When it comes to pregnancy and postpartum, there is a profound lack of support in the United States, unseen in other developed nations. The lack of support women have in the transition into motherhood, sometimes referred to as matresence, similar to adolescence, places women at increased risk for mental health disorders specific to pregnancy and postpartum.
These disorders, otherwise known as perinatal mood and anxiety disorders (PMADs), include not only postpartum depression but also postpartum anxiety, postpartum OCD, postpartum PTSD, postpartum bipolar disorder, and postpartum psychosis.
Pregnancy and postpartum, like puberty, involve significant biological changes, particularly the postpartum period, which is the most significant hormonal shift a person can experience. However, this is also a period that involves a host of psychological and social stressors.
Matresence, like adolescence, is a time of transition, not just hormonally but on many levels; this makes it a psychologically vulnerable time in which PMADs. And yet, women are not receiving the support they need to reduce the likelihood of developing PMADs, for example, parental leave, which is a protective factor against the development of PMADs.
Additionally, there is often a romanization of motherhood that contributes to the guilt and shame women can experience when struggling with the often difficult realities of pregnancy and postpartum. The romanticization of motherhood can lead women to believe there must be something wrong with them when, in fact, even if a woman is not experiencing PMADs, motherhood can be immensely difficult.
Acceptance and commitment therapy (ACT), which was developed in the 1980s by Steven C. Hayes, Kelly Wilson, and Kirk Strosahl, has a tremendous amount to offer mothers.
PMADs are the number one complication associated with pregnancy and postpartum. Acceptance is needed here, but acceptance does not mean resignation or inaction. Acceptance supports action. Accepting difficult realities allows mothers to identify and engage in actions to advocate for what they need, like improved maternal health care, paid leave, and affordable childcare.
In addition to acceptance, mindfulness is another central process in ACT. Mindfulness can help mothers gain awareness of the stories they have internalized about themselves. By helping mothers gain awareness of the stories they have been told about themselves, they can defuse or “unhook” from these self-limiting and harmful narratives. Take “mom guilt” for example. This kind of guilt often results in mothers neglecting themselves and their own needs, leading to things like “mom rage.” ACT can help mothers gain awareness of their emotions and take appropriate action. In this case, not being fused with thoughts such as “I am being selfish” or being controlled by feelings of guilt such that they inhibit themselves from practicing self-care.
Compassion is another powerful tool for mothers. Not only are the ideals about motherhood unattainable, but everyone falls short of their values. It’s a part of the human experience. We are not perfect people. We are not perfect parents. ACT helps mothers have compassion for themselves when they have fallen short of their values as parents.
The things we care the most deeply about can cause us the most pain. If it feels like you are constantly failing, it is because you care. Acceptance, mindfulness, and compassion can help women allow themselves to be imperfect people while committing to showing up as the mothers they aspire to be, knowing that they will never entirely get it right.