This paper examines the complexity and fluidity of maternal identity through an examination of narratives about "real motherhood" found in children's literature. Focusing on the multiplicity of mothers in adoption, I question standard views of maternity in which gestational, genetic and social mothering all coincide in a single person. The shortcomings of traditional notions of motherhood are overcome by developing a fluid and inclusive conception of maternal reality as authored by a child's own perceptions.

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

Adversities in pregnancy, including poor diet and stress, are associated with increased risk of developing both metabolic and mental health disorders later in life, a phenomenon described as fetal programming or developmental origins of disease. Predominant hypotheses proposed to explain this relationship suggest that the adversity imposes direct changes to the developing fetus which are maintained after birth resulting in an increased susceptibility to ill health. However, during pregnancy the mother, the developing fetus, and the placenta are all exposed to (...) the adversity. The same adversities linked to altered offspring outcome can also result in suboptimal maternal care, which is considered an independent adverse exposure for the offspring. Recent key experiments in mice reveal the potential of prenatal adversity to drive alterations in maternal care through abnormal maternal–pup interactions and via alterations in placental signaling. Together, these data highlight the critical importance of viewing fetal programming holistically paying attention to the intimate, bidirectional, and reiterative relationship between mothers and their offspring. (shrink)

Support from grandparents plays a role in mothers’ perinatal mental health. However, previous research on maternal mental health has mainly focused on influences of partner support or general social support and neglected the roles of grandparents. In this narrative review and meta-analysis, the scientific evidence on the association between grandparental support and maternal perinatal mental health is reviewed. Searches in PubMed, EMBASE, MEDLINE, Scopus, and PsycINFO yielded 11 empirical studies on N = 3381 participants, reporting on 35 effect sizes. A (...) multilevel approach to meta-analysis was applied to test the association between grandparental support and maternal mental health. The results showed a small, statistically significant association (r =.16; 95% CI: 0.09–0.25). A moderator test indicated that the association was stronger for studies reporting on support from the maternal grandmother in particular (r =.23; 95% CI: 0.06–0.29). Our findings suggest that involved grandparents, in particular mother’s own mother, constitute a protective factor for the development of maternal postpartum mental health problems. These findings have clear implications for interventions. Future studies should examine whether stimulating high-quality support from grandparents is a fruitful avenue for enhancing maternal postpartum mental health. (shrink)

This study investigated the impact of maternal reflective functioning (RF) and attachment security on children’s mentalization. The Adult Attachment Interview (AAI) was administered to mothers in a sample of 41 mother–preadolescent dyads. AAI transcripts were rated in terms of the Berkeley AAI System ( Main and Goldwyn, 1998 ) and the Reflective Functioning Scale (RFS; Fonagy et al., 1998 ). Preadolescent mentalization was assessed using a semi-structured interview adapted from O’Connor and Hirsch (1999) and also by analyzing mental-state talk produced (...) during an autobiographical interview. Relationships between maternal RF and children’s mentalization were analyzed, with consideration given to the different RFS markers and references to positive, negative, and mixed-ambivalent mental states. Children’s mentalization was positively correlated with the mother’s RF, particularly the mother’s ability to mentalize negative or mixed-ambivalent mental states. No significant differences in mentalization were observed between children of secure and insecure mothers. (shrink)

The effects of parent rewards on youth outcomes have been studied extensively; however, research has not systematically categorized parent rewards. Centralizing the analysis of rewards within a given study would help compare the prevalence of reward types at superordinate and subordinate levels. Moreover, it could reveal which level is the most effective for assessing cultural group similarities and differences in a globalizing world. Mother-child conversations between European-American (n = 51) and Hispanic-American (n = 44) dyads were transcribed. A content analysis (...) assessed material and social reward talk themes and created new subthemes. A series of 2 (culture) × 2 (gender) ANCOVAs assessed cultural differences in reward talk themes and subthemes. Results revealed the prevalence of certain reward subthemes, like praise, significantly differed by cultural group. In conclusion, investigations with different cultural groups should consider reward talk on a subordinate level rather than superordinate. (shrink)

One of the most robust findings in psychopathology is the fact that specific phobias are more prevalent in women than in men. Although there are several theoretical accounts for biological and social contributions to this gender difference, empirical data are surprisingly limited. Interestingly, there is evidence that individuals with stereotypical feminine characteristics are more fearful than those with stereotypical masculine characteristics; this is beyond biological sex. Because gender role stereotypes are reinforced by parental behavior, we aimed to examine the relationship (...) of maternal gender stereotypes and children’s fear. Dyads of 38 mothers and their daughters were included. We assessed maternal implicit and explicit gender stereotypes as well as their daughters’ self-reported general fearfulness, specific fear of snakes, and approach behavior toward a living snake. First, mothers’ fear of snakes significantly correlated with their daughters’ fear of snakes. Second, mothers’ gender stereotypes significantly correlated with their daughters’ self-reported fear. Specifically, maternal implicit gender stereotypes were associated with daughters’ fear of snakes and fear ratings in response to the snake. Moreover, in children, self-reported fear correlated with avoidance of the fear-relevant animal. Together, these results provide first evidence for a potential role of parental gender stereotypes in the development and maintenance of fear in their offspring. (shrink)

The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which (...) it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health.Also watch the Video Abstract. (shrink)

A pronatalist perspective on maternal bodies renders the adoptive maternal body queer. In this essay, I argue that the queerness of the adoptive maternal body makes it a useful epistemic standpoint from which to critique dominant views of mothering. In particular, exploring motherhood through the lens of adoption reveals the discursive mediation and social regulation of all maternal bodies, as well as the normalizing assumptions of heteronormativity, “reprosexuality,” and family homogeneity that frame a traditional view of the biological family. As (...) participants in motherhood who resist “repro-narrativity,”“reprosexuality,” and essentialism, adoptive maternal bodies have the potential to both queer our notions of normal mothering and normalize our notions of queer mothering. (shrink)

BackgroundBehavioral and physiological regulation in early life is crucial for the understanding of childhood development and adjustment. The autonomic nervous system is a main player in the regulative system and should therefore be modulated by the quality of interactive behavior of the caregiver. We experimentally investigated the ANS response of 18–36-month-old children in response to the quality of maternal behavior during a mother–child-interacting paradigm.MethodEighty mothers and their children came to our laboratory and took part in an experimental paradigm, consisting of (...) three episodes: a resting phase, a structured play phase, and a free play situation between mothers and their child. Children’s and mother’s heart rate, the sympathetic nervous system activity via the pre-ejection period and the left ventricular ejection time, and the parasympathetic nervous system activity via the respiratory sinus arrhythmia were continuously measured by an electrocardiogram. Maternal sensitivity of interactive behavior was assessed by using the Emotional Availability Scales.ResultsChildren of mothers with insensitive behavior had a significantly lower RSA at baseline, showed a lack of RSA withdrawal during structured and free play, and had shorter LVET across all episodes compared to children of sensitive mothers.ConclusionOur findings depict the influence of low-quality maternal interaction on the child’s ANS regulation, in calm and more stressful play situations. The overall higher SNS mode with impaired PNS reactivity may negatively influence child’s ANS homoeostasis, which may result in a long-term impact on mental and physical wellbeing. Further, the maternal sensitivity may function as a buffer for the stress response of their child. These results could serve as a basis for the development of appropriate psychoeducational programs for mothers of low sensitivity in their interaction with the child. (shrink)

Maternity careproviders often have strong views concerning a woman’s choice of where to give birth. These views may be based on the ethical principle of autonomy, or on the principle of beneficence. The authors propose that an approach utilizing shared decision making allows careproviders and women to move beyond disagreements regarding which evidence on risk should “count,” instead adopting a process of increased knowledge and support for women and their partner while they make choices regarding place of birth.

The onomasticon of Hellenistic Uruk demonstrates that, in some cases, individuals with Greek names were included in otherwise Babylonian families. Often, such Greek names have been interpreted by scholars as evidence for Hellenization. This article suggests an alternate explanation, based on evidence throughout the family trees for a series of naming practices that focus on the perpetuation of names of female relatives and transmission of preferred family names through maternal lines. Particularly important to this discussion are the practices of mammonymy, (...) a term coined here to refer to papponymy’s gendered parallel, i.e., the naming of a girl after her grandmother or other female ancestor, and the practice, previously unexamined in the Assyriological literature, of “maternal-line papponymy,” the tradition of naming a son for his maternal grandfather or other male ancestor from a maternal line. Maternal-line papponymy can be observed in family trees in which the members bear only Babylonian names, as well as in family trees that include individuals with Babylonian names and individuals with Greek names. The Greek names used for boys are often those of fathers or grandfathers of women with Greek names who married into these Babylonian families. This article argues that the incorporation of Greek names into the elite Babylonian families of Hellenistic Uruk cannot be assumed to be straightforward evidence of impulses toward “Hellenization.” Rather, this evidence indicates that Greek names were given to sons in such families within the context of traditional Babylonian maternal-line naming practices. This finding has important implications for scholarship’s understanding of acculturation and the display of cultural identity in Hellenistic Babylonia. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

: A pronatalist perspective on maternal bodies renders the adoptive maternal body queer. In this essay, I argue that the queerness of the adoptive maternal body makes it a useful epistemic standpoint from which to critique dominant views of mothering. In particular, exploring motherhood through the lens of adoption reveals the discursive mediation and social regulation of all maternal bodies, as well as the normalizing assumptions of heteronormativity, "reprosexuality," and family homogeneity that frame a traditional view of the biological family. (...) As participants in motherhood who resist "repro-narrativity," " reprosexuality," and essentialism, adoptive maternal bodies have the potential to both queer our notions of normal mothering and normalize our notions of queer mothering. (shrink)

Although female and male gametes are presumably equivalent in their genetic contribution to embryos, they carry specific information, perhaps reversibly imprinted into the genomes during oogenesis and spermatogenesis, as to their maternal or paternal origin. This information is crucial for embryogenesis and, in the absence of at least one haploid set of chromosomes from each parent, embryos do not develop to term. The paternal genome is probably required for proliferation of extraembryonic tissues and the maternal genome for some stages of (...) embryogeneis. Furthermore, the effects of certain mutations are determined by the paternal or maternal origin of the inheritance. (shrink)

Medea killed her children to take away the smile from her husband's face, according to Euripides, an offence against nature and morality. What if Medea had still been carrying her two children, perhaps due to give birth within a week or so, and had done the same? If this would also have been morally reprehensible, would that be a judgment based on her motives or on her action? We argue that the act has multiple and holistic moral features and that, (...) in fact, there is no absolute principle, such as the right of the fetus to life, which governs our moral judgments about fetal-maternal conflicts. We suggest that they illustrate a pervasive feature of human moral discourse and can only be addressed by attending to a range of negotiable moral considerations which depend on particular features of each situation. (shrink)

This study identified the influences of maternal socio-demographic and antenatal factors on stillbirths and neonatal deaths in New South Wales, Australia. Bivariate and multivariate analyses were used to explore the association of selected antenatal and maternal characteristics with stillbirths and neonatal deaths. The findings of this study showed that stillbirths and neonatal deaths significantly varied by infant sex, maternal age, Aboriginality, maternal country of birth, socioeconomic status, parity, maternal smoking behaviour during pregnancy, maternal diabetes mellitus, maternal hypertension, antenatal care, plurality (...) of birth, low birth weight, place of birth, delivery type, maternal deaths and small gestational age. First-born infants, twins and infants born to teenage mothers, Aboriginal mothers, those who smoked during the pregnancy and those of lower socioeconomic status were at increased risk of stillbirths and neonatal deaths. The most common causes of stillbirths were conditions originating in the perinatal period: intrauterine hypoxia and asphyxia. Congenital malformations, including deformities and chromosomal abnormalities, and disorders related to slow fetal growth, short gestation and low birth weight were the most common causes of neonatal deaths. The findings indicate that very low birth weight (less than 2000 g) contributed 75·6% of the population-attributable risks to stillbirths and 59·4% to neonatal deaths. Low gestational age (less than 32 weeks) accounted for 77·7% of stillbirths and 87·9% of neonatal deaths. The findings of this study suggest that in order to reduce stillbirths and neonatal deaths, it is essential to include strategies to predict and prevent prematurity and low birth weight, and that there is a need to focus on anti-smoking campaigns during pregnancy, optimizing antenatal care and other healthcare programmes targeted at the socially disadvantaged populations identified in this study. (shrink)

Trafficking and persistence of fetal microchimeric cells (fMCs) and circulating extracellular vesicles (EVs) have been observed in animals and humans, but their consequences in the maternal body and their mechanistic contributions to maternal physiology and pathophysiology are not yet fully defined. Fetal cells and EVs may help remodel maternal organs after pregnancy‐associated changes, but the cell types and EV cargos reaching the mother in preterm pregnancies after exposure to various risk factors can be distinct from term pregnancies. As preterm delivery‐associated (...) maternal complications are rising, revisiting this topic and formulating scientific questions for future research to reduce the risk of maternal morbidities are timely. Epidemiological studies report maternal cardiovascular risk as one of the major complications after preterm delivery. This paper suggests a potential link between fMCs and circulating EVs and adverse maternal cardiovascular outcomes post‐pregnancies, the underlying mechanisms, consequences, and methods for and how this link might be assessed. (shrink)

Through her reading of Euripides'Bacchae, Colridge's "Christabel," de Sade'sPhilosophy in the Bedroom, and Hitchcock'sPsycho author Alina M. Luna finds precedent for a destructive impulse lurking beneath the maternal gaze.

A metaphysical strand of C. S. Peirce’s American pragmatism resonates deeply in potential alliance with “incorporeal feminism”: a transcontinental philosophy with origins in Luce Irigaray’s ethics of sexual difference. A psychoanalyst trained by Lacan himself, Irigaray analyzes the unconscious of various philosophical systems, revealing dualism as an underlying phallic structure. In the dualism between idealism and materialism, she explains, the terms become sexually coded: idealism, paternal-masculine; materialism, maternal-feminine. Incorporeal feminism does not merely invert the roles, but radically reimagines the relation (...) between them, postulating the ideal as a maternal condition of possibility for birthing the material into existence; not separate substances but the inseparable activity of materiality making itself. For Peirce, ideas act; and though he was by no means a feminist, his metaphysics lend at least three insights to incorporeal feminism: an alternative to dualism in the trichotomic categories “firstness, secondness, and thirdness”; an evolutionary cosmology where the material universe is a gestating embryo within a womb; and an objective idealism: a model for addressing the dilemma of when sexual difference begins. Within “firstness,” sexual difference is ideal; an incorporeal activity pre-existing and latently imbuing materiality to varying degrees, ultimately expressing itself in certain life-forms as bodily differences. (shrink)

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)

The design of medical knowledge-based computer systems requires effective interdisciplinary communication for the development of a community sharing common goals and a common language for design. Over the past 9 years the Perinatal Research Group, an interdisciplinary team of computer scientists, engineers and clinicians, have developed a prototype knowledge-based computer system to aid clinicians in the care of women in labour. The group were uncertain which approach to adopt to progress this system from a prototype to a useful clinical tool (...) to support decision making. A case study and activity theory analysis, of an existing clinical knowledge-based computer system in routine use, helped to resolve a number of communication and methodological issues that the design team encountered. Sharing of backgrounds and perspectives caused the design team to question previous assumptions and to explore alternative functions and roles for knowledge-based computer systems in maternity care. We are now undertaking a longitudinal case study and activity theory analysis of obstetric teams and women in labour to analyse the relationships between clinicians, patients and technology. This work will inform the development of our knowledge-based computer system to place the patient at the centre of the decision-making process. (shrink)

Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...