The Pregnancy Brain Myth

Pregnancy

Jun 26

The way a woman’s mind works changes during pregnancy. Many women say they experience baby brain or pregnancy brain, referring to feeling less confident with their thinking, attention, and memory. But is this a real phenomenon?

Many have attempted to answer the question of how a woman’s cognitive abilities changes during pregnancy, with very mixed results. Some studies show improved performance on certain tasks, others show deficits, and still others note no changes.

The Role of Estrogen

The studies that note improvements, which are consistent with animal experiment data that note improvement, attribute the differences to the increases in estrogen during pregnancy. The hormone estrogen has been linked with enhanced cognitive abilities, particularly in categories such as verbal fluency and verbal memory. And we know how dramatically hormones change during pregnancy, with estrogen levels increasing six-fold, progesterone three-fold, and cortisol doubling.

The Role of Mood and Anxiety

Mood, anxiety, and emotional changes can also affect thinking. In fact, one of the key symptoms of major depression is a deficit in concentration. If you are anxious, that can also make it more difficult to pay attention and recall facts later. For women struggling with mood and anxiety concerns during pregnancy, cognition is very likely negatively influenced.

The Role of Sleep

Sleep is one of the most significant confounding factors. What does this mean? It means that sleep, and specifically sleep deprivation, affects cognitive abilities. Most have experience understanding how much more difficult basic things like paying attention or remembering facts can be when you are sleep deprived. Pregnancy is a time when sleep becomes much more challenging due to a number of factors (see my article on Sleep Disturbance During Pregnancy), including physical discomfort and the need to use the restroom. Sleep deprivation leads to impaired ability to focus and concentrate. Studies that do not take sleep deprivation into full account find that there is a deficit in cognition for women in pregnancy, while those that do take sleep into account, find no differences.

The Role of Bias and Stereotypes

There is also bias. Women have heard repeatedly that pregnancy is supposed to make it more difficult to think clearly. Before pregnancy you did not pay much attention to the fact that you forgot your umbrella on a rainy day, misplaced your keys, or neglected to buy a certain essential item at the store. During pregnancy, you are expecting to make these mistakes, so they become more prominent in your mind and you attribute them to pregnancy brain.

Others around you might have the same bias. At work, for example, if you make an error (and who doesn’t make any mistakes?) it might be attributed to your pregnancy rather than brushed off.

This type of bias makes a difference in the laboratory. Many psychological studies have been done to show the effect of “priming.” That is the phenomenon when an individual’s expectations are set, unconsciously, and those expectations influence outcomes. So if a pregnant woman comes in to perform a cognitive exam in a lab setting, and she expects to do poorly because of pregnancy brain, she will.

Pregnancy Brain a Myth, Most Likely

As we have seen, the studies on cognition in pregnancy are mixed. There are several explanations for why women find their thinking worsens during pregnancy – sleep deprivation, emotional upheaval, and society’s bias. Until there is a way to account for all these alternative reasons in a research study, we may not have a definitive answer to this question. Until then, however, the power of positive thinking has been proven, and bias works both ways. If you recognize that high estrogen levels improve certain types of thought, work to manage your mood and anxiety, and focus on prioritizing sleep, you will find that being pregnant helps you think more clearly.

Selected References:
Farrar, D. et. at. Assessment of cognitive function across pregnancy using CANTAB: A longitudinal study. Brain and Cognition 84 (2014): 76-84.
Christensen, H., Leach, L.S., Mackinnon, A. Cognition in pregnancy and motherhood: Prospective cohort study. 2010 British Journal of Psychiatry 196: 126-132.
Logan, D. et. at. How to memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women. 2014. Journal of Clinical and Experimental Neuropsychology 36: 528-539.

Anna Glezer, M.D.

Dr. Glezer began her training at Harvard and then transitioned to the University of California, San Francisco, where she has been a practicing physician, teacher, mentor, and is an associate professor. She is board certified in adult and forensic psychiatry, a member of the American Psychiatric Association, and the immediate past President of the Northern California Psychiatric Society.

She has worked with hundreds of women going through the emotional challenges of conception, pregnancy, loss, and postpartum. She has been interviewed for, and her written work has appeared on multiple leading sites, including Huffington Post, Fit Pregnancy, Health Line, Help Guide, and more. She has presented at local and national conferences and published in academic journals. Several years ago, she established the annual Bay Area Maternal Mental Health Conference and launched the educational website Mind Body Pregnancy, aimed to inform women, their partners, and their providers about mental health and emotional issues common in the reproductive years.

She began her private practice to help women throughout the Bay Area access reproductive mental health services and is really passionate about helping as many women as possible.