9.4: Parenthood

Learning Objectives

1. Define the fourth trimester.
2. Describe the physical, emotional, and psychological adjustments experienced by mothers during the postpartum period.
3. Differentiate between the “baby blues” and postpartum depression
4. Explain the evolving role of fathers in prenatal and postnatal care.
5. Identify common challenges that couples face during the transition to parenthood.

The postpartum period, often referred to as the "fourth trimester", marks the transition to parenthood. The transition to parenthood is one of the most profound life changes individuals and couples experience. It involves redefining identities, relationships, and responsibilities as they adapt to the arrival of a new baby.

Becoming Parents

Motherhood

The journey of becoming a mother begins with the physical and emotional changes of pregnancy and continues through childbirth and beyond. This transition is filled with a range of emotions, both positive and negative. Mothers experience changes to their identity and role, which are shaped by their values, cultural norms, and societal influences. There is a perception that after a baby is born, a new mother will instinctively know what to do. This is seemingly supported by biology. Sex steroid hormones, progesterone and estrogen, as well as surges in oxytocin, change the structure of the new mother's brain in areas that are associated with empathy, emotion regulation, emotional sensitivity, and attachment. These changes help mothers feel more attuned to their baby's cues and respond to their needs, in turn promoting a stronger parent-child bond (Kim et al., 2016).

Figure \(\PageIndex{1}\). Skin-to-skin contact helps both mothers and newborns bond. Image is licensed CC BY-SA 2.0.

However, for many first-time mothers, learning to change diapers, be comfortable with feeding, soothing a crying baby, all while feeling exhausted and overcome with the hormonal changes postpartum, can take weeks or months to adjust. Many mothers experience the “baby blues,” a transient emotional state characterized by mood swings, weepiness, irritability, and feelings of overwhelm. Baby blues typically begin a few days after delivery and subside within two weeks. This condition is believed to result from the rapid hormonal fluctuations following childbirth, coupled with the demands of caring for a newborn and sleep disruption.

In contrast, postpartum depression (PPD) is a more severe and persistent mental health condition that affects up to 15% of mothers (American College of Obstetricians and Gynecologists [ACOG], 2021). Symptoms of PPD include prolonged sadness, loss of interest in activities, feelings of worthlessness or guilt, difficulty bonding with the baby, and even thoughts of self-harm or harming the baby. Unlike baby blues, PPD requires medical attention, and treatment may include therapy, medication, or a combination of both.

Fatherhood

The transition into fatherhood begins well before the baby is born. Fathers play a critical role in prenatal and postnatal experiences, contributing to the well-being of both the mother and child. Fathers actively prepare for the birth of their child in various ways, including attending prenatal appointments, childbirth education classes, and supporting their partner's physical and emotional needs. Many fathers engage in reading books, consulting healthcare providers, and seeking advice from experienced parents to build confidence and knowledge about the birthing process and caregiving (de Montigny & Lacharité, 2016). This preparation often enhances the father’s sense of involvement and helps lay the foundation for a strong co-parenting relationship.

Figure \(\PageIndex{2}\). Fathers also undergo significant emotional and cognitive changes after the birth of a child. Image by Ian D. Keating is licensed CC BY 2.0.

While much of the attention during the postpartum period focuses on the mother and baby, fathers also undergo significant changes. Many fathers experience a sense of joy and fulfillment as they bond with their baby. Fathers may choose to engage in skin-to-skin contact, bottle feeding, diaper changes, and playtime routines to help establish the father-child connection. Research shows that oxytocin, a hormone associated with bonding, increases in fathers during the early months of their child's life, reinforcing emotional attachment (Feldman et al., 2010). However, some fathers may also encounter stress or feelings of inadequacy, particularly if they struggle to balance work and family life or adjust to new routines.

Some fathers experience a phenomenon known as paternal postnatal depression (PPND), a condition characterized by sadness, irritability, and withdrawal. PPND is often linked to stress, changes in routine, and difficulty adjusting to the demands of fatherhood. Like maternal postpartum depression, PPND is treatable with therapy, support groups, and, in some cases, medication.

Becoming a Family

The transition to parenthood often brings significant challenges, as couples navigate shifting roles and responsibilities while adjusting to their new identities as a family. Some of these challenges include, but are not limited (Levine & Munsch, 2024):

• fatigue and exhaustion
• depression, anxiety, and/or self-doubt
• concerns over changes to physical appearance for women,
• family finances,
• increase in household responsibilities,
• changed relationships between parents and extended family,
• sources of gratification.

Figure \(\PageIndex{3}\). New parents celebrate the arrival of their baby in the Maternal/Newborn Ward at Naval Hospital Yokosuka. Image is in the public domain.

These challenges are deeply influenced by cultural norms, which shape expectations about parenting roles and family dynamics. In many Western cultures, the transition is often characterized by the need to balance work and family life, with growing societal emphasis on shared parenting. Both mothers and fathers may struggle with the pressures of meeting these expectations while managing sleep deprivation, reduced personal time, and the emotional and physical demands of caring for a newborn (Dermott & Miller, 2015).

In collectivist cultures, the transition to parenthood is often supported by extended family networks that provide both practical and emotional assistance. However, this communal approach can also bring challenges, such as navigating differing generational views on parenting practices or balancing the expectations of elders with the couple's personal preferences. Fathers in these cultures may feel pressure to fulfill traditional roles as providers, while mothers may encounter societal expectations to prioritize caregiving and domestic responsibilities (Kim & Hong, 2007). Despite these differences, the transition to becoming a family universally requires couples to renegotiate their relationship, adapt to new demands, and find a balance between cultural expectations and their own values.

References, Contributions and Attributions

American College of Obstetricians and Gynecologists. (2021). Postpartum depression. Retrieved from https://www.acog.org

de Montigny, F., & Lacharité, C. (2016). Fathers’ perceptions of the immediate postpartal period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 33(3), 328-339. https://doi.org/10.1177/0884217504266075

Dermott, E., & Miller, T. (2015). Modern fatherhood: Emotional and caring roles of fathers. Family Matters, 96, 24-31.

Feldman, R., Gordon, I., Schneiderman, I., Weisman, O., & Zagoory-Sharon, O. (2010). Natural variations in maternal and paternal caregiving and the oxytocin system: Effects on parent and child. Psychoneuroendocrinology, 35(8), 1133-1141. https://doi.org/10.1016/j.psyneuen.2010.02.013

Kim, J. K., & Hong, S. (2007). Paternal roles in East Asian families. Journal of Family Studies, 13(4), 456-470. https://doi.org/10.5172/jfs.327.456

Kim, P., Ho, S. S., Evans, G. W., Liberzon, I., & Swain, J. E. (2016). Neural responses to baby-cry and maternal love: A review. Social Neuroscience, 11(1), 1-10. https://doi.org/10.1080/17470919.2015.1065240

Levine, L. E., & Munsch, J. (2024). Child development from infancy to adolescence: An active learning approach (3rd ed.). SAGE Publications.