Matrescence - the transition into motherhood

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Dr. Alexandra Sacks, MD is a reproductive psychiatrist affiliated with the Women’s Program at the Columbia University Medical Centre.

A leading expert in “matrescence,” she is known for popularising the concept in her TED talk with over 1.2 million views worldwide, and in her New York Times article “The Birth of a Mother,” the number one most read piece of 2017 for the “Well Family” section.

Dr. Sacks has coauthored a book What No One Tells You: A Guide to Your Emotions From Pregnancy to Motherhood which will be published in April 2019.


Episode highlights

  • Dr. Sacks noticed a pattern where women who thought they had postnatal depression didn't, in fact, meet the clinical diagnostic criteria, yet they were not feeling well. Dr. Sacks explained that what they were describing was the natural transition to motherhood – sleep deprivation – hormonal shifting, social structures – the changed relationship with their partners – financial change – professional change after a maternity leave – changes in body/minds.

  • Dana Raphael coined the term “matrescence” which encompasses all of these things.

  • The transition to motherhood includes a physical, mental and social change. Prefix is maternity/mother – sounds like adolescence – not coincidence – the analogy is apt. Women when told about it experienced tremendous relief in Dr. Sacks’ practice. Once they were told it was normal they did not feel as concerned or alone as they realised other mothers were feeling this too.

  • Antidepressants are the most common form of medication for women of reproductive age.

  • Why now for the attention on “matrescence”? Within medical community doctors treat disease. Not much discussion over what it feels like to be a healthy human – even if uncomfortable. Need to have more of a discussion around this. Not enough discussion on natural prevention and wellness.

  • Binary between postpartum depression or sailing through – grey area transition in between is not talked about – it may be good AND bad – doesn't have to be one or the other. It is easier for the mind to compartmentalise – good mother and bad mother but human experiences are much more in the grey rather than binary.

  • The push and pull of motherhood - feeling ambivalent.

  • The need to take care of your own needs as a mother. When we cut out activities that bring us pleasure we are setting ourselves up for depression – our nervous system needs to experience JOY in order to stay healthy and integrated and to tolerate stress – to stay hopeful in times of stress.

  • The difficulty in preserving your own identify as a mother.

  • Mother guilt – something Dr. Sacks talks about everyday in her practice. Consequence of push and pull – wish you could be unconditionally giving – society tells us that we should.

  • Children are designed to live in the natural world – not designed to live in a world where all their needs are catered for forever and ever.

  • Dr. Sacks discusses that to mother a healthy child we need to tolerate them having their own independence – this is much more facilitated if you can hold onto your own independence – not healthy for the mother, or the child, for the mother to give up all of her own identity.

  • Self care is not optional – it is not for us to judge if selfish or self preserving – it is not optional. Dr. Sacks noted mothers are human beings not robots.

  • The perfect motherhood is not available to us – we can only strive for “good enough”. Donald Winnicott coined the phrase good-enough mother – human beings are not perfect and we don't have perfect relationships - we have flawed relationships – that is all we need to build a satisfying life. Our children don't need us to be perfect – it is not a good model.

  • The benefits of preparing for postpartum in pregnancy.

  • The social isolation which comes with postpartum body issues. Alison talks about her uterine prolapse and the need to open the conversation around these issues so mothers do not feel alone.

  • Matrescence can be experienced differently each time you have a new baby whether that be the second or third child as you have never had a baby and an older child before.

  • The power of emotional connection by telling you story - psychotherapy has demonstrated brain changes in neural imaging - central to human experience and opens up conversations where we learn things about other people- see the #motherhoodunfiltered movement which Dr. Sacks started on social media.

  • Physical injuries - athletes aren’t afraid to talk about a shoulder that doesn’t work but women become embarrassed to talk about health issues associated with birth - haemorrhoids, prolapse etc - sense of shame about their bodies. Virgina Monologues started because of an embarrassment of using the word Vagina. Labour and delivery is a marathon just like being an athlete.

  • We need to normalise the language which is used around birth. So women feel less stigma and shame.


Relevant links

The website for Dr. Sacks can be found here.

Dr. Sacks’ TED talk is available below

Dr. Sacks’ book What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood  can be preordered now, with a due date for April 2019. 

You can follow Dr. Sacks on social media here:

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@AlexandraSacksMD on Facebook

@Alexandra_Sacks on Twitter

@AlexandraSacksMD on Intagram