Women in Pregnancy need time to adapt to a new role of Motherhood. Let’s ask the Government to support this.
Mental resilience and healthy bodies are the result of a good start in life, when a baby is loved and talked to and respected. The first 1,000 days can shape a child’s future. We have one chance to get it right. The website of Unicef says “Early Moments Matter”.
The foetal brain can be sensitive to maternal stress (or alcohol) all through pregnancy. For the first 20 weeks, the neurones are migrating to their final position. But in the second and third trimester, neurones are starting to make links and synapses with each other, forming pathways. Thus, there can be environmental effects from the mother all through pregnancy, but what these effects are differ at different stages.
The last few months of a baby’s time in the womb are the critical ones for the number of connections which form between the brain cells or neurones in the brain. Our genes control the chemicals which encourage the direction and growth of the neurones to make connections, or synapses, with other parts of the brain. Successful connections are strengthened, and unsuccessful connections lead to the neurones dying away (so-called neurone pruning). Alcohol, drugs or stress-induced cortisol are very likely to damage some of the normal formations. The result can be behavioural, emotional and cognitive problems, as well as physical (Gangophadhay, 2016, Schore, 2017). Sensitive early mothering can reverse the effects to some extent, but if the babies’ environment doesn’t improve, this is going to be more challenging.
In New Zealand, the Dunedin research project, following 940 children from age 3 through to age 38, (Caspi et. al., 2016) found that a single factor, poor brain health at age 3, was an early statistically significant predictor for high-cost economic burdens on the state (criminal convictions, hospital bed nights, prescription costs etc.) 35 years later. The components of the brain health index were verbal comprehension, language development, motor skills and social behaviour.
Since synapses form in the baby’s brain as early as in the second trimester, increasing during the last 2 to 3 months of pregnancy, poor brain health at age 3 will include any damage occurring before birth as well as the risk factors studied in the Caspi study, which included ACE’s in the first few years of life. The devastating effects of Foetal Alcohol Syndrome are widely known. Not so well known is the effect of stress on the mother, and the increase in cortisol which goes through the placenta. For a mother expecting her first child, stressful relationships at work or in the home, or anxiety caused by preparing to take Maternity Leave, can make life very stressful. There may be anxiety and pre-natal depression in about 14% of expectant mothers (Glover, 2015). Other situations causing high levels of stress which might happen at this time include moving home, family bereavement or even marital disharmony and break-up.
When stress causes changes in our brain’s chemicals, the laying down of the connections or synapses in the baby will be affected. In contrast, when parents have the time to talk to their bump and take steps to prepare for the arrival with excitement, their oxytocin is helping their baby’s brain to grow.
I am suggesting that it should become the norm (by choice rather than mandatory) for our mothers-to- be to reduce their full-time hours to around 20 hours per week at 6 months pregnant. The mothers’ gradual slowing down at work, through a drop in hours, would be recompensed by the Government as a “brain-building grant”, in addition to the current standard Maternity Pay, taken at 4 weeks before the planned due date. The employer would employ the replacement maternity-cover employee to overlap and begin at the time of the start of the brain-building grant. In several European countries it is mandatory to take 8 weeks off before the expected birth date (European Parliament). In contrast, in the UK, mothers are entitled to take up to 11 weeks of their paid maternity leave before the birth (losing those weeks after the birth), but it is non-mandatory. This results in mothers taking as much as possible of their leave after the birth. A flat-rate or blanket grant for all mothers to reduce their work hours down to 60% or less, at least 4 weeks before the birth could be based on 40% of the average UK male wage (for instance 2 months = £2,200 in 2021). It should be the same for all infants, and not dependent on their mother’s salary.
Mothers would have time to meet up with other mothers-to-be and mothers-of-babies to make friends in their area. Their workplace would have time to find employees to learn the role and cover for the mother on Maternity Leave. The expectant mother would have time to bond with her unborn, to sing, laugh and love, to think about the couple’s future life bringing up their family, and to form networks within her community. All this will help to build her baby’s brain, and also build her baby’s physical and mental health for the future. It will also be good for the mother’s own mental health, by giving her time to adjust to her new role and reduce post-natal depression. The expenditure on brain-building grants will be more than paid back in the future, by improving the health of the nation, reducing heart disease and diabetes and improving the outcomes for children.
We need to petition our Government to kick off with a brain-building grant. This should be followed up with a joined-up approach focussed on children under 3 and their families. It could include Children’s Centres, Health Visitors, reducing taxation on single-income families with young children and financial support for all during pregnancy and the first 3 years.
Dr Elizabeth Bland