January 19, 2021

By Emeline Mugisha, M.S.N., M.P.H., R.N

The majority of first-time moms (64-82%) experience a decline in cognitive abilities, like thinking and remembering, during or after pregnancy. For some, this can have a significant impact on everyday life. While studies confirm that your body undergoes enormous changes during the child-bearing process, very little is known about how pregnancy affects the human brain and its cognitive health.

So, is ‘mommy brain’ real? The science is lacking, but we’ll break down what we do know.

What are the symptoms of ‘mommy brain’?

Cognitive function refers to various mental processes that we use every day to learn, remember, think clearly, and manage daily life. Certain areas of the brain are responsible for different cognitive abilities. ‘Mommy brain’ refers to self-perceived, negative changes in cognitive function that occur among women who are currently or recently pregnant.

Symptoms of ‘mommy brain’ include:

• Memory problems
• Poor concentration
• Forgetfulness
• Confusion or disorientation
• Reduced motor coordination
• Deficits in executive functions (such as attention)

When asked about their symptoms, moms most frequently report forgetfulness. Additionally, women report a variety of real-world consequences of ‘mommy brain,’ including:

• Impaired ability to hold a conversation at work and home;
• Greater reliance on note-taking for organizing work and home commitments;
• Frequent forgetting of appointments;
• Difficulties with reading comprehension; and
• Inability to return to work because of severe memory problems.

'Mommy brain' is often seen as a cultural phenomenon because there is much that we still don't know and other factors that may explain the mental fog associated with motherhood. Furthermore, objective confirmation of ‘mommy brain’ is inconsistent across studies. While some studies report negative cognitive changes during pregnancy, some report little or no modifications. However, results likely vary because of different testing approaches (including brain regions, brain measures, sample sizes, and time frames during and after pregnancy).

What happens to the maternal brain during and after pregnancy?

Based on existing data, there are no clear answers about what happens to the maternal brain during pregnancy and after birth. Most experts think that neuroplasticity and neurogenesis play a role. These processes are ways that your brain may adapt to the experience of motherhood. Neuroplasticity involves ongoing brain changes throughout your life in response to stimuli from new experiences. Neurogenesis is a process of brain growth that is responsible for new learning.

Though research about ‘mommy brain’ is growing, it remains limited and inconsistent for several reasons. First, scientists are only beginning to understand how pregnancy and motherhood impact the human brain. Second, human studies are difficult to conduct due to strict guidelines around magnetic resonance imaging (MRI) during pregnancy and, understandably, the reluctance of pregnant women and mothers who have recently given birth to undergo voluntary MRI testing. Furthermore, studies largely depend on self-reports, which can often be less reliable.

There is a consensus among the few imaging studies that decreases in brain measures such as size and tissue volume can occur during pregnancy. However, little is known objectively about the nature or prevalence of these changes. Additionally, there is no conclusive evidence that alterations such as a change in brain size lead to a loss of function in all cases.

Furthermore, while decreases in maternal cognition and memory may also occur during pregnancy, the effects seem subtle and temporary. For example, a 2018 Australian study found that pregnant women performed worse than non-pregnant women on general cognitive functioning tests, memory, and attention, particularly in the third trimester. However, the differences were small and did not significantly impact everyday functioning.

Research on what happens after pregnancy also reveals inconsistent findings: While four studies suggest that some areas of the brain grow and experience less aging, a 2016 study in Spain reported brain shrinkage among first-time moms that lasted for at least two years. Shrinkage in some areas seems to support the transition to motherhood (for example, mother-to-infant attachment), while others impact brain structures important for memory.

Most recently, a 2020 study in the U.S. sought to objectively test long-term effects on maternal attention by comparing reaction times between moms at least one year postpartum and non-mothers. The study found no deficits in overall attention between moms and non-mothers and greater executive control attention (which helps resolve conflicting information) among mothers.

What factors during and after pregnancy might explain ‘mommy brain’?

Several other factors may affect cognitive function among moms. For example, after you give birth, your body experiences both sleep deprivation and various hormonal changes that can affect memory and attention. Additionally, stress from interactions with others and transitions in your social environment can impact cognition. As a mom, you may also feel overwhelmed or unsupported at times, which may, in turn, cause you to feel more distracted and forgetful.

All of these changes and feelings are normal, providing both an explanation and hope that they resolve. To help relieve symptoms of ‘mommy brain,’ it's essential to take a step back, consider all the new responsibilities you are juggling, and create a self-care plan that is most life-giving for you. Self-care may look like getting more sleep, taking care of your body, or speaking with a healthcare provider if your symptoms impair your quality of life and everyday functioning.

Sources:

Davies, S. J., Lum, J. A., Skouteris, H., Byrne, L. K., & Hayden, M. J. (2018). Cognitive impairment during pregnancy: a meta-analysis. Medical Journal of Australia, 208(1), 35-40. https://doi.org/10.5694/mjal7.00131

Hoekzema, E., Barba-Müller, E., Pozzobon, C., Picado, M., Lucco, F., García-García, D., Soliva, J. C., Tobeña, A., Desco, M., Crone, E. A., Ballesteros, A., Carmona, S., & Vilarroya, O. (2017). Pregnancy leads to long-lasting changes in human brain structure. Nature Neuroscience, 20(2), 287–296. https://doi.org/10.1038/nn.4458

Luders, E., Kurth, F., Gingnell, M., Engman, J., Yong, E. L., Poromaa, I. S., & Gaser, C. (2020). From baby brain to mommy brain: Widespread gray matter gain after giving birth. Cortex, 126, 334–342. https://doi.org/10.1016/j.cortex.2019.12.029

Miller, V., VanWormer, L.A. & Veile, A. (2020). Assessment of attention in biological mothers using the attention network test - revised. Current Psychology. https://doi.org/10.1007/s12144-020-00826-w



Emeline Mugisha, M.S.N., M.P.H., R.N. - Emeline Mugisha is an award-winning, master's-prepared nurse with over a decade of experience in community/public health and clinical health services at the field and management levels. She has co-authored two professional manuscripts in Women's Health Issues and the Journal of Midwifery and Women's Health. She has an M.S. in Public Health Nursing and an M.P.H. from Johns Hopkins University.