The Impact of Postpartum Depression on Mother-Child Attachments

Writer: Greily Rodriguez

Editor: Eishah Malik and Samantha Rodriguez

Postpartum depression poses a disruption in mother-child attachment by impairing the maternal response to the child. It affects 10-15% of women, posing a barrier to the child’s development and the relationship between mother and child (Brummelte & Galea, 2015). Maternal attachment is essential to the maturation of the infant’s skills, and depressed mothers often display an insecure attachment towards the child that can result in adverse child outcomes (Brummelte & Galea, 2015). An insecure attachment between a child and mother can lead to a profound emotional disconnection that would greatly affect the mental health of both, even resulting in a depression diagnosis for the child. Women are more likely to develop depression in comparison to men (Brummelte & Galea, 2015). Therefore, alongside the multiple hormonal changes that arise during pregnancy, it is possible to deduce that they could potentially trigger a change that could negatively impact the pregnant mother’s mental health. Steroids and peptides, like cortisol, estrogens, progesterone, and oxytocin, dramatically fluctuate during the reproductive years, especially during pregnancy and the postpartum period (Brummelte & Galea, 2015).

There is a relationship between what could be a prenatal disposition to depressive symptoms, or a depressive diagnosis, and a postpartum depression diagnosis, or symptoms. The pregnant mother begins to distinguish herself from the fetus at about the 18th to 25th gestational week, when she can feel the fetus’s movements (Kaydırak et al., 2021). There is already an attachment happening as she bonds with the fetus by caressing her belly or calling out the baby’s name. This becomes a key developmental process that improves the bond between the pregnant mother and the child (Kaydırak et al., 2021). Failure to form this prenatal bond between the mother and the child can result in further consequences that can be carried out in the postpartum stage.

Through a non-invasive Functional Magnetic Resonance Imaging (fMRI), an approach has been studied to see how the brain systems can be affected in women during late-stage pregnancy to 18 months postpartum, to know the activity that could be occurring and disrupting the attachments needed (Pawluski et al., 2017). The first stage was to analyze the mother’s brain in a resting state that occurs without any external stimulation, focusing on the regions where a behavioral dysregulation like depression can be underlying (Pawluski et al., 2017). The core associated with a resting stage is seen differently in postpartum women who experience depression (Pawluski et al., 2017). The cortex has less activity in a resting stage in the left frontal lobe as opposed to an increase in activity in the right, marking a comparison between postpartum mothers who experience depression and postpartum mothers who do not experience depression (Pawluski et al., 2017). Other studies report that at rest, women with postpartum depression would have decreased corticocortical and corticolimbic connectivity, showing a weaker connectivity among the amygdala, anterior cingulate cortex, dorsolateral prefrontal, and the hippocampus (Pawluski et al., 2017). This significant difference in neural activity would have been very important for self-regulation, empathy, and emotion (Pawluski et al., 2017). By not having this connectivities, pregnant mothers who experience depression develop a disconnect from their child that not only leads to an insecure attachment but also to an inability to self-regulate when it comes to the child’s demands, having empathy towards their child’s hurting, or any type of an emotional attachment that would create a significant bonding between the two; a bonding that is supposed to be filled with love but is instead filled with deep insecurity.

Centering the neuroendocrine systems, experimental studies with animals have provided evidence of the involvement of oxytocin and vasopressin in the formation of attachments, tuning the nervous system towards sociality, emotional regulation, and aggression (Carter, 2017). A theory is therefore proposed: an infant’s attachment to the mother could be learned through operant conditioning mechanisms that would affect the infant’s nervous system. (Welch & Ludwig, 2017). Oxytocin would be included in the mother and infant as a co-regulator of emotional connection or disconnection, with the autonomic co-conditioning learning mechanism being exploited negatively (Welch & Ludwig, 2017). However, at the same time, it can be exploited to turn it into a positive mechanism (Welch & Ludwig, 2017).

Therefore, when investigating and manipulating mother and child attachment due to postpartum depression, it is very important to consider all of the factors and aspects that are affecting this bonding.