Motherhood: a natural progression and a major transition

For all women pregnancy and the birth of a child represents a time of change, in identity and role, as well as physiology. It is also a time of emotional change which for some women may be experienced as a substantial upheaval and for others as more of a change in the balance of emotions (Green, 1990). Since its inception, many of the papers published in the journal have explored these issues using a range of methodologies and some of those in this edition have also chosen this area on which to focus.

The loss of pre-pregnancy self and the gradual, but dramatic changes in maternal shape and size in the course of pregnancy, the associated changes in body image (Clark et al., 2009) and the images provided by ultrasound examinations all present women both with the physical evidence of what is happening and function as drivers for psychological adjustment to and reassessment of their new situation. The birth experience, associated interventions and the new baby itself are similarly markers of further transitions and drivers for yet more change and adjustment.

Becoming a parent for many women is hugely enjoyable and a reason for pride, despite the routine needs of infant and childcare (Green & Kafetsios, 1997), while for others it is more of a struggle, depending on individual circumstances, resources, the quality of the partner relationship and wider social and emotional support. Adjustment to pregnancy, potential parenthood and becoming a parent takes time. The pathways to motherhood are individual ones, and the timing too, although there are commonalities and some generalisations that can be made.

While women react in different ways, minorities become anxious or depressed and some are both anxious and depressed, although the majority are neither of these things. However, mood changes are common and are likely to have a variable time course. Pre-existing mental health problems are associated with their continuing or re-occurrence during pregnancy and postpartum. For some women there is also a marked change in physical health and well-being, with somatic and other health symptoms more commonly occurring in different age groups (Klemetti, Kurinczuk, & Redshaw, 2011).

The way that motherhood is valued in any society impacts on how women see themselves and how others react to them. In many societies motherhood is seen as an essential and natural development and is associated with identity as an adult. For women who are childless by choice, the perception is commonly that are not doing what is expected for selfish reasons and that that they will remain unfulfilled (Woollett, 1991). Women who are not childless by choice and who may have sought help with their situation are perceived as having ‘failed’ in being able to take on this key responsibility.

For women who do have children, apart from the psychosocial issues fundamental to taking on this new role, changes in the couple relationship and the pleasures and frustrations of being a new mother, there are other issues arising from the way that the work of childrearing is perceived, the need for income arising from paid work and the changes in status and career development possibilities that are associated with having and caring for young children.

It would be very unadaptive if women having their first babies somehow, through their own resources and with the help of family and other social support, did not manage to cope during pregnancy and following the birth of their first baby. ‘Bonding’ is not the instant process that many new mothers worry about; rather, there is evidence that it involves a process of mutual adjustment and learning for both partners that takes place over time, with considerable variation in the way that mothers become attached to their infants and later infants to their mothers (Stern, 2004). However, it is important that their needs should be recognised and where possible addressed, to support them directly in their changing circumstances, but also in facilitating the developing maternal–fetal and then mother–child relationship and early parenting (Deave, Johnson, & Ingram, 2008).

Some of these fundamental issues are explored in the papers published in this edition of the journal. Several papers address changes and adjustment in pregnancy: Hausenblas and colleagues’ study explores pregnant women’s beliefs and behaviours with regard to activity and Kazmierczak and Goodwin investigated pregnancy and body image, anxieties and more positive emotions and self-esteem during late pregnancy. A quantitative paper by Trillingsgaard and colleagues looks at the nature of adult attachment relationships antenatally and postnatally and how that fits with becoming a mother, emphasising how these may point to the way in which individuals cope the challenges of the transition. Another paper by Mason, Briggs and Silver looks at postnatal adjustment in relation to emotional well-being at several time points, mother–infant attachment, maternal stress and social emotional outcomes for infants. Qualitative papers on the experience of first-time motherhood by Cipoletta and Balasso and that of Olivari and colleagues on health professionals’ experience of working with pregnant teenagers and concerns about precocious pregnancy and the need for emotional and practical support during pregnancy and afterwards remind us about what is needed for new mothers at this time and about the implications for care and practice.

Other papers focus on responses to less common but very significant experiences of the transition to parenthood that fewer parents undergo: the impact of preterm birth on maternal well-being was explored by Goutaudier and colleagues and the emotional reactions of parents, mothers and fathers, to the diagnosis of a congenital anomaly both before and after birth is investigated by Fonseca, Nazare and Canavarro. Both types of experience throw light on the psychological processes associated with what it means to become a parent, a mother or a father and the individual nature of transition is emphasised. The paper by McManus and Nugent describes the way in which parents of high-risk newborns can be targeted and supported in the early days with a simple intervention that is infant-focused and behaviourally based.

Becoming a mother is a natural process and at the same time a normal life event that is marked by a major transition that is multifaceted in its impacts. The way in which individuals prepare themselves, their prior views, mental health, attitudes and expectations, how they behave and feel in the process and how they appraise or see themselves subsequently is an important area of study which researchers continue to address.