Centering around pregnancy, Part One: Appreciating extreme changes

Starting point for a three part series examining physiological flux as it relates to stress (broken up in order to prevent brain leakage)

adapted from art by: Oksana Horiun

A primary focus of the Maternal Stress Project is to map the stressors that modern American mothers face. It's hard to change what we cannot fully see. 

For now, the stressor map centers around the window of time from just before pregnancy through birth and into early parenting.

Mapping the web of stressors related to modern American motherhood

While a full maternal stressor map could—and should—extend out in both directions, there are good reasons to start with pregnancy. For one thing, the pregnant body is absolutely incredible and any chance I have to highlight that, I will gladly do so.

To be a bit more technical about it, there a several good reasons to start here:

1. There is a concentration of stressors directly related to this stage of life: fertility, perinatal care journey/access, sleep, workplace discrimination, social narrative, birth trauma, breastfeeding/feeding decisions… just to name a few. 

2. This is a period of extreme physiological flux. 

3. This is a period of extreme physiological flux that is frustratingly understudied.

4. This is a period of extreme physiological flux where the body going through the fluctuation deprioritizes itself in favor of the second human body it is working to build… and so does the outside world.

I had planned on making you, dear reader, suffer through one very long post interweaving the above reasons, but had a gentle reminder from my collaborator,

Chelsea Conaboy

that you might all turn against me if I didn’t keep it light. So, for the sake of your inbox, this meaty topic will come ‘atcha in multi-part series: 

Part 1 – (the teaser below) – Appreciating the extreme physiological flux of pregnancy 

Part 2 – Why does physiological flux matter?

Part 3 – What does the physiological flux have to do with stress?  

Bonus post – Molly and Chelsea debate whether or not pregnancy, itself, is a stressor

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Part one: The physiological flux of pregnancy and postpartum  

If I had my way (and maybe this will happen someday¹), every student remotely interested in human biology will have an entire course about pregnancy physiology. We can even make it more appealing by calling it “Physiology: EXTREME” and have some lightning bolts and sound effects and make all the college kids clamor to study the inner workings of the human body. It really is that cool. 

During pregnancy, the body experiences some of the most dramatic hormonal, neurological, metabolic, immune, and cardiovascular changes it will ever experience in its lifetime. The uterus stretches and gently cradles a growing fetus and then transforms into the most powerful muscle in the human body and kicks that baby out. The pregnant body grows a new freakin’ organ… and then trashes it (love you, placenta). Our immune system turns a blind eye to a parasitic foreign object for nearly TEN MONTHS. Our cardiovascular system remodels arteries in order to do a job it has never done before. The brain becomes plastic². Just to name a few.

And after the thrilling conclusion of growing and birthing an entirely new human, this amazing body is expected to return to its day job like it's no big deal. Oh, and produce food. And make sure the helpless little critter it just expelled doesn’t die. 

That is incredible. 

Why the incredible, ⚡️EXTREME⚡️ physiological shifts during pregnancy are relevant to the topic of maternal stressors and health will be discussed in the next posts.

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A starting point 

Yes, not every parent and caregiver will go through pregnancy, and there are other periods in the reproductive lifespan where a cycling body is in physiological flux. Especially in the cases of perimenopause and menopause, these moments of flux also annoyingly align with specific gendered and caregiving-related stressors (e.g. those related to caring for aging parents/family members, age-ism, etc.).

While I am very interested in expanding the map in both directions outside of the ‘to and through early parenting’ stage (honestly, the perimenopause -> menopause + stage deserves its own map!) I am starting here. 

As noted in the “But what about the children?” post, beyond simplicity, starting with pregnancy relates to the following thought I keep coming back to: 

Pregnancy is lovely. Motherhood is beautiful. We need mothers to survive and stay healthy for the sake of their children. I am starting to think that this view is what has stymied interest in general women’s health. Case in point: perimenopause+menopause. Perimenopause/menopause is another critical inflection point for women’s health in the reproductive lifespan. This point is even less researched and less supported medically and culturally. I have a theory on this — when it is just a woman’s body, a cycling body, that is changing, it does not register with the same level of importance as when there is a sweet, innocent baby to swoop in and rescue. Maybe if we continue pushing a reframe of the easy one, pregnancy, as an adult health issue, we will more readily acknowledge a child-agnostic stage, such as menopause, as an important health consideration as well.

I will also circle back on this at the end of Part Three in the series. 

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Next post: 

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1. Yep, I already have a course description for this. It WILL happen someday!

2. ok, there is always a little bit of plasticity in the adult brain but this time of life is ⚡️EXTREME!⚡️. For those interested in the science of the maternal brain, definitely check out Jodi Pawluski's work and her podcast, Mommy Brain Revisited, and/or Chelsea's awesome book, Mother Brain.