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The authors researched pregnancy and the transition to parenthood, this is a period with neurobiological and psychosocial changes that may have implications for the health of women and their babies. The authors are writing about neuroimaging and psychophysiological changes in brain structure and function during the peripartum period, as well as structural and functional changes in the brain during pregnancy and into the postpartum period.

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Mommy Brain- But first let me take a nap (Informal)

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Mommy Brain- But first let me take a nap (Informal)

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In her article, Sacks talks about the changes that are happening in a pregnant woman’s brain. She explains many mothers with a newborn experience lack of sleep, which often is a result of short-term memory loss. She speaks about how a mother’s brain changes with the experience of caring for a newborn and how her personality changes through it.

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Credit... Rinee Shah

A new mother finally gets her fussy baby to sleep and steps into a relaxing hot shower - with her glasses on. At a family barbecue she can't recall the name of a relative she rarely sees.

It's easy to laugh off such lapses as "mommy brain," but there remains a cultural belief that pregnancy and child care impact a woman's cognition and mental life, long after a baby is born.

Women have often chalked up these changes to hormones, fatigue and the intoxicating love for a new baby.

Hormones do affect cognition, and, as anyone who has ever done shift work or had jet lag knows, sleep deprivation saps our mental abilities.

And the current evidence in scientific literature suggests that pregnancy changes the brain on a physical, cellular level in ways that we are only beginning to understand.

However, there is no convincing scientific evidence that pregnancy causes an overall decline in cognitive performance or memory.
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Instead, most experts believe that pregnant women's brain changes are an example of neuroplasticity, the process in which the brain changes throughout life by reorganizing connections in response to the stimulation of new experiences, and neurogenesis, the process of growth that allows for new learning. A 2016 study in Nature Neuroscience found that even two years after pregnancy, women had gray matter brain changes in regions involved in social cognition or the ability to empathically understand what is going on in the mind of another person, to put yourself in their shoes.

It may be that some subtle aspects of memory are sacrificed to enhance other areas of cognition. A 2010 study in Psychoneuroendocrinology showed that pregnant women experienced some impairment in the ability to remember words, but did not show changes in other memory functions such as recognition or working memory. This means that these women might forget the name of a character in their favorite TV show, for example, but would have no trouble in the type of memory that involves learning, reasoning and comprehension.

One theory is that these changes may have an evolutionary benefit to strengthen the communication between a mother and her infant. They may improve a mother's ability to help a child to first understand the outer world, and then learn how to make sense of internal sensations.

In keeping with evolution, animal studies show that the neural circuitry changes of pregnancy provide a crucial adaptation, thought to heighten a mother's mental and emotional focus to this new and hugely dependent creature in her life. At the same time, as both neuroscience and psychological research on attachment theory suggest, a human mother's brain enhances its empathetic capacities, strengthening a mother's ability to pick up on a baby's nonverbal communications through facial expressions and cries.

Of course, parents who do not go through pregnancy - including fathers, adoptive parents and L.G.B.T.Q. parents whose partners give birth - also experience psychological and physiological attachment, which some researchers have studied. But "daddy brain" is rarely discussed in a cultural or scientific context in association with cognitive decline.

Meanwhile, the cultural belief in "mommy brain" is so powerful that some studies have shown that pregnant women who walked into an experiment describing themselves as cognitively fuzzy were found in the lab to perform at a much higher level than what they reported. Were the cognitive changes just in their heads, or are our medical formulations missing something? In addition to the unscientific myths about hormonal women being best suited for the home and hearth, what else has propelled this broader misinterpretation about what "mommy brain" is and isn't?

It's not only the physiology of pregnancy that changes the brain, but also the lived experience of parenting. Brain scans cannot yet factor in all of the ways becoming a parent may change you, from the way you sleep to the way you exercise and even socialize. As Helena Rutherford, an assistant professor at the Yale Child Study Center said, "Individual differences factor into parental brain studies. Like other areas of psychology and neuroscience, there isn't a one-size-fits-all approach."

To have a full understanding of how pregnancy and motherhood affect women, we need to look not just at the brain, but also at the mind. The mind, like consciousness, arises out of our biology, but it is influenced by so much more than cells and signals: Our emotions, memories, relationships, even unconscious mental life also play a part.

"If we have learned anything," the U.C.L.A. psychologist Martie Haselton writes in her book " Hormonal: The Hidden Intelligence of Hormones - How They Drive Desire, Shape Relationships, Influence Our Choices and Make Us Wiser," it is that "although biology plays a role, our social context (and our agency to reflect and make choices) matters just as much."

In 1956, decades before scientists started using M.R.I.s and functional neuroimaging to study changes in brain activity, the pediatrician and psychoanalyst Donald Winnicott published a paper on "Primary Maternal Preoccupation." In it he described the intense psychological demands of taking care of a creature as helpless and dependent as a newborn, which requires new mothers to adapt their emotions and attention to zoom in on the baby.

Those improvements come with trade-offs, of course - an intensely narrowed focus means a blurrier periphery.

Many new parents describe the bandwidth demands of an emotional tug-of-war: They're pulled in to take care for their babies, but at times also have to push away from that vortex to tend to their own emotions and other aspects of life that preceded and coexist with parenthood. This can be complicated by the guilt some parents describe feeling when they shift their attention to themselves and experiences other than the baby. And the psychological experience of mothers suffering from psychiatric conditions like postpartum depression presents additional complexity.

Then there are the cognitive and emotional demands of all of the learning that takes place in parenting. In addition to adjusting to a child's rapid development, it is also psychologically demanding to make space for other relationships with your partner, family, co-workers and friends that have inevitably shifted with your new parenting role.

Learning also occurs in your remembering of your own parents' behaviors as you re-enter a relationship you've been in before, but only from the child side.

Many women experience "mommy brain" as a deficiency, the lost ability to remember people's names or keep their attention undivided while at work. But science reminds us that if we look at the changes without judgment we may find that they confer advantages. And to understand how data about brain changes impact real people's lives, it's important to consider the emotional life of the mind.

The writer Elizabeth Stone once wrote that the decision to have a child is "to decide forever to have your heart go walking around outside your body." Perhaps it's only fair that parenting necessarily requires some shifting in your mental space as well.

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Reframing 'Mommy Brain' (Published 2018)

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A new mother finally gets her fussy baby to sleep and steps into a relaxing hot shower - with her glasses on. At a family barbecue she can't recall the name of a relative she rarely sees.

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The article written by Post and Leuner gives many information about the brain changes during and after pregnancy. They explain what happens in the brain and which hormones are released and possibly missing when a woman is suffering from PPD.

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In this article, the author speaks about the ups and downs of foster care from a foster parent point of view. She explains what to expect when you welcome a child into your home, which will most likely leave you again at some point.

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When my husband and I decided to become foster parents, we knew one thing for certain: It would be a challenge. We knew it'd be hard to love kids and then let them go. We wondered how our children would react to sharing their parents and their home. We expected that there would be a lot of people who wouldn't understand our decision. But we also believed that opening our home to children who needed love and security would be rewarding and worthwhile. I have to say that, over these past four years, I haven't once regretted our decision. It has shaped us in ways I never could have imagined.

There are still things I wish I had known that would have made things a little easier. If we were sitting down, having a heart-to-heart before you took the leap into fostering children, here's what I would tell you.

How foster parenting changed the kind of mom I am

1. Find a support network
Foster parenting can be an isolating experience. Not many people understand what it's like to welcome new children into your home, to parent alongside a biological parent who is a virtual stranger and to work so closely with Children's Aid. Most of your friends won't have experience with parenting through trauma or loving a child who leaves. Most of them won't understand the very specific stressful situations that can arise as part of being a foster parent (a child leaving your home suddenly, an unexpected court ruling, an injured child). And, because of privacy and confidentiality, you can't share this with them because these children's stories are not yours to tell.

The only people who truly understand what you're going through are other foster parents. Finding a support network is invaluable-it will save your life. I know because it saved mine. When you connect with other foster parents, you'll have people who can answer questions and offer insight into child behaviours or challenges you might be having with a child's birth parent. You'll have friends who won't blink when your toddler throws the most epic tantrum or when you have a baby who won't stop screaming. They know because they've been there-in fact, they're probably there right now.

When you're starting out, make the effort to attend the training sessions offered by your agency. You'll learn about things like caring for kids with special needs, court proceedings for foster children and self-care for foster families and-perhaps more importantly-you'll connect with other foster parents. Attend special events offered by your agency and get to know other families. I met some of my closest foster-parent friends when we connected through respite: One of us was taking the other's foster children for a short period of time and we exchanged numbers and stayed in touch. You'll need the support and friendship, so don't be afraid to seek it out.

2. Don't underestimate the importance of biological parents
You'll spend most of your time before-and even after-becoming a foster parent thinking about how you'll best love the children in your care. And that's exactly the way it should be-these kids need support, stability and lots of love-but don't forget about their parents.

Your foster children's birth parents/family aren't bad people. In most cases, they have made some bad choices or are struggling with something outside of their control and need help and time. They want to parent their children well. They want their families intact. They love their kids and their kids love them, and this is a relationship you want to support. After all, the primary goal of foster parenting is reunification: to send children home to their families.

My husband and I foster babies and toddlers, so we communicate with their birth families regularly-the kids we take care of can't speak for themselves. I invest a lot of time in building a relationship with the biological family because it benefits everyone involved.

Understand that you're a stranger. You know how much you love these children and how well you care for them. But, especially at first, these kids have a very nervous parent who doesn't know where their children are or if they're safe, and that's scary. Respect these emotions. Answer questions. Provide details about how you're spending your days with their kids. Don't take things personally.

In most cases, this relationship can be a positive one. I've watched parents turn their lives around for their kids and seen families get put back together. I've been able to offer support and encouragement from a unique perspective. It's a reward I wasn't expecting when I started this journey, but it has become one of my favourites.

It doesn't always work out this way, though. Some relationships will be challenging, and that won't change. But my advice is to remain kind and supportive, to respect the biological parent's place in your foster child's life and to remember that this isn't about you. This is a hard time in their lives, and they're probably doing the best they can.

3. Real life is different from training
Foster parents get a lot of training. There's PRIDE training before you're approved, interviews and home studies. Your agency will provide you with plenty of training opportunities once you've started as a foster parent. These workshops and lectures are incredibly helpful, but I've learned that, no matter how great the material, the theoretical nature of a training session can't compare to the practical, real-life experience of parenting a foster child.

Every child who enters your home is dealing with trauma. They've been removed from their families or moved from another foster home, but either way, they've been uprooted from somewhere familiar and moved somewhere strange. That's traumatizing and scary, and it takes time to get to know this little person who has moved into your home and become part of your family and for him to get to know you and how things work in your home (it's probably very different from life in his family). There's a lot of trial and error and learning on the fly.

There's no real way to prepare yourself for toddlers, preschoolers, kids or teens who are dealing with significant trauma. They're carrying a heavy load, and the emotional fallout from that can be overwhelming for them and for you. There will be screaming, tantrums, aggression and unexpected emotional outbursts. I've sat up late into the night with a three-year-old who didn't understand where her mom was and why she couldn't see her. I've dodged toy cars and toddler fists during hour-long tantrums. I've felt devastation when a visit with family has been cancelled. (And this is all in addition to the big feelings that come with typical toddlers and preschoolers.)

It's eye-opening to see how much pain little people can hold, and it takes patience and commitment to help them walk through it. It's the most difficult part of this work but also the greatest privilege. There has been no greater reward than seeing the progress that can happen in a child's life when she is loved, safe and secure. And that leads to the final point....

4. Foster parenting is both easier and harder than you think
I often describe my experience with foster parenting as "hard but good." It's the kind of thing that stretches you and changes you-it's painful but in that hurts-so-good way. Foster parenting has made me a better parent, but it's happened through frustrating days, long nights and more than a few tears over how to best love and support the children in my care.

Our family has sacrificed some freedoms and spontaneity that we used to take for granted, and it can be challenging to live a life that is different from most families. But it has expanded my kids' world and given them greater compassion and understanding for people. They've freely opened their hearts to the kids who come into this home, loving them without boundaries or questions.

It really only takes a moment to fall in love with a child who needs you, who comes into your home desperate for love and acceptance, scared and unsure of what's happening in his life. There are good and bad days, but it's easier than I ever could have imagined to love another person's child.

And, yes, it's so hard to say goodbye. It's the question I get asked more than anything else: "Don't you get attached? Isn't it hard when they leave?" Yes, and of course. But that's one of those hard-but-good things. Opening your heart and loving a child you know is leaving is hard, but loving a child who desperately needs it is something I will never regret. And being a part of helping a family come back together is such a beautiful thing. As we're getting ready to say goodbye to one of our foster kids, I usually tell my kids that "we're sad for us but happy for them" because when it's healthy, there's no better place for a child to be than with his parent and family.

So that's what I tell new foster parents: It's hard but good. It's messy, chaotic and unpredictable, but it's also redemptive, rewarding and beautiful. And I wouldn't change a thing.
Read more:
Elliot: A new kids' book about the foster system
How adoption made our family complete

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4 things I wish I'd known about foster parenting

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When my husband and I decided to become foster parents , we knew one thing for certain: It would be a challenge. We knew it'd be hard to love kids and then let them go . We wondered how our children would react to sharing their parents and their home.

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The brain changes through experiences and people get good at things through practice. This means foster, adoptive and biological parents can all be loving, caring, and the best parents to their individual children, as long as they spend time with their baby’s, children, and teens. Mother does not know always best, but an involved parent does.

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The Possible Worst Outcome of a Little Miracle (Informal)

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The Possible Worst Outcome of a Little Miracle (Informal)

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The author is telling the story of a father and his daughter, who lost their wife and mother due to the mother’s undiagnosed postpartum depression. The author named many things partners have to watch out for in each other’s behavior after the baby is born.

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Here's what I wish I had known, and what you can do to prevent it from happening to you.

As I write this, it's the night before Mother's Day, a day I dread each year.

I dread it because my wife - the mother of my 6-year-old daughter - is gone.

Each year, I fight back tears as my daughter lies in my bed asking questions about why her mommy is in heaven. It's a question that, quite frankly, offers no sensible answer for a child. She can't wrap her head around it.

Nighttime is usually full of fear for my beautiful daughter Adriana. It's the time of day that she's not a normal 6 year old.

Every night, after tickle attacks and belly laughs, Adriana complains of a stomachache, sore throat, or headache. She becomes restless and her breathing becomes heavy. The symptoms she's experiencing are from anxiety.

Adriana lost so much at such a young age. Her mom died when she was just 5 1/2 weeks old. Going to school each day, seeing other parents, and hearing teachers refer to moms at home are all constant reminders of what she doesn't have.

My daughter fears losing me, and all the other adults in her life. She's afraid that she'll be all alone in this world - a child fending for herself, missing everyone she loves. While this fear might be irrational for most kids, it's very real for her.

But this year, for the first time ever, my daughter quietly said, "I don't feel scared anymore. I feel more relaxed than I've ever felt." My heart fluttered. I asked her why she felt so calm.

"My heart is full of love and joy tonight. You see, Daddy, when people are sad it's because their heart is too small to hold lots of love and joy. The only way to make others' hearts bigger is to give them some of yours."

On August 30, 2013, my beautiful, healthy, and smart daughter Adriana was born. My wife and I were both 30 years old and had everything a young couple could dream of in this world. We felt invincible and unstoppable.

Together we had a connection that brought out the best in each other. Our love gave us the courage to step out of our comfort zones and grow as people and professionals.

We had a once-in-a-lifetime kind of love - a love that never dies.

On October 8, 2013 our perfect world changed forever. On that October morning, I awoke to find my wife Alexis lifeless in our basement. It's a sight that still sucks the air out of my lungs.

Our daughter's birth

It all started with a term I had never heard: traumatic birth.

In our case, Adriana came into the world in a code blue birth with no doctor in the room.

Just 12 minutes prior to Adriana's arrival, my wife was screaming that she needed to start pushing. The doctor matter-of-factly dismissed her; there were other births that were a higher priority than ours. We were told that since Alexis was a first-time mother, it would be at least 2 more hours.

Twelve minutes later, Adriana was coming, fast and furious. I remember the panic like it was yesterday. The only nurse in the room told me to grab one leg while she grabbed the other, and started coaching Alexis in breathing exercises.

Alexis and I stared at each other in fear, wondering when a doctor would arrive. In the midst of the screaming and pushing we realized something was wrong. The baby was stuck. She had no slack - the umbilical cord was wrapped around her neck.

The nurse tried to remain calm but soon screamed for somebody, anybody, to find scissors and cut the cord. Lights were flashing and alarms were blasting. Finally, what seemed like a dozen or more doctors rushed into the room.

I'll never forget looking at my daughter's blue body, anxiously waiting to hear a cry or a gasp for air. When that cry finally came, it was a relief unlike anything I can explain.

I looked at Alexis, exhausted and scared, and knew something was wrong. The thing that made her so special was gone. Her energy had been sucked away and replaced with confusion and self-doubt.

Little did I know what the next 5 1/2 weeks would be like.

The first weeks home

The first sign that told me there was something wrong came about 2 1/2 weeks postpartum. Alexis had been struggling with debilitating anxiety and called her OB-GYN to express her worries.

They referred Alexis to a licensed clinical social worker with a masters in psychology. In her first appointment, Alexis was diagnosed with post-traumatic stress disorder (PTSD) from the delivery.

PTSD led Alexis to believe that her very first act of motherhood was hurting her child. She believed that Adriana had brain damage and it was her fault because she couldn't wait the 2 hours the doctor said.

Alexis was so convinced that Adriana had brain damage that we had neurological testing done. The testing proved Adriana was fine. Alexis refused to believe it.

The next two weeks can only be described as complete and utter chaos.

It was 13 sleepless nights with a baby that cried incessantly. Meanwhile, I watched my wife's depression spiral out of control so quickly it's hard to put into words.

Each day started the same. We called crisis centers, hospitals, her OB-GYN, our pediatrician... anybody that would listen, to try to get help. Alexis, unlike most women, did not suffer in silence. She knew she was in trouble.

We asked for help 7 times in the last 13 days of her life. At each and every appointment, Alexis filled out screening questionnaires. Each time, we left with nothing - no resources, no information to seek help, and no hope.

It was only after she died that I was able to read some of her answers to the screening questions. They were horrifying, to put it mildly. But because of , no one could tell me just how dire the situation was.

Escalating emergency

I didn't realize how bad it was until one night when Alexis looked me in the eyes and said, "I know what we have to do. We should find a great family for Adriana and give her up for adoption. We had the most perfect life before we had a baby. We could go back to that same perfect life."

That night was the first of multiple trips to psychiatric emergency rooms.

Each time, Alexis pleaded to be admitted. She was always told she was "not crazy."

Each appointment was spent finding reasons why she was "not like them," - the other admitted patients: you have a master's degree, you're the daughter of a minister, you're pretty and well-spoken, you're financially secure, you have a supportive husband, you have family and friends...

None of them listened to her say, "I don't know how to make the anxiety stop. I can't control the voices. I haven't eaten in 5 weeks. I haven't slept more than an hour a day. I can't stop crying. I have a plan to hurt myself. I don't deserve my husband or my baby. I can't bond with my baby. I don't care about anything anymore. I can't make even the smallest decisions. I don't want to have my baby taken from me. I'm a burden on everyone that loves me. I'm a failure as a mother."

Imagine how hard it is to suffer from mental illness, reach out for help, find the courage to admit all of these things, and still be turned away each and every time.

Her desperate pleas for help were met with, "You're fine, you're not really going to harm yourself."

After each appointment, Alexis would get in the car and say, "Nobody is going to help me. Nobody cares about me."

On our 4th wedding anniversary, we sat in the psych ward, in a glass room that locked from the outside. While my wife was pleading with a social worker to be admitted, I pulled the emergency room psychiatric doctor aside and tearfully asked him how I was supposed to protect her.

His response was that women like her never attempt suicide in a sloppy way. Women like her would never want to be remembered not looking their best. Women like her only do it in 2 ways: asphyxiating themselves in their garages with a vehicle or overdosing on pills.

I left with instructions to remove car keys and prescription pills from our house.

"Not cut out for motherhood"

My wife's main concern was the suicidal thoughts she started having after her OB-GYN prescribed Zoloft.

About a week after starting Zoloft and telling her OB that she was having intrusive thoughts, the doctor (the same doctor who told Alexis not to push during delivery) doubled her dose.

Alexis started researching alternate treatment options and made an appointment to review them with her OB. She also wanted to level with the doctor - Alexis wanted to say she felt abandoned in the delivery room, and tell her about the PTSD diagnosis.

It didn't go well. The doctor was so offended that she told Alexis to go on birth control and not have any more babies. She told Alexis, "You're not cut out for motherhood."

When Alexis came out of the exam room, it was as if all the anxiety and stress was gone. I asked Alexis why she was so relaxed. She said she knew what she had to do.

Alexis told me she needed to take everything one day at a time. That night I took a picture of her looking at our perfect baby girl. They were looking into each other's eyes. Alexis was smiling with her perfect smile.

I sent the picture to her parents to let them know that I thought she had turned a corner. I thought she was going to be alright.

Adriana cried and cried that night. I sat in the nursery rocking her and singing Coldplay songs to her. Alexis came into the nursery at about 3:30 in the morning and said "Pop, you're so good with her. I don't know how you do it. You're going to be the best dad. When she falls asleep will you please come snuggle with me?"

Adriana fell asleep almost immediately. I crept into bed and snuggled next to the love of my life thinking the medication had finally started working. I was so exhausted and whispered to Alexis, "Promise me you won't do anything to hurt yourself. I can't do this alone. I need you."

She said, "Yes." Then Alexis looked at me over her right shoulder and said "I love you, Pop."

The next morning, Alexis took her life.

After I found her, my heart became so small. Just like Adriana said - it seemed incapable of feeling love and joy.

Thank God for my beautiful daughter's huge heart full of love and joy. Over time she's spread that joy, and my heart has started to heal.

I've realized that during my lowest points when it feels impossible to smile, I can still make other people feel joy. In turn, it puts a smile on my face - if even just for a second. These small moments of joy have slowly built me back up. I now see that helping others find their joy is my life's calling.

After Alexis' death, I decided I needed to do something to make sure this didn't happen to other mothers. I wanted to memorialize my wife with a legacy that my daughter could be proud of.

I established the Alexis Joy D'Achille Foundation with the help of family, friends, the Allegheny Health Network, and Highmark Health insurance company - two of the most compassionate healthcare organizations in operation today.

I'm proud to say that in December 2018, our foundation opened a state of the art, 7,300 square foot center for maternal mental health at West Penn Hospital in Pittsburgh, Pennsylvania.

Over 3,000 women received treatment at The Alexis Joy D'Achille Center for Perinatal Mental Health in 2019.

We want to make sure that moms never feel alone, so we've encouraged moms and families everywhere to share their stories using the hashtag #mywishformoms.

The campaign is a social cause initiative focused on breaking the silence around postpartum depression and has been nothing short of amazing. More than 19 million people from almost every country on earth have participated.

Like most fathers in this country, I was ill-prepared for the reality of childbirth and pregnancy. I want to share what I know now, so hopefully no other mother, father, or child has to walk in my shoes.

Partners should be present at doctor's appointments

We need to show the women we love that we support them. Also, it's crucial to establish relationships with the OB-GYN team before the baby is born.

The relationships built with doctors over the course of 40 weeks give partners a point of contact to reach out to if something seems wrong with mom during pregnancy and postpartum.

Become educated and feel confident in asking questions

Be an advocate for mama. As partners, it's the least we can do considering we don't endure labor or push out a child.

Nobody, not even a doctor, will ever know your partner the way you do

If something seems off, speak up. I wish I had.

Pay attention to mom's eating habits

Alexis lost nearly 50 pounds in just 5 1/2 weeks postpartum. She was 10 pounds under her prepregnancy weight. Her loss of appetite was a big red flag.

Make a postpartum plan

Postpartum depression is the number one undiagnosed complication of childbirth in this country. Making a plan for support can be extremely effective in minimizing risk.

Don't be afraid to ask friends and family if they'll be willing to help out once the baby arrives.

Anyone who has had a baby and has the time will happily help. "It takes a village" is true, so find yours before the baby comes.

Let mom know she's needed

Always let mom know how much she's appreciated and needed. I always say marriage is 100/100 not 50/50. If both of you give 100 percent all the time, everything is going to be fine.

After delivering a baby, mom's 100 percent might not be her usual. That's when we as partners need to step up and give her our all.

Let her know how much she means to you and the baby. Make sure she knows that there's never a situation where you're better off without her. Although she might require extra help during this time, tell her she's never a burden.

A fed baby is a healthy baby

Please, please, please stress this to her. The pressures around breastfeeding are enormous triggers for some women.

Breastfeeding may be ideal for baby, but not if it compromises mom's mental health.

Take note of what she's saying and doing

If she talks about phantom baby cries or hearing voices, don't brush it off.

Alexis became scared of taking the baby out in the dark. She would crank the heat to 85 degrees on summer nights, worried that it was too cold. She became obsessed with talking about how our diets needed to change.

All of these fears and compulsions were signs of her postpartum anxiety.

Recognize when simple decisions are debilitating

If your partner is having trouble making the simplest of decisions, there's probably something wrong.

The simplest of tasks might become burdensome. For example, Alexis would say, "I don't know how I can make it to my appointment this afternoon. I have to get out of bed, brush my teeth, wash my face, comb my hair, change the baby, dress the baby, burp the baby, put on socks, put on shoes, tie my shoes, put the baby into the car seat..."

You get the point. She'd go through the list of everything she had to do, to the smallest detail. It became paralyzing.

Pay attention to her sleep

If she's not sleeping enough, sleeping too much, has trouble falling asleep or staying asleep, she may need help.

Listen to her when she talks about harming herself or the baby

If she says these things, take it seriously. Women are more likely to attempt suicide during the postpartum period than any other time in their life.

It's estimated that suicide and drug overdose may be responsible for up to 30 percent of maternal deaths. According to the Centers for Disease Control and Prevention (CDC), suicide is the leading cause of death in nonhispanic, white women during the postpartum period.

Remember that postpartum depression isn't the only issue to look out for

Many women experience other symptoms or conditions like:

Know that dads are at risk, too

It's important to note that postpartum depression isn't exclusive to women.

As many as 10 percent of dads may also get postpartum depression. If a dad is dealing with a mother that has untreated postpartum depression, often they themselves will end up experiencing a mental health episode too.

Watching this area of medicine change so quickly over the past 6 1/2 years has inspired me to keep fighting for family health. God willing, I plan to use my story to help women and families get the care they deserve.

I won't stop until women everywhere in this country have access to the same kind of care that we've brought to women in Pittsburgh.
Steven D'Achille is the founder and president of the Alexis Joy D'Achille Foundation for Postpartum Depression. He's active with other women's mental health organizations, sits on the board of Postpartum Support International, and has spoken at events and conferences all over the world to share his story. Steven's a proud born-and-bred Pittsburgher, hailing from McCandless Township. He and his family own and operate the Pizza Roma and Pomodoro Italian restaurants in the North Hills, and he's often found warmly welcoming customers to both establishments.

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Here's what I wish I had known, and what you can do to prevent it from happening to you. As I write this, it's the night before Mother's Day, a day I dread each year. I dread it because my wife - the mother of my 6-year-old daughter - is gone.

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Why Am I Not happy? This Is What I Wanted (Informal)

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Why Am I Not happy? This Is What I Wanted (Informal)

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The article is about the story of a woman that struggled to receive naturally and decided to foster in hopes to adopt. Doyle explains, that foster and adoptive parents often struggle with Post Placement Disorder, which is comparable to postpartum depression.

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Postpartum Depression Happens To Foster Parents, Too - Her View From Home

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Foster parents can experience postpartum depression too. Adding children to the family through adoption or fostering can be hard.

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Postpartum Depression Happens To Foster Parents, Too

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Is this How I am Supposed to Feel? (Informal)

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Is this How I am Supposed to Feel? (Informal)

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In Conaboy’s article, she speaks to new mothers who possibly have postpartum depression (PPD). She speaks about the symptoms of this illness and gives real-life examples of how a mother with PPD would act, so a struggling woman could possibly relate and get the help she needs.

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IN THE WEEKS AFTER my first son was born, I squandered hours of precious sleep leaning over his bassinet to check that he was still breathing, or Googling potential dangers that seemed to grow into monstrous reality by the blue light of my smartphone. Among them: The lead paint my husband and I had discovered recently - a real but manageable risk - had turned our new home into a hazard zone. I cleaned our floors incessantly but still imagined a cartoonish cloud of poison dust following us as I carried the baby, so tiny and fragile, from room to room.

When the doctor screened for postpartum depression during my six-week checkup, she noted that my responses to the questionnaire were somewhat mixed though my score was within the normal range. She asked whether I had thoughts about harming myself or my child and, when I said no, she moved on. But I was struggling. Before baby, I had managed a tendency toward low-level worry. Now, it was as if the volume had been turned up. Among the biggest worries I faced was worry itself.

The way I saw it, motherhood made me feel this way, and I would be a mother forevermore. Would I always be this anxious? And would my baby suffer for it? I feared that something deep within me - my disposition, my way of seeing the world, myself - had been altered.

In truth, something very foundational had changed: my brain.

What I didn't know then - what I wish I had known then - was that I was in the midst of the most rapid and dramatic neurobiological change of my adult life. The unmooring I felt, and that so many new mothers feel, likely was at least in part a manifestation of structural and functional brain changes, handed down through the millennia by mothers past and intended to mold me into a fiercely protective, motivated caregiver, focused on my baby's survival and long-term well-being.

In the past two decades or so, researchers have begun documenting the makeover of the maternal brain. But while the transformation thought to occur is stunning, the brain remains almost entirely absent from the popular conversation about what it means to become a mother, even as a woman's body - the status of Kate Middleton's baby weight, for instance - is open to discussion ad nauseam.

Entering into motherhood is "a major event" for the brain, says Jodi Pawluski, a researcher at University of Rennes 1 in France who focuses on what she and her colleagues call the " neglected neurobiology" of the maternal brain. "It's one of the most significant biological events, I would say, you would have in your life."

Women experience a flood of hormones during pregnancy, childbirth, and breast-feeding that primes the brain for dramatic change in regions thought to make up the maternal circuit. Affected brain regions include those that enable a mother to multitask to meet baby's needs, help her to empathize with her infant's pain and emotions, and regulate how she responds to positive stimuli (such as baby's coo) or to perceived threats. In the newborn months, a mother's interaction with her infant serves as further stimulus to link her brain quite tangibly to her baby's.

Some effects of those brain changes may moderate over time. Researchers have found that the anxiety or hypervigilance that many new mothers feel, for example, peaks in the first month postpartum and then diminishes. But they suspect that other effects linger, shaping mothers even well past their child-rearing years and even influencing their relationships with future grandchildren.

In one key study, a team of researchers used anatomical magnetic resonance imaging to look at the brains of women who were not pregnant but hoped to be. The researchers followed up with images soon after childbirth and again two years later. For comparison, they scanned women who had never had a pregnancy.

After childbirth, the volume of gray matter in the mothers' brains changed dramatically, particularly in regions involved in social processes and "theory of mind," or the ability to attribute emotions and mental states to other people - key in raising a human. The degree of change, enough that researchers could easily sort the women who had had a pregnancy from those who hadn't, surprised Elseline Hoekzema, a lead author on the 2016 paper who studies pregnancy and the brain at Leiden University in the Netherlands.

"I've never seen anything like this in any of the data sets I've worked with," Hoekzema said by e-mail. "In a way, it's no surprise given the very extreme nature of the hormone floods that women are exposed to during this period, but still I hadn't expected such remarkably robust findings and this degree of differentiation."

The more brain change the mothers experienced, the higher they scored on measures of emotional attachment to their babies, a finding that echoed past studies. And the changes in most brain regions remained two years later.

The researchers also scanned men, those who became fathers during the study period and those who did not have a child, and found no comparable change in gray matter volume. (Other studies have found that fathers, including gay fathers raising children without maternal involvement, experience significant changes in brain activity, but those changes depend on exposure to the child. The more time a man spends as primary caregiver, the more activated the parental network in his brain becomes, and researchers suspect a similar effect may be present for others in a parental role.)

The brain scans seemed to validate the rapid, pronounced, long-lasting change in mothers that a much bigger body of animal research has found. Reviewing a range of studies, Pawluski and her coauthors wrote in a 2016 paper that as a developmental period, pregnancy is as formative as puberty. "Under healthy conditions, the female brain transforms into a motivated, maternal mechanism," they wrote.

Researchers are a long way from being able to say what changes in the brain mean for an individual woman's experience of new motherhood or how they interact with the physiological demands of that phase of life, such as breast-feeding and sleep deprivation. They are just beginning to investigate how the maternal brain is affected by trauma, such as abuse and poverty, or by substance use. Importantly, they can't yet say whether postpartum mood disorders are the result of something gone awry in the typical changes that a mother's brain goes through or whether they are caused by a triggering of other brain circuitry.

Doctors, pregnancy books, and mom blogs typically do alert women to the standard list of symptoms of postpartum depression, sometimes including other postpartum mood disorders, such as severe anxiety or obsessive compulsive disorder. They encourage women to seek help if they experience symptoms such as hopelessness, excessive worrying, trouble bonding with baby, or a loss of interest in friends and family, especially when those symptoms interfere with their ability to take care of themselves or their child. As many as 1 in 5 women will develop postpartum mood disorders at some point after giving birth, and educating people about those conditions is critical. But these sources typically spend very little time on the neurobiological changes all mothers can expect to face.

What would happen if we gave expectant mothers even a basic understanding of how and why their brains change? Would it help them to cope with the unfamiliar emotional experiences that very often are part of a healthy experience of new motherhood? Might it open a door for women who experience more problematic symptoms to talk with their loved ones or their doctor? Could it even help some women to feel empowered by their own biology?

As I read and researched, my anxiety began to feel manageable. But my frustration grew. So many women feel changed by motherhood in ways that can be unsettling and confusing. Here was information that might provide comfort to some: In most cases, not only are these changes normal, they also are productive, helping women to become the parents that their babies need. Why hadn't I known this sooner?

IN THOSE FIRST HARRIED WEEKS of new motherhood, I paged through a stack of hand-me-down parenting books while the baby slept. I was looking for something that could explain how I was feeling. In a worn copy of Infants and Mothers: Differences in Development by famed pediatrician and child development expert T. Berry Brazelton, first published in 1969, I came to a section about bringing home a newborn and read this: "Caring concern will become the foundation for learning to be a parent."

Many new mothers say that they feel like crying "most of the time" and wonder if that means they aren't cut out for being a mother, Brazelton wrote. "It must be reassuring to know that this is a common result of the physical and psychological readjustments that follow delivery. These will pass. They may even be an important part of her ability to become a different kind of person - a 'mother,' rather than a young girl."

I'd think about that passage often in the months to come as I dug into the research. The pregnancy tracker app that I had looked at almost daily before giving birth to see how my body was changing used an animated diagram of a woman from the neck down. Yet, half a century ago, Brazelton, who died in March, had sensed what researchers have begun to validate today using brain-imaging tools and animal models: that mothers become "a different kind of person."

Brazelton, then about to turn 98, answered his cellphone when I called in spring 2016, just as my son was turning 1. We met for lunch at Concord's Colonial Inn. He had traveled with a caregiver from his home on Cape Cod to attend the funeral of a former colleague from Boston Children's Hospital. I told him my story, what the passage from his book meant to me during some particularly dark days, and how it spurred my interest in the neurobiology of the maternal brain. Then, it seemed, our therapy session began.

The anxiety I experienced was typical, he said: "You're frightened and you don't feel adequate and you're working very hard to pull yourself together, to start facing this child that you've fallen desperately in love with for the first time in your life, and you realize what a major responsibility that is and what a turning point in your life it is. . . . I see getting disorganized and thrown into a frenzy like that as a major opportunity to reorganize yourself and pull yourself back together and become the new person that you want to be."

Brazelton said that had been his philosophy since he began practicing in Cambridge in 1951. "At that point, everything that went wrong with the child was blamed on the parents. And the parent was already feeling inadequate and guilty, so it re-enhanced the feeling of failure. It seemed to me that was the opposite of what we ought to be doing. We ought to be building up a mother's self-esteem, so she can pass that on to her child."

Brazelton said he was encouraged by the federal task force recommendation made just a few months before our meeting that all women who are pregnant or who have recently had a child be screened for depression, and he hoped a movement among pediatricians to be more involved in maternal mental health would grow.

By that point, I felt sure he would agree with my conclusion: Shouldn't we be better preparing mothers about well-documented brain changes they could expect, before baby is born?

"I don't think that most mothers are ready for that kind of information," Brazelton said. "It would scare a lot of people. I don't think they'd want to think their brains are going to change. They'd be frightened about which way it was going to go."

If mothers raised the topic with him, he said, he would be glad to talk about it. Otherwise, it might add too much to their fears.

I fumbled with my words, dismayed and confused. The conversation had been so uplifting. Here suddenly was the heavy idea that women can't handle information about their own bodies, their own brains. "Isn't that a very, in a sense, old-fashioned idea?" I asked, self-conscious even as I said it about posing such a question to someone of Brazelton's experience and stature. He took the question differently than I meant it and talked about the challenges of working mothers who lack social support. Our lunch ended soon after. People were gathering at the church.

BRAZELTON WAS A PROGRESSIVE DOCTOR in his day. He listened to mothers at a time when others discounted them. That's what drew people to his writing and to his popular cable TV show, What Every Baby Knows. Yet his comments to me seemed anchored in the idea that motherhood - women in general, perhaps - requires careful handling, an old idea that remains pervasive.

The truth is, it's easier to talk about decorating the nursery than about the gripping fear that sends you into a full-body sweat the first time you take baby to the grocery store. It's more comfortable to debate baby names and stroller brands than to discuss the depth of loneliness that can come at 2 a.m. when you are awake again with a crying baby.

"There is stigma [attached to] talking about challenges," says Liz Friedman, a founder of MotherWoman, which organizes a network of perinatal support groups across Massachusetts. "We don't want to tell pregnant women about challenging births," says Friedman, who now runs Group Peer Support for Parents. "We want to keep this facade that motherhood is everything we've ever hoped for and pregnancy is blissful. . . . We feel like we are raining on people's parades and dramatizing our own struggles and scaring people, and we don't want to do those things."

"Yet," she says, "we do need to talk about this."

Some of the obstacles to a more open conversation are deeply rooted - ancient, even. The belief that a woman's uterus puts her at risk for "hysteria" goes back about 4,000 years. Today, of course, the idea that her brain is muddled by motherhood fuels pregnancy discrimination in the workplace and elsewhere. The research on "mommy brain," the forgetfulness or general fogginess that many women report experiencing, is somewhat mixed. Deficits in memory and cognitive function that have been detected are generally small, are thought to disappear over time, and may be a function of the brain adapting to its new role.

Even as we've gained a more nuanced picture of how neurology and genetics influence mental health in the population at large, researchers are playing catch-up when it comes to maternal mental health. Generations of scientists were uninterested in the topic, says Dr. Peter Schmidt, chief of behavioral endocrinology at the National Institute of Mental Health, who has studied postpartum issues since 1986. Schmidt focuses largely on determining the triggers for postpartum depression or psychosis.

"Nobody cared, really, because they were women's issues," he says-not seen as the serious matter of public health that they are. Male researchers who were interested sometimes experienced pushback from women worried about "a longstanding misogynism that women are impaired by their reproductive system."

The field has broadened considerably in recent years, Schmidt says, with a growing interest in the maternal brain, specifically, newer technology available to study it, and the publication of high-profile papers that have proven to investigators that studying maternal mental health is "not career suicide." Notably, the number of women researchers has grown, too.

There's also a recognition of gaps in understanding how men and women differ. The American College of Physicians in May issued a call to close those gaps by including more women as subjects in clinical research and regularly reporting gender-specific data in the results of those studies.

If women have been too often absent from scientific studies in general, it follows that there has been "an invisibility" of the mother, says Dr. Alexandra Sacks, a reproductive psychiatrist in New York and coauthor of a forthcoming guide to the emotions of pregnancy and new motherhood.

Parenting research is typically focused on the child. Researchers I interviewed said they often get a version of this response when they apply for funding to investigate the maternal brain: What about the offspring? The emphasis on babies "is understandable," Sacks says, "but it's time to also recognize the mother's health story."

That's beginning to happen, says Dr. Samantha Meltzer-Brody, director of the perinatal psychiatry program at the University of North Carolina and president of Marce of North America, a group that advocates for maternal mental health research, clinical care, and education. For a long time, she says, she felt like one of a few vigilantes in her field, pushing to get mothers struggling with postpartum mood disorders the support they needed. Recent years have brought a "huge sea change," though there's much more to be done.

Participation in postpartum support groups has swelled. The American College of Obstetricians and Gynecologists recently recommended redesigning postpartum care to include a fuller assessment of a woman's mood and emotional well-being. And the first drug for treating severe postpartum depression could hit the market soon. Meltzer-Brody was principal academic investigator on clinical trials that found brexanolone, made by Cambridge-based Sage Therapeutics and administered intravenously over about 2½ days, significantly reduced symptoms in women with severe postpartum depression.

Still, while postpartum disorders have begun getting the attention they desperately need, less time is spent helping women to understand the range of what is typical for a healthy postpartum experience and developing a new idea of motherhood that does not romanticize it. "That's where we need to go next," Meltzer-Brody says.

I started thinking about a map of the maternal brain as a kind of tool to cut through the romanticization, the history of scientific neglect, the invisibility of mothers. The map would be a tangible measure of the profoundness of new motherhood - one that demonstrates with certainty that the changes women experience "are biological and not constitutional," as Dr. Leena Mittal, director of reproductive psychiatry at Brigham and Women's Hospital, puts it.

What we know about the maternal brain so far demands more investigation, Mittal says. But she and other clinicians I spoke with were less convinced that a routine discussion about typical brain development is warranted during prenatal care. One worried about women who feel the pressure to do everything just right during pregnancy, and how learning about how a woman's neurobiology connects with infant bonding might add to that pressure. There are no specific conclusions that doctors can draw from the brain research to help an individual make choices about how best to care for herself and her baby, Mittal says.

"What we know at this point is interesting and very much the beginning," she says. "What it really, truly means in terms of targeted treatment - that's the goal."

DOCTORS AND OTHER PROVIDERS who care for pregnant women have a lot to cover. Many women learn about even very common physical effects of pregnancy - diastasis recti, for example, or a separation of the abdominal muscles that can contribute to low back pain and pelvic floor dysfunction - not from their doctors, but from friends or family members. Maybe the evolution of the maternal brain will be like that, a topic discussed more commonly in breast-feeding classes and mothers' groups.

That would be helpful, of course. But is it enough? For one thing, many women don't have access to those support networks or don't connect with them until they find themselves struggling.

Kate Worrall doesn't remember any of the medical professionals she saw during pregnancy and through labor talking with her about her brain or the emotional context of new motherhood, beyond rote language about identifying postpartum depression. The 33-year-old lobbyist from Sharon was unprepared for the range of emotions she felt when she brought her son Tommy home from the hospital in December 2015 or when short winter days during maternity leave began bleeding into long, sleepless nights.

"I felt a little bit more lost than I had anticipated," she says.

She had never struggled with anxiety before having a baby. But the challenges of comforting a screaming child and getting him to sleep stirred up a feeling of helplessness that she says she still struggles with today, though she eventually found a therapist who could help her cope.

"I did feel blindsided by it," she says.

She was surprised when friends started telling her they had had similar experiences. As she awaited the arrival of baby Colin, born in June, she at least felt more prepared this time. Now, she said she makes it a point to talk with other expectant mothers about the mental and emotional challenges of motherhood. But Worrall says this isn't just a matter for mothers to talk more openly about. She sees the anxiety she still experiences as part of the biological changes of motherhood that should be covered during prenatal care. "Like with all sorts of mental health, it needs to be just a component of the broader physical health," she says.

If that education is done thoughtfully, it could even be empowering.

A mother's brain is a powerful thing.

A surge of oxytocin at childbirth triggers changes that allow a woman quite literally to sync to her baby through a coordination of biology (synchronized brain responses and heart rates) and behavior (matching responses in gaze, touch, and vocalizations). That intense connection teaches a baby from the very first day how to relate to another person, says Ruth Feldman, Simms-Mann Professor of Developmental Neuroscience at the Interdisciplinary Center in Herzliya, Israel. When we connect with friends, romantic partners, and colleagues and even as we view ourselves as a member of a sports team or as part of a nation, we "repurpose the basic machinery" established in the connection between mother and baby, she explained in a 2017 paper on the neurobiology of human attachment.

The parental brain incorporates human-specific functions such as empathy with ancient ones aimed at protecting the young for the survival of the species. That complexity makes it "a peak expression of human evolution," she says. In fact, she speculates that the parental bonding phenomenon came first. Before there were humans.

"Who we are is about parents," she says. "The maternal brain is the key."

Feldman thinks we should talk about it. Women experience so much change during pregnancy and new motherhood, she said. "If they understand it more, where it comes from and also how natural it is and how important it is for the child's brain and the child's development - it helps you go through it."

Research on the maternal brain is still relatively new, and talking about the findings requires some careful consideration, Feldman says. "But the fact that it would take some mindfulness on how to disseminate this information doesn't mean we shouldn't give it."

I anticipated the emotional roller coaster of motherhood as I was expecting my second child last summer. Knowing what may be coming didn't make the ups and downs any less real, but it made them less scary. I worried plenty. But I didn't worry about the worry.

I wonder how things would have been different the first time around if I'd known more. I might have coped better if I'd understood that some of what I was experiencing was just my brain- this dynamic, empathy-teaching, humankind-shaping maternal brain - doing exactly what it was supposed to do. Maybe, at the very least, it would have helped me to put down my smartphone at night and get some sleep.

Chelsea Conaboy is a freelance writer and editor focused primarily on health care. She lives in Portland, Maine. Send comments to magazine@globe.com. Get the best of the magazine's award-winning stories and features right in your e-mail inbox every Sunday. Sign up here.

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american college of obstetricians and gynecologists

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Pregnant women don't learn about profound brain changes - The Boston Globe

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IN THE WEEKS AFTER my first son was born, I squandered hours of precious sleep leaning over his bassinet to check that he was still breathing, or Googling potential dangers that seemed to grow into monstrous reality by the blue light of my smartphone.

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In this letter, I explain how I felt during my research and which parts I found the most exciting and difficult. I talk about my changes after receiving feedback on my draft and my overall learning during this semester.

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In the book, the author Eagleman argues about how the brain changes over time and how it changes through the experiences of every person individually. He explains the different stages of brain development and how children are different from teenagers and adults.

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Buy The Brain: The Story of You on Amazon.com ✓ FREE SHIPPING on qualified orders

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He is a Stranger to Me (Informal-Counterargument)

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He is a Stranger to Me (Informal-Counterargument)

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Haas wrote this article in order to motivate fathers to spend time with their children early on, and not when the child is out of the toddler age and can play actual games. He explains, why fathers feel sometimes weird about their children, and how to avoid this from happening.

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Almost all parents will tell you that child rearing is much more difficult than they had anticipated. Before your first child's arrival, your fantasies involved playing with him or observing him proudly. The scenes were always pleasant, always gratifying. You did not anticipate colic, tantrums, "I hate you," defiance, disappointment, or purple hair.

While it is true that "the years fly by," when you are going through a taxing developmental period of your child's life, time can move very slowly. Whether it is the sleep deprivation and resulting crankiness you experience during your child's infancy or the anxiety you feel during your child's adolescent forms of rebellion, fathering is stressful as well as joyful. By the time your child leaves home forever, you will have made thousands of decisions affecting his or her life, and you will have agonized about whether those decisions were the right ones. Fathering does not occur naturally or easily. But you can learn to be more patient, more giving, more loving, more generous, and more forgiving than you ever thought you would be.

You should bond with your child even before he comes through his mother's birth canal. It can begin when you first put your hand or your ear to your wife's bulging abdomen, when you participate in childbirth classes, or when you view the ultrasound image of the fetus. Unfortunately, many men view infancy as a time of closeness between mother and child. They may not want to "interfere." Many men also feel terribly awkward handling a baby or involving themselves in the baby's natural functions. ("I don't change diapers!" or "I change diapers, but not if the baby has diarrhea!") You may believe that you can't feed her as well, dress her as well, burp her as well, or understand her cries as well as your wife can. Oftentimes, men do not view their children as fun until they can play and become involved in activities which the father enjoys.

The relative lack of early contact with your child has a circular effect. The older your child becomes without a bond having been established, the more awkward you and your child will feel when you are together. And the more awkward you feel together, the less you will want to engage each other again.

The more time you spend with your child, the more you will enjoy that time. You and your child will build familiarity, a closeness. In addition, you won't have to deal with your child's resentment because of the lack of time you have devoted to him. When a father infrequently plays with his child, the child's resentment over his feelings of deprivation hamper the quality of the encounter. He is angry and impatient with you, which causes you to feel impatient and alienated from him, which causes him to feel even more deprived and angry with you, and so on and so on. This is one of the reasons fathers are so disappointed when, after having failed to spend time with their children for protracted periods of time, they plan a special day together and it bombs. You may come with the best of intentions, full of enthusiasm and energy. But your child greets you with old hurts.
Don't postpone your fatherhood.
You approach your child and say, "Let's play together," or, even better, you say, "Let's play whatever you would like." Your child says, "No thanks, Dad. I don't want to play now."

You feel rejected. ("Well, if he doesn't want to play with me, to heck with him.") You feel hurt and self-righteous about not offering again. "I tried," you say to yourself.

But certainly you would agree that, just because you found the time to play with your child at that particular moment, it is unreasonable to assume that your child will necessarily want to interrupt what he may be involved with in order to respond to your unexpected overture. He may also be reluctant to accept your offer for fear of being disappointed once again because your interest will not last very long.

Don't let your ego interfere.

Instead of walking away and shaking your head after your child says, "Not now, Dad," simply respond with "Okay, let's make a specific date for another time. What do you think might be fun? When would you like to do it?"

Oftentimes, fathers view play with their children as another thing they have to do. They already feel tired and overwhelmed by other obligations and worries. Perhaps they are unable to effectively compartmentalize their lives. They are unable to leave their work at the office. They are unable to prevent their marital frustrations from spilling over into their relationships with their children. They are unable to cease obsessing about their financial straits. Or they may simply see themselves as inadequate, awkward fathers and wish to avoid the anxiety associated with this perceived deficiency.

The more competent you feel as a parent, the more joy you will derive from fathering. Obviously, the less "baggage," the fewer burdens you bring to your fathering, the freer you will be to spontaneously and enthusiastically play with your child. Fathering can provide an arena for personal growth. When you are actively fathering, you will develop aptitudes and sensitivities which will serve you well in the myriad of other roles you play in your world.

The music they listen to, the clothes they wear, the language your children speak may all seem alien to you. You have forgotten how wide a gulf you perceived there to be between you and your father when you were a child. You can't relate to any of it, so you don't take an interest in any of it. And so you imagine a much wider gap between you and your child than actually exists. Your child may act differently, talk differently, dance differently, or eat differently than you did when you were his age. But he has the same emotional needs that you had. He needs your affirmation, your understanding, your love. He needs a close relationship with his father.

It begins early, even before the birth. Fathers usually wish to have a boy. Research indicates that fathers touch their infant sons more than their infant daughters. Throughout the child's formative years, fathers spend more time with their sons than their daughters. Those fathers who have a very strong masculine identity, who perhaps are very athletic, demonstrate a clear preference for spending time with their sons than their daughters. Those fathers who fervently hope that their sons will follow in their footsteps as physicians, lawyers, businessmen, will also stay close in order to plant and fertilize those seeds. On the other hand, those fathers who also identify themselves with their sensitive, emotional side will more likely feel comfortable with daughters than men who adhere to rather rigid stereotypes about how a male should behave. Having a closer relationship with your daughter will facilitate the development of your interpersonal sensitivities and emotionally empathic capacities. Your daughter can push you to more fully realize all aspects of your self.

"My son is so different from me. Is he really mine?" you wonder aloud. "What do I have in common with my little girl?" you plead. Fathers are often confronted with children whose interests seem to be completely different from their own. Athletically inclined fathers are terribly disappointed when they face sons who perhaps prefer music, art, or computers to the rough and tumble, competitive world of sports.

But you can always find a way to relate to him. Even if there is no seeming "common ground," take this opportunity to expand your own horizons and diminish your feelings of estrangement from your child. You must move into his spheres of interest. Your child will be happy to share his activity with you if he perceives you to be genuinely interested. Having a different temperament from your child provides you with a challenge and an opening. The stage will be set for you to "stretch" your self-concept, to experience parts of yourself which you previously had dismissed or never even discovered.

Difficult children are difficult to be with. Instead of pleasure, they often provide stress and frustration. Instead of offering joy, they cause you to wish you had a different child. You find yourself being continuously critical of him. You believe that he can't do anything right. It is natural to want to withdraw from interactions which are painful and unrewarding.

Before I had my own children, I believed that our socializing environment was predominantly responsible for who we become. Particularly after having my second daughter, who from day one was so temperamentally different from my first daughter, I began to fully appreciate the predominant influence of our unique, genetic blueprint. There is no getting around it. No matter how effective, consistent, or patient a parent you may be, some children will prove more problematic, more troublesome, more stressful to be with, more volatile in their moods -- in short, more difficult, or to put it in a positive light, more challenging than others.

Ironically, it is the more difficult child who needs you the most. He hears your constant criticisms. He sees your looks of exasperation. And he feels terrible that you think those things about him, for he is desperate for your love. He is desperate for you to tell him he is not the bad person who he suspects everyone (including himself) believes him to be. He needs your encouragement. He needs you to believe in him. He needs you to go the extra mile. He needs you not to give up on him. He needs you to love him no matter what.

How do you not lose patience with a difficult child? By relating to his insecurities. Your child is so bossy because inside she feels so powerless. Your child is a brat because inside he feels frightened and out of control. Your child does exactly what you just told him was not permitted because he feels worthless and anticipates your rejection. Your child doesn't allow himself to hear your words of praise because he feels so unlovable.

"But, I've given him my love and attention," you insist. "Why does he still feel so insecure?" Remember, your child was born with a propensity to develop in particular temperamental ways. His insecurities, therefore, may be an ongoing part of his life. But you can ease his burden. You can keep his insecurities from destroying him.

There is no one in the world who has more power and potential influence to help your child feel better about himself than you. And there is no one in the world who can better teach you how to be more patient and self-sacrificing than your own difficult child. The patience, self-control, and generosity you can ham from raising a difficult child will also help you better deal with the most problematic, most troublesome people you will inevitably encounter in your lifetime.

After the arrival of your child, your sense of overwhelming responsibility as a father and as a provider really kicks in. Some men almost feel a sense of panic and want to run away. To make matters worse, perhaps your wife stopped working or drastically cut back her hours. Even though you may want her to be home with your new baby, her lack of financial contribution increases the load you feel. Ironically, just as you should be diverting some of your attention to your newborn, you feel the pressure to work longer hours in order to give your family what you want them to have. Furthermore, as your children get older and reach an age when they may need you the most, you are moving through your thirties and forties, your "professional prime," a time when you feel you must give your career all of your efforts in order to obtain a certain level of status and security.

The more children you have, the more justified you may feel in not devoting more time to them. You feel even more financial pressure. You work even longer hours. You're tired and you say to yourself, "I work hard all week. I've already fulfilled my responsibilities to my family -- and then some." And you infer, "I've already demonstrated how much I care about my family."

Oftentimes it is difficult to distinguish your drive to succeed in your career from the realistic financial obligations you must meet. It is more socially acceptable to invoke the latter than former in justifying your absence from family life. It appears less selfish to blame your financial responsibilities than to acknowledge your more narcissistic strivings for success when you work on weekends or arrive home after your child's bedtime.

Your children need you. They need your attention, your encouragement, your wisdom, your physical contact, your affirmation of how important they are to you. They need your love more than they need a CD player or a $100 pair of sneakers. And you need to be with your children so that you can develop a healthier perspective and balance in life.

You may believe that parenting comes more naturally to your wife than to yourself. She's got the maternal instinct. Mothers raise children. That's what my mother did. Women just know what to do with children, how to be with them, you believe. And so you rationalize your relative lack of involvement with your children by subconsciously saying to yourself, They're better off with her anyway.

Furthermore, many men believe that parenting is mostly the female's responsibility. If you accept this notion, then you may not feel completely comfortable being an actively involved father because you will have entered a feminine domain. Fathering might actually detract from your sense of masculinity. Until you incorporate nurturing and attachment to your children into your male ideal, you will feel that attention to these aspects of life will actually weaken you. Have you noticed that when most men get together in order to bond and affirm their manliness, they speak about four topics -- sports, money, work, and sex? Children are what women talk about, you assume. Unfortunately, the quality of your relationship with your child does not garner you the esteem of your peers. Will you be strong enough, secure enough as a man, to fly in the face of convention?

Perhaps you have asked your child, "Would you rather go with Mom or Dad?" You felt rejected when she said, "I want to go with Mom." They prefer to be with their mother, you tell yourself.

It may indeed be the case that your child would rather spend time with your wife than with you. But perhaps that's because your wife is more enthusiastic, more appreciative, or more attentive than you are when interacting with your child. While most daughters (particularly younger ones) might gravitate toward their mother, it is not unusual to find a girl who chooses to be with her father because he is more fun to be with, because he makes her feel so special, or because he indicates by his demeanor that he truly enjoys and looks forward to his time with her.

Your daughter may, in fact, appreciate the differentness of being with a man, her dad. The relationship which each parent has with their child is unique. As a father, your role need not be to imitate your wife's behavior when you are interacting with your daughter. On the contrary, you can provide your daughter with another flavor of positive role model which will help her establish later relationships with a greater variety of people. She will also have two different styles or approaches to life to draw upon when making future decisions.

Children want to be with a parent who clearly demonstrates his/her love, interest, and enthusiasm while being with them. You will feel the satisfaction of being wanted and loved when your children feel that too.

Couples often disagree about how to raise their children. You may perceive your wife to be too indulgent, too lax. She may, just as firmly, believe you to be unrealistically demanding or too stem with your son or daughter. You may believe she coddles your children, spoils them. Your wife, because of past feelings of deprivation, may see in you the father who withheld his love from her when she was a child. Old resentments may be displaced onto you if she perceives you to be repeating the same pattern with your children.

So you leave the field to her in order to avoid another argument. And you rationalize your withdrawal from child rearing by saying to yourself that you want to keep a somewhat shaky marriage from becoming even more unsatisfying and, perhaps, ultimately untenable.

If the prospect of marital conflict interferes with your desire to be with your children, you must resolve that conflict, instead of withdrawing from family life. Begin by talking with your wife about the kinds of parenting which each of you received. How did you feel in your relationships with your parents? What were your perceptions of your parents as you were growing up? How did your relationships with your parents affect your subsequent romantic relationships and the kinds of partners you chose? Successfully defusing the tension between you and your wife may require some professional assistance in unraveling old childhood hurts which affect the way each of you now approaches your children and your mate.

Ultimately, of course, the development of better communication skills in your marriage and greater empathy for one another will serve you in good stead in developing a more communicative and empathic relationship with your children.

All husbands and wives who I see in my practice have had both their marriage and their parenting styles affected by the mother and father who reared them. In their own ways, Ben and Barbara reflect many of the issues which I have discussed in this chapter.

Ben, a 38-year-old accountant, and Barbara, a 36-year-old teacher, had been married for seven years before they appeared at my office because of marital difficulties which had been simmering for years. (No one seeks psychotherapy or counseling after experiencing a problem for only a short period of time.) There were the usual complaints. From Ben: Barbara didn't seem to have much time for him anymore. Barbara was overly involved with the children. Barbara had put on weight and didn't care about her appearance. Barbara wasn't interested in sex. From Barbara: Ben was uninvolved in family life. Ben seemed to care more about his work than about her or the children. Ben always excused himself as being too stressed or too tired. Ben wasn't affectionate anymore. Ben didn't seem to care about having an emotionally close relationship anymore.

Both Ben and Barbara grew up in very modest circumstances. Their parents occupied traditional roles. Ben's father worked seven days a week as a tailor in Boston. Barbara's father worked overtime in his steel mill whenever it was available. Ben's mother and Barbara's mother were housewives. Ben's father, an immigrant, was from "the old school." "Be happy for what you have," "Life is tough," "You don't need very much," "Money doesn't grow on trees," were some of the lessons he imparted to Ben. Barbara's father, abandoned by his parents at an early age, was a bitter, cold man. He was uninterested in his children. Barbara remembers her frustration at repeatedly attempting to gain his attention or a word of approval. He virtually ignored Barbara and her brothers.

Ben learned his lessons well. Both as a child and as an adult, Ben has led a life of self-denial. Although his financial circumstances are significantly different from his father's, unfortunately Ben feels as though and acts as though he is living under the same constraints. And he expects the same of his children. "My children always seem to be whining or complaining about this or that. And their mother spoils them rotten. What kind of character will they grow up with? Shouldn't there be limits?" Ben rhetorically asked.

Barbara was more aware of her previous hurt and anger toward her father than Ben was of his feelings of deprivation. She was determined to provide for her children what she never received. She admitted, "It's difficult for me not to give my children what they want. But, unlike Ben, I don't see my children as being so demanding or unreasonable." And Barbara acknowledged that, in many ways, particularly when there is an issue of giving, she sees her father when she observes her husband. Every time Ben says "No" to his children (or to her), Barbara hears that voice from her childhood denying her once again.

In any couple I see in therapy, both parties are absolutely convinced of the correctness of their point of view. Each is dumbfounded that the other doesn't see "the obvious." But the issue, of course, is not who is right or who is acting most appropriately. In Ben and Barbara's case, one of the first steps in their treatment was for them to understand how the parenting which they received has affected their feelings and expectations toward their own children. Only then can they respond most helpfully to the needs of their children, as opposed to acting on the sanctions of their own childhood.

Reprinted with permission from The Gift of Fatherhood: How Men's Lives are Transformed by Their Children, Fireside, 1994

Copyright © 1994 by Aaron Hass, PhD

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12 Reasons Fathers Might Not Want to Spend More Time with Their Children

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Almost all parents will tell you that child rearing is much more difficult than they had anticipated. Before your first child's arrival, your fantasies involved playing with him or observing him proudly. The scenes were always pleasant, always gratifying. You did not anticipate colic, tantrums, "I hate you," defiance, disappointment, or purple hair.

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I interviewed Ms. Virginia Kyles, who is a mother to 3 children spanning 40 years, while also being a foster mother for over 30 years. She explains how her mindset and view of things has changed ever since and how she felt while working with foster children.