainstream approach, at deepening our understanding about the complexities and facets of the ‘birth of the mother’, and at proposing the need for a matrescence-informed model of care to better support the new mother’s transitional journey, mental health and wellbeing.
RESEARCH
Maternal mental health is a public health issue and can be detrimental not only to the woman’s health, but to the child, to the family and their communities. Therefore, “addressing perinatal mental health promotion (…) must be a global priority” (McNab et al., 2022). Entering parenthood is a vulnerable time for individuals. The Western Australian Department of Health states that “during the perinatal period, onset and re-occurrence of mental illness is higher than at any other time for women” (2015). From pregnancy to birth and then during the day-to-day of mothering, women’s brain plasticity is increased, and with it, the chances for mental disturbances (Barba-Müller et al. 2019 and Hoekzema et al., 2017). On top of this and other intense biological changes, emotional, and psychological labours of maternal demands, recovering from the delivery, navigating life and identity transitions, adjusting to a new social role and the inherent changes in human relations are other important adaptive processes taking place when welcoming a child into care (Mercer, 2004; Leahy, 2020 and Athan & Reel, 2015). These challenging factors might take a toll on new mother’s mental health and wellbeing. Nonetheless, it will explored, maternal care is heavily focused on the child’s health and development, the infant’s needs and child care expectations and techniques.
McLeish & Redshaw found that a common perception among the mothers was that their experience, their mental and emotional state, was at the bottom of the natal carers’ priorities. As they stated: “most mothers did not feel able to make use of professional help for their feelings of emotional distress. Many extended the self-censorship which they practised with family and friends, to their interactions with health professionals.” (2017). Indeed, our maternal care mainstream approach seem to be one to focus on addressing maladaptiation as a child care provider, rather than supporting adjustment and development of the individual. As stated by Emannuel and St. John, “women’s psychological health in the transition to motherhood has traditionally been viewed with a biomedical focus on anxiety, depression and dysfunction.” (2010). Athan also reached similar conclusion when pointed that “‘postpartum’ has virtually become synonymous with maladjustment” (2011). It is possible to infer that the current model of care is failing new mothers. As reviewed by Dooley Hussmann, “postnatal care evaluates mother and infant’s biological health and, specially, child’s development and mother’s competency on performing mothering duties, disregarding new mother’s unmet needs for guidance and information about the process they are undergoing (2020).
Maternal mental health and wellbeing out to be dealt with the importance that it deserves. New mothers are more vulnerable, and vulnerable also are the ones under their care. Nonetheless, even though families and society would benefit from healthier and stronger mothers, our bio-medical approach to maternal care seem to disregard their needs and undermine their strengths. It doesn’t come as a surprise that new mothers do not feel supported by our current model of practice. On the contrary, the system seems to work in two fronts: 1) paying attention at their shortcomings and eventual issues as a care provider and 2) addressing maladaptation when a diagnosable illness. Maybe, instead of attributing to them a secondary role on their own journey and bringing their development to the centre of their care we could potentially prevent pathologies and increment mental health and wellbeing during the transition into motherhood.
DISCUSSION
We agree that “among all the transitions a woman experiences in her lifetime, the transition to motherhood is arguably the most complex and consequential for her physical and mental health.” (Prabhakar, Stolterman & Šabanovic. 2019). The understanding about the phenomena of becoming a mother as a transitional phase seem to go unchallenged. For Mercer, “the woman’s transformation and growth of self in becoming a mother is congruent with psychosocial developmental and transition theories” (2004). An incipient idea which is starting to permeate maternal mental health and wellbeing research seem to encapsulate all the intricacies and nuances of this transformational process.
The term Matrescence was coined by the anthropologist Dana Raphael (1975) when referring to the complex process of becoming a mother. It proposes a paradigm shifting perspective on the women’s objective and subjective experience of entering motherhood.
Matrescence has since been explored and expanded by several authors. In the mental health field, Athan and Reel, reproductive psychologists, published a Maternal Psychology article in 2015, bringing attention to the ambivalence of the matrescent’s 3 subjective experience and the multidimensions in which transformation takes place. They stated that “perhaps reviving the conceptual term matrescence (…) would be most apt within the landscape of maternity (…) it is an experience of disorientation and re-orientation marked by an acceleration of changes in multiple domains”.
In 2017, Alexandra Sacks, psychiatrist, published a famous article in the New York Times newspaper putting the concept of matrescence into spotlight. For her, “the process of becoming a mother (…) has been largely unexplored in the medical community” (2017). Indeed, to this date, matrescence “has not been fully adopted in the medical community as say other forms of life stages such as adolescence” (Vales-Lewis, 2022). Perhaps, as stated by Athan, “a theory of matrescence provides a destigmatizing and agentic lens for mothers of all kinds to identify, explore, cope with, and shape their destinies according to their own individual differences” (2020). Matrescence could be the window through which maternal care could look at new mother as protagonists, instead of secondary subjects, empowering them to their due leading role in their developmental journey.
Leahy believes that the concept of matrescence “explodes rigid disciplinary boundaries, exposing them as insufficient to adequately explain a transition as complex as new motherhood” (2020). Given the shortcomings of our current biomedical approach to the women’s experience of entering motherhood, it is worth considering if a matrescence-informed model of care could better support the new mother’s development and adaptation. Matrescence, as a conceptual reference, encompasses the multitude of objective and subjective aspects of a human developmental stage and it might gift us with a foundation for understanding and supporting the complex shifts of a woman’s inner and outer worlds.
IMPLEMENTATION OF FINDINGS IN CURRENT PRACTICE
According to Dooley Hussmann’s research, “maternal postpartum mental health has primarily been viewed using a medicalmodel focused on diagnosing negative symptoms, while little attention has been given to maternal resilience, strength, or holistic mental health, including positive emotions, growth, and coping” (2020). As previously explored, mother’s natal care, as practiced nowadays, is mostly focused on the development of the baby. A matrescence-informed model of care would take into consideration the development of the new mother.
Supporting new mothers as matrescents would mean moving out of a biomedical model into a biopsychosocial one where women and maternal care providers view new mothers more holistically as transitional beings and within a challenging context that requires from them adaptation and growth. Kuipers and colleagues stated that “(…) support should ideally include the dialogue about transition and adaptation of the maternal identity and maternal role attainment (...) what motherhood means to each woman on an individual intra and interpersonal level” (2019). Sandford suggests that the inner journey of matrescents is about the “process and work of becoming subjects once again”, of recovering their protagonism, as they struggle with lack of agency and choice and find difficult to give meaning to their experience (2012). Conceivably, a matrescence-informed care would foster self-determination to empower women and support them as the leading agents in their transition.
CONCLUSION
While assessing the mainstream maternal care approach, it is possible to conclude, even though addressing pathologies is a necessity, support should go beyond. The becoming of a mother is a transitional phase; a complex and meaningful human developmental stage which imposes physiological, emotional, psychological, social, cultural, and spiritual challenges, putting a woman’s ability to cope and to adjust to the test. Maternal mental health and wellbeing practice to support the birth of the mother would ideally mean adopting a matrescence-informed care: a person-centred, strengths-focused, collaborative and nonjudgemental practice for increasing women’s protagonism and self-advocacy and aimed at positive change, optimal adaptation, human development.
BIBLIOGRAPHY
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