Psychological factors that may affect infant mental health

Psychological factors that may affect infant mental health include imaginings
about the unborn baby and changes to the parent’s identity. This requires a
reworking of experiences and attitudes about one’s family of origin experiences.
It involves intra-psychic changes as well as actual changes in the relationships
with parents and other family members.
One aspect of the transition to parenthood can be thought of as involving a
change in identity from that of a child (to one’s own parents), to that of a parent (to one’s own child) .During pregnancy, many women become increasingly introspective, and
emotions may be more intense. This can create problems as old conflicts (with parents, for example) are reactivated. The pregnant woman is likely to feel sensitive and psychologically vulnerable as she moves towards the birth of herself as mother and the birth of her infant. Similarly, expectant men
experience a less obvious transition, a reworking and thinking through of the
kind of parent they want to be. This is inevitably influenced by their own
experiences in their family of origin.
The imagined baby
Babies carry powerful wishes, hopes and dreams for their parents and, to a lesser extent, for the extended family. The infant may have existed in the imagination
of parents, grandparents, siblings and others long before conception. However, the baby that arrives is rarely the baby who was imagined and wished for. The
relationship that develops between the parent and infant is affected by the nature of expectations and wishes about the baby, the experience of pregnancy and
birth, and the capacity of the family to accept and welcome the infant who does arrive.
Daniel Stern wrote:
between the fourth and seventh months of gestation there is a rapid growth in the richness, quantity, and specificity [of the imaginings] about the baby to be…The
elaboration…peaks at about the seventh month…Between the seventh and ninth month…representations about the baby decrease and become progressively less
clearly delineated, less specific, and less rich…After all, birth is the meeting place for the baby now in her arms and the one in her mind. As far as possible, she needs to
keep the real situation unburdened with the past so that she and her real baby can start to connect, with a minimum of interfering baggage (p. 23).
As Stern indicates, the histories of each parent, and of their relationship
before conception, influence imaginings about who the baby will be. The
imagined baby is also affected by the circumstances of conception, the obstetric
history, and other factors in the parents’ lives.
For example, a couple, pleased to be pregnant for the first time, may tell
family and friends as soon as the pregnancy is confirmed. They are keen to
include others in their excitement. A couple who have had difficulty conceiving
or have experienced a past obstetric loss may find it hard to let themselves
imagine the baby, wonder if the infant is a boy or a girl or discuss names, because
of the intensity of past disappointment and loss. Where the pregnancy is
unplanned, and the parents are uncertain whether to continue the pregnancy, it is unlikely that much imagining about the infant will occur, and this may be
psychologically necessary until a decision is made about whether to continue the pregnancy.
The physical experience of pregnancy can influence how the baby is imagined
and talked about. This may give clues to how the parent experienced her infant even before he or she was born. Some quotes illustrate the range of experiences
women may have: I vomited for nine months, and spent three months in hospital on my back. I was
so depressed, I didn’t want him. (Kate, 29.)
She used to get her feet up there under my ribs and really have a go at me.
I loved being pregnant, I felt so close to her then. Both of us had everything we needed. Changes to the woman’s identity
During pregnancy a woman struggles to answer the question ‘What kind of
mother will I be?’ This may be a conscious or unconscious process and feelings
and thoughts may be confusing, bemusing, surprising or frightening. Past
unresolved conflicts and present traumas can affect a woman’s fantasy life and attitude to her pregnancy. For example, she may identify with characteristics she
liked and admired in her own mother and others she does not want to repeat. She may be anxious, with high expectations, wanting to do things very differently from her own parents.
I knew all the things I didn’t want to do and be. I just didn’t know what was
realistic. I think I set myself unrealistic goals to be perfect almost, and when I
wasn’t, that was hard.