Episode 140 - Baby Brain
Mel:
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey. Welcome to today's episode of the Great Birth Rebellion podcast. Today I'm joined by my guest Dr. Sarah McKay who's a neuroscientist with a special interest in how women's brains work and change through their unique life stages and today we're exploring the neuroscience behind how pregnancy and motherhood sculpt our brains and change our minds.
Sarah:
[0:45] For the better.
Mel:
[0:47] For the better, exactly. I'm glad you added that.
Mel:
[0:52] So we get an upgrade our brains change um for the better before we start on all of that sarah can you introduce yourself your qualifications in your work.
Sarah:
[1:03] okay so well I have a phd in near I've got three degrees in neuroscience i should say and so i've got a bachelor of science honors degree in neuroscience from otago university in New Zealand because I grew up in New Zealand and then I have a master's in neuroscience and a DPhil or which is from Oxford University and a DPhil is just the fancy Oxford University way of saying PhD so, bachelor's master's and PhD all in neuroscience and mom I suppose book author um, I just turned 50, so I feel like that's a qualification.
Mel:
[1:42] It's a qualification for me.
Sarah:
[1:44] I have always, so I literally met and fell in love with neuroscience in first year uni in 1993. I thought it was really cool learning about synapses. I was just like blown away by that little biological mechanism. And one of the reasons why I still love neuroscience, although I'm not an academic researcher anymore, is that it's still cool to find out new things about the brain and how it works. And luckily, what I have focused in on, which is around women's health across the lifespan, there's lots of people that want to talk to me about the stuff I find cool. So that's how I spend my time. I've spent a lot of time in the last few years writing. Last year, I wrote two books. Don't write two books in one year. It is a lot of work. I literally had like 12 hours between submitting one and starting the next. And um i've written in the last few and baby brain came out in 2023 i've updated a lot of courses that i teach wrote two books last year so i'm taking a gap year turned 50 at the beginning of the year and so i'm taking like a little gap here except i'm doing podcasts and things because that's kind of fun yeah i'm doing like watercolor classes i'm like going to dog training i'm going to the gym, I might then to play pickleball I don't know, I'm just having a year to just take my foot off the accelerator because the last few years I've just been doing too much and trying too hard.
Mel:
[3:14] I took hard. But thankfully, your brain is upgraded to its optimum format.
Sarah:
[3:20] Well, yeah, I think it might be just that it's kind of reached its limit. So it needs to reset.
Mel:
[3:26] I love that you're getting a gap year and doing tools. I took up banjo this year and knitting. So I can crochet very well. But I thought I'm going to learn some new things too. But can you tell me the names of the books that you've written?
Sarah:
[3:43] So the first book i don't love the name i didn't want to call it that however it is called the women's brain book the neuroscience of health hormones and happiness i wanted to call it all in her head however the the publishers at that time the marketing department thought oh it's a like the girl on the train or the woman in the window so they thought all in her head might sound a bit too much like domestic noir sure not like neuroscience so that was a bit disappointing um but that's okay the second book then so that was 2018 beginning of 2018 that came out then in 2023 i published baby brain which we have already said the surprising neuroscience of how pregnancy and motherhood sculpt our brains and change our minds for the better 2023 and then earlier this year so the first half of last year i spent writing brain health for dummies which is part of the four dummies brand so that's just come out in the last month or two and the second of last year because there has been so much new cool neuroscience in women's health i felt like the women's brain book needed an upgrade it needed to be updated with all of this new neuroscience because I was starting to get a little bit, not embarrassed, but I'd hand it over to people and go, oh, but there's so much new stuff and some of it's outdated and read some of it but not all of it.
Sarah:
[5:10] And so then I thought, I'm just going to update that. So I spent the second half of last year updating that. So the updated version of that with the same title but a different cool new cover comes out in July this year.
Mel:
[5:22] Brilliant. I love that.
Sarah:
[5:24] So I say there's three and a half books.
Mel:
[5:26] Three and a half books. that's that's three and a half more than most of us so hats off um tell me what's your along with the little bit of research that i did about you before kicking off this podcast episode what's your familiarity with andrew huberman of oh
Sarah:
[5:46] Oh i was like what's she gonna say my familiarity with him. So, back in the last century, so my PhD topic was looking at this sort of development of the visual system, very early postnatal development of the visual system. And I was really interested in how neurons and the visual pathway wire up.
Sarah:
[6:10] Very early in development and what kind of guides those connections so is it like nature is it nurture and when it comes to visual system is it like completely genetic or is it determined by actually what we see does seeing guide visual system development and so his phd was at the same time on a very similar topic and then.
Sarah:
[6:29] Um i went to like neuroscience summer camp for PhD students which is so nerdy but was very cool um I do like a little like you know excursion with fellow scientists but so I went to Cold Spring Harbour Lab in Long Island near New York where they run science camp for academics and um I did structure and function of the visual system and Andrew Huberman was also doing the same program so we spent about three weeks hanging out and so I met him then and then later that year then I went over to back over to the US and we hung out a bit more doing neuroscience going to a conference and then I went back and had Thanksgiving at his mum's house which was very nice of him to put me up there and then we kind of kept in touch briefly because we were both doing same topics and then lost contact but then like kind of reconnected again a few years ago before he became famous um and um he did some teaching on one of my because i run online professional development courses and he did some teaching on one of my courses and then one day he said i think he's starting a podcast and i was like oh that's a really good idea i think there's a market for people talking about neuroscience said you probably do quite well and now like you can't even ring him up on the phone like he's like trying to get hold of the king or something.
Mel:
[7:56] Yeah, he's proper famous now. So really.
Sarah:
[7:58] Yeah, it's kind of wild. He's done really well. Yeah? He's done very, very well. Fantastic. Amazing. So that's my Andrew Heumann story. I just would like to add that there was never any romantic connection because people seem to think that because we went to summer camp together, there must have been never a touch. I was already dating my now husband at the time. It was professional friendship only.
Mel:
[8:22] Fantastic. I assumed as much.
Sarah:
[8:24] People always like the juicy gossip.
Mel:
[8:26] No, you're just friends. That's completely fine. All right. So today we're going to talk about the topic of matrescence. And can I just say that Google and spellcheck don't recognize matrescence as a word yet?
Sarah:
[8:44] No, it doesn't. No. It's the best word. I wish I had known that word when my boys were little because they are now 15 and 16, turning 17. And had I known that word 16, 17 years ago, I think things would have made... I mean, sometimes one word can just shift your way of thinking. I thought then... I don't even think the internet was a thing then, but there wasn't that much information out there about this. I thought that you had a baby, you got pregnant, and it was this event. And then you had the baby, and that was another kind of event. And then you looked after the baby.
Sarah:
[9:28] And some parts were great and easy, and other parts were the hardest thing I've ever done. And had I known that matrescence kind of encompassed that whole process, as a journey of becoming and had I known it was neurological and social and spiritual and psychological and physical and all of the things, in the same way adolescence is, like we can say matrescence is a bit like adolescence, then I think I just would have given myself a whole lot more grace because I was pretty tough on myself and I found it hard and I thought that I shouldn't find it hard.
Sarah:
[10:04] And people didn't talk then about how it was hard and had I known that matrescence was a process of becoming then I think it would have given me insights into what was happening.
Mel:
[10:20] A growth process, not a failure,
Sarah:
[10:22] Not a problem to be solved, not a thing I didn't manage to do right.
Mel:
[10:27] Yes and i love that inference that you make in your book that matrescence is like adolescence and society recognizes that it's a huge transition for children to go from being children into adolescence and the amazing changes that happen in their body and their brains and you talk about matrescence it's the maternal version yeah
Sarah:
[10:52] I thought i didn't know that, Because I always said parenting, like the easy part with the babies, because my boys are very straightforward and I didn't, you know, I had very straightforward pregnancies and deliveries and straightforward babies who ate very well and slept very well. And they were by all accounts, what you would say, easy. But it was so hard. And so it wasn't them that was hard. It was me that was hard. I didn't like what I, I didn't, I couldn't understand who I was and what I was doing and why I felt so different.
Mel:
[11:27] Right.
Sarah:
[11:27] Because I didn't know that that was part of the process. I thought it was just like having a new friend.
Mel:
[11:33] You didn't yet look up.
Sarah:
[11:34] Like that you looked up. I didn't know what I was thinking. You know, like you meet someone and they're just this new person in your life. It doesn't alter every cell in your body.
Mel:
[11:44] Let's talk about the altering of cells in your body. So from what you know of neuroscience, what happens to us when we get pregnant?
Sarah:
[11:53] Yeah. So in short, the way I like to sum it up is that pregnancy prepares the mind for motherhood. So we are very familiar with the idea that pregnancy and then, you know, you deliver a baby and then you nurture the baby. That a large part of what happens to your body is growing the baby, but then also preparing your body to nurture the baby. So if you choose to breastfeed, but that process is also shaping and sculpting your brain. A process that we're very familiar and comfortable with talking about happening to other animals, other mammals, and we're just biological mammals too. So the process of, shape our bodies it actually shapes and sculpts our brain and a lot of the shaping and sculpting and changing that takes place in our brain the neurological shifts and changes take place during pregnancy we now understand that and they're driven largely by the hormones of pregnancy and they completely reorganize the brain and even change it structurally with the intention because we understand which networks change of being able to respond and nurture and care.
Sarah:
[13:03] For your baby we know that it's about responding to the baby's cues and needs and wants because the parts of the brain that change most all the parts of the brain change but those that change most are involved with social cognition or reading social cues so what someone else is thinking or what someone else is feeling i mean you don't really need you know pregnancy isn't changing your brain so you need to worry about your boss thinks or feels it's to keep your baby alive you know the evolutionary mandate is to keep this new baby alive so your brain has changed to enable you to do that we are largely social creatures and we also learn how to parent not all of knowing how to take care of a baby as a human mammal is innate the baby doesn't pop out and we know what to do we need to learn how to do that from other people but i think that what the intention and i'm using those words loosely mother nature's intention is that the learning curve is a little less steep because our brain is kind of being primed to learn how to respond to our baby's cues that is in much the same way as every other.
Sarah:
[14:10] Sort of mother particularly in the mammalian kingdom that we have studied we know that pregnancy shifts their brains so they deploy the appropriate kind of maternal behaviors we can talk about maternal instinct and what that means because that's a very loaded term but the appropriate parenting behaviors to keep that baby alive what we've now i mean it started in 2009 the research but it started being published about.
Sarah:
[14:37] 2017 so we've kind of got what like eight years now it's not a lot actually of research in this maternal brain space and it's continually new new stuff is coming out all the time new research is always emerging this really cool women involved with doing that research yeah we're now understanding the specifics about the brain structural reorganization what's driving it and kind of why and i mean it's the why is for the baby really.
Mel:
[15:02] I mean we're entering into a new phase of life yeah
Sarah:
[15:05] A new.
Mel:
[15:06] Brain for it
Sarah:
[15:07] Yeah yeah and that's what i said it's not like getting a new friend it's just like hanging out in the house with you um really you need to be doing nothing else except focusing in on that baby to keep it alive. Much in all as we think we're still going to keep on doing all of the other things that we've always done and nothing will change. You know there's some other there's some neurological shifts so we're.
Mel:
[15:31] Growing it's not just our uterus that changes and we're not just pumping blood to this tiny little baby while it grows while we're pregnant
Sarah:
[15:40] Our actual.
Mel:
[15:41] Brain is changing you said the whole brain changes
Sarah:
[15:45] Yeah the first studies that came out um which have got a really cool origin story which i can talk about we're looking at just the struck they were like doing brain scanning studies so like MRI.
Sarah:
[15:57] Let's look at a group of women before their first pregnancy. Very important that they haven't been pregnant before. And the same group of women after that first pregnancy. It's actually really hard to do because you scan a woman who isn't pregnant yet and then she has to actually go away and get pregnant. And then you scan her afterwards and the process isn't always, as everyone knows, isn't always straightforward. So to get enough women to run a study and you didn't scan her brain and then have to wait five years for the baby. It's hard science to do, but we're getting better at that now. This field is blossoming. And so looking at the structure of women's brains before and after that first pregnancy, we could see that the parts of the brain, particularly the gray matter, which is kind of like the wrinkly gray matter, if you're looking at a whole brain, you're holding it in your hands, what you kind of see on the outside has got slightly thinner, particularly in parts of the cortex involved with social cognition. Now, that sounds like, oh, my brain is dissolving or is, you know, diseased or is dysfunctional. But we see the same during adolescence. So that's why I said adolescence is a bit like matricence, when as a very normal, healthy part of brain development during teenagehood, the brain gets slightly thinner. And we understand very well from teenagers, both looking at animal models and looking at humans.
Sarah:
[17:18] That that is involved with the emergence of new behaviours and new skills like growing up and becoming a bit more of a capable human and that's a process of pruning and fine tuning of the connections in the brain and the brain almost becomes streamlined and that's a much better way of thinking about pruning and tuning and streamlining versus degeneration so when we say shrinkage that's that implies loss whereas when it comes to the brain's volume change volume loss can sometimes mean it's kind of improving it's like kind of getting leaner and meaner and so we think the same thing is happening in the pregnant brain overall what we see the difference between before and after that first pregnancy we see a four percent volume loss which is actually quite a lot four percent doesn't sound like a lot but there's a lot when it comes to an event that takes place in the brain and like we scan the brain immediately after the baby's born and then we scan it a few months later you see a little bit of a bounce like the brain kind of bounces back but the changes remain enough that if you were to scan the brains of women in the 80s you could we've now got enough data to say mother not mother mother not mother so the changes are permanent.
Mel:
[18:32] So it doesn't just change in its function it's not like it it fires
Sarah:
[18:37] Differently it.
Mel:
[18:38] Actually physically looks different
Sarah:
[18:39] Physically looks different and that the gray matter is slightly thinner like if you were just to look at it it would look slightly thinner which might look like degeneration but it's not it's streamlined it does also function differently as well so we can look at the structure of a brain but we can also look at the function of a brain so we can take a photo of its structure or we can take a video of it in action and look to see how how does one part of the brain communicate with another? So we're looking to see often how efficient the different networks in the brain, like how well organized are they? How easily do they connect and communicate? And interestingly, if you look at a new mother's brain, a lot of those networks are actually far more efficient and flexible and well-connected. So the entire focus, which I'm trying to change away from talking about motherhood and brains as being just like one of dysfunctional, emotional kind of foggy messes, is actually, if we look at it objectively, that brain is far more efficient and well-connected and is actually working better than it did before it had the baby. You know we can see the function change as well what they have tried to do.
Sarah:
[19:53] Is look to see do the structural changes relate to the functional changes and so they've done some kinds of studies where they're able to look to see how responsive is the mother to her new baby not necessarily around attachment because that's again a loaded term but you know if a mother's like listening to sounds of her baby cry versus another baby's cry, how strongly is her brain reacting. The brains that have changed more structurally also have a stronger functional response. There's definitely an underlying reason for that. It's enabling us to tune in to the baby. We don't have – I would love this data to come out. This is from rats and mice. But everyone who hears it goes, oh, I reckon that's in humans too. So there is some work in rats and mice that's looking at hormones postpartum, in particular oxytocin, which we know is involved with breastfeeding and love and cuddles and snuggles and attachment with the baby. In rats and mice, oxytocin changes the wiring and auditory cortex, so the part of the brain that hears things.
Sarah:
[21:03] So a baby mouse's cry is like ultrasonic. It's so high-pitched you can't hear it. In fact, adult mice can't hear baby mice crying unless they're lactating. And it's the oxytocin that has changed the auditory cortex so it can hear the baby cry. So what happens when you have like a new baby and like you're asleep at night and then the baby, you hear the baby's eyelids open before it even cries, like you wake up. I reckon that oxytocin is doing something to our sensory perception and input. Maybe our auditory cortex is so finely tuned to our baby. I don't think we hear its eyelids open. I'm being a bit silly. But it doesn't take much to wake you up and to tune into the baby. We've got some data that shows that the processing in a brain of a new mother is responding much quicker to the sound of a baby crying, particularly her own baby, than a brain that's not a mother.
Mel:
[22:02] The few things that really stuck out to me was firstly that a lot of the research seems to be less than 10 years old. Have we even done any of this?
Sarah:
[22:10] Yeah. Yeah. It's super new. Yes.
Mel:
[22:13] New. I mean, so I was a midwife six years before the very first research came out on this, so I wouldn't have even been told that in my training.
Sarah:
[22:22] No.
Mel:
[22:22] So what you're saying is when we get pregnant, our brain, obviously our body reorganizes itself in lots of different ways in order to grow a baby but our brain does the same thing and and on an elementary level we see production in gray matter and that's not about um less function in the brain it's what you called prune and tuning so we almost get the
Sarah:
[22:47] Brain is like yeah it's it's almost like prioritizing various tasks over others It's prioritizing us to respond to the baby.
Mel:
[22:56] Right. And so a reduction in volume of grey matter doesn't mean a reduction in function or, you know, that we're less brainy. Correct.
Sarah:
[23:05] Correct. Yeah. And the timing about you being a midwife is interesting because the first paper that was published was end of 2016, early 2017. But the idea for that came out in 2009. So that's how long it takes to do science. a lot of the time. And I have to tell this story because it's a very cool story. It's these three Spanish women, one Dutch, Alselena Hoxiemut, and Erica Barbara Muller, and a woman, Susanna Carmona, who's done such an amazing job leading this field.
Sarah:
[23:37] And they were, like, just driving a car off to the pub to celebrate Erica's honours thesis or master's thesis that she'd submitted. And then they said, oh, what are you going to do next in life? She says, oh, I might have a baby. And then they went, oh, what will happen to your brain? Ha, ha, ha. And then they started going, what will happen to your brain? And they worked in a brain imaging lab. And then it was 2009. What would you do now? You look on your phone. You, like, start reading the research on your phone. But it was 2009. You couldn't read research on your phone. then so they turned the car around and went back to the research lab they didn't even go to the pub they didn't hate the pub they went back to the lab and then started like because they wanted to like they were so captivated by the idea and they started going through the research and they were going there's nothing there is literally nothing there's a little bit on animals and so then they were like well why don't we do the study and so then they stayed up all night and they literally designed the study they said we're going to get women who've never had a pregnancy, and could scan them before and after. And so they ended up scanning themselves. At the time, none of them had babies. And then they were like, we need a control. And so they scanned the – these were all heterosexual couples and so they scanned the father's brains as well, which has proven to be super interesting in its own right, looking to see what happens with the male brains. And now they've just recently published a study where they've got lesbian couples. So they've got like the mother who's given birth and then they've got the other mother who didn't give birth but went through that whole process to like do that kind of comparison.
Sarah:
[25:05] So they've done a lot of research and it almost blasted open the door of this like entire new discipline. They're still putting new stuff out all the time.
Sarah:
[25:15] And there's just so many cool women and there's mostly women involved in the space doing this research. Some of the newer stuff that's published, a lot of it, it's like this kind of like.
Sarah:
[25:28] Really pioneering research like like kind of Marie Curie that they're doing the experiments on themselves so one woman she was in a brain researching group and she said she knew she was about to go through IVF and she said to her friends why don't we scan my brain through my pregnancy because we'll know the exact date I'm gonna fall pregnant and it was successful so we know the date of conception and then they were and then they were able to scan her brain at multiple points through her pregnancy which is very hard to get ethical approval of to do a lot of people but she was informed enough to be able to do that and they took her bloods every every day that they scanned her so they've got this like they call it dense sampling so they've now got this brain scan of this one woman's pregnancy and that's all open access data so that data is now being shared so we're now able to see exactly when and pregnancy that the changes start to happen and take place mostly in the third trimester mostly correlated with estrogen levels and then there's some really wild data which is hasn't been picked up more broadly and perhaps for some people was uncomfortable and that women who've had labor and delivery versus women who didn't have any experience labor the changes the structural changes are greater it's almost like labor and delivery.
Sarah:
[26:48] As they say, gives the final push of plasticity. It kind of makes those changes bigger, the structural changes bigger, which is essentially the brain responding to the hormones of labor and delivery in that process. The brain has responded to that. It's not to say it makes the brain better. It's just the brain has responded to that as well. So there's so much exciting new work coming out.
Mel:
[27:09] I did read all about that study. That one was called Pregnancy leads to long-lasting changes in human brain structure. I guess, yeah, partly I want to highlight to people that this was the first, 2016. And if you've never heard this before, this is why. We knew that pregnancy is spectacularly transformative of women's bodies,
Sarah:
[27:33] But it's the same of women's brains.
Mel:
[27:35] And as you're saying, labor and birth is all part of that transformation as well.
Sarah:
[27:41] Yeah, and it was women in these positions asking these questions and being able to get the funding and being able to do the studies that have driven the field as well. No one was asking the questions before because I think it's almost like it's a generational shift that we've seen in the last 10 years of women working their way up kind of in the research fields and being able to ask questions. We've got thousands of studies on left-handedness.
Mel:
[28:12] I know. Do you know I was mortified? I'm currently doing some researching for some podcasts on preeclampsia and the number of research papers that talk about the importance of the women having exposure to their partner's sperm by any means outnumber some of the other more important topics. And I'm like, how did we get so many papers on the importance of exposing yourself to male sperm? And we still have really only recently discovered not only that women's bodies and brains change in pregnancy, but, you know, things like the anatomy of the clitoris is pretty brand new as well.
Sarah:
[28:51] When I wrote my first book, along those lines, I was looking, I was writing about the neurobiology of orgasms, which was rather interesting, and then I was like, oh, multiple orgasms. Like surely there's a basic neural circuit there involved with the repetition in women versus habituation in men. And I found about three or four papers on it, and three were on multiple orgasms in men. Right. They weren't even looking in the biological sets where they happen. They were trying to figure out how they could make it happen where it doesn't. Of course they were. You've just got to laugh. That said, because I'm an eternal optimist, I just find it exciting that the research is now emerging at a time when I just get to watch it from the sidelines and share it on instead of it all being done 30 years ago. Yes. It's contemporary and it's new and it's exciting. So I'm just a bit selfishly grateful that it's happening now.
Mel:
[29:50] I think it's great. And, I mean, this even came out before. So I finished my PhD in 2014 and I actually was doing it while I was pregnant. And I remember, I mean, I felt the change occur in me where I literally just wanted to crochet and watch cartoons. And I thought, what is going on? I was usually a...
Sarah:
[30:14] You were nesting.
Mel:
[30:16] Absolutely. I thought I was capable of writing a PhD, but not in that moment. So I wanted to ask you, women describe baby brain, but what is baby brain?
Sarah:
[30:28] Oh, I've got many thoughts on this. That's why I called the book Baby Brain. So I will caveat by saying I never experienced it. However, I didn't know it was a thing. And I had boys, and there's like one weird study saying mums of boys are less likely to experience memory loss than mums of girls. That's never been replicated. So I don't know. I went into this not experiencing it, and so I did take a little bit of my bias in there which I've tried very hard to shake off over time because lots of women experience it and I was really interested in what it was and is it real and what's the evolutionary kind of mandate for becoming forgetful so baby brain is this you know what how a woman would, experience just describe not so much like what you were doing which I would call more like nesting just kind of wanting to be cozy and just kind of at home and and you know there's a drive to isolate yourself because it's biologically you don't want to get infections and stuff before you have the baby that's a woman on a kind of nest and that's you know healthy and be expected in some cases but baby brain is more about feeling forgetful and foggy and not being able to pay attention and not being able to remember all of the things and using the wrong words or not remembering names or putting your purse in the fridge all of the stories that you hear and.
Sarah:
[31:50] I think it's really important, though, to look at it in terms of during pregnancy and then after pregnancy because they're entirely different neurological and physiological states, but we tend to use them colloquially across both. So I was kind of interested in that and kind of interrogating them separately.
Sarah:
[32:09] So first I looked at, well, I mean, not me, I looked at the data that other.
Sarah:
[32:13] People have explored looking at what do we see during pregnancy. The best way to do any kind of study is a longitudinal study like the is to take a big group of women and follow them before pregnancy during pregnancy and after pregnancy not comparing a group of pregnant women here and a group of non-pregnant women there you've got to look at how one woman and or a large cohort kind of change and all of the large cohort studies that have tested memory and attention and all of these different cognitive skills before during and after don't find any kind of alterations we're not picking up any objective changes in memory whatsoever um and that's kind of interesting because if you say to the woman look here here's your test scores she'll go well i don't believe you because i feel different but objectively the test scores aren't so there's something going on there if we look at just during pregnancy the some studies do find in the third trimester which interestingly is when most of the brain reorganization takes place do find some you might like on a you know you might normally get 20 out of 20 or 19 out of 20 on a test result you might get 17 out of 20 so you might just like drop a couple of marks it's not clinical it's not anything that we would worry about but women are noticing that in their everyday life there's also a big difference from going and sitting in a nice.
Sarah:
[33:40] Calm, quiet, cognitive testing lab with no distractions versus trying to do all the things in everyday life. So third trimester, we find sometimes there are little aspects of different types of memory loss, But, by the same token, there is some research being done that's found memory enhancement in the third trimester, particularly for, like, instead of just remembering random items, remembering baby-related items, things that you're kind of already paying attention to. So there's some data showing enhancement then as well.
Sarah:
[34:12] And the tests that have been done in motherhood, we're not really picking anything up at all. So it's pretty unclear. We can't say women become forgetful during pregnancy and motherhood. The data's not supporting that. Women are saying that they're feeling that. So how can we kind of interrogate that paradox? And that's when it gets really interesting. Because if we look at, say, a group of women who say they have baby brain, but their test scores are fine, there's quite a strong correlation there with overall well-being. So like, are you getting enough sleep? Do you have lots of social support networks around you? Are you feeling like you're coping?
Sarah:
[34:48] Physically how well are you mentally how well you are the higher someone scores on overall well-being the less likely she is to rate her memory as bad for instance if she's scoring very poorly on overall well-being she's much more likely to relate to her memory as bad and it's also important to think about memory this is how I always explain it it's not just like me like you've got memory but you've got attention and attention is kind of like a funnel that determines what information comes in and what to filter out so when you've got a new baby and your brain has been reorganized to focus in on the baby your brain hasn't been reorganized to also remember all of the things that you have to do in the workplace to also remember the grocery list to also remember where your kid put his shoes and who's got homework due and the dog needs to get vaccinated and all of the other things it's primarily focusing in you and on the new baby and you can't remember all of the things but because we've been told oh baby brain you'll become stupid and forgetful when you have a baby women are blaming their own neurobiology for not remembering everything when it's not their brain that's letting them down it's the support that she's not getting you can't do all of the things.
Sarah:
[36:07] It's not that you can't do all the things. You shouldn't be having to do all the things. Women who are well-supported and nurtured and looked after and have lots and lots of support systems around them are much less likely to report baby brain because they're not trying to do all of the other stuff. They're only trying to look after the baby. There's lots of sort of social aspects in this sort of narrative we have as well.
Mel:
[36:28] Yes, and I wondered if it was something like that in a sense of I'm actually only going to remember the things that are most important to me at this point anyway. And that's why I'm subconsciously forgetting or not paying attention to some things.
Sarah:
[36:44] Yeah, and especially if it's your first baby and you're in the third trimester, it's really hard to, like you're constantly being reminded the baby's there, you're not sleeping, the baby's moving, it's full on, it's exciting, it's scary, you've constantly got this internal physical distraction inside you. So it is hard to focus and remember. um but you know i don't suppose you know mother nature intended us to be trying to do all of the things and all these expectations that we have on ourselves or responsibilities that we have um it's interesting because throughout in baby brain i've spent a lot of time surveying my my sort of audience and putting lots of questions out and getting information back and i had um a few women kind of respond saying that they didn't have baby brain and they had really good experiences two of the two that are what that i remember most clearly um you know that were like so i did you have baby brain no i had a great experience and then both of them were expats living in asia and they had um live in nannies and live in help yes yeah i was like well there you go that's we all need extra wives extra help and extra that's that and that was almost like well there we go because they weren't trying to do absolutely everything as well as tend to their new little bubby.
Mel:
[38:09] Well, is there anything that we know about, is there anything women can do to facilitate or nurture the changes that are going to happen in our brain already? Like, are there known factors that can interact with this process?
Sarah:
[38:24] Well, I mean, the changes that take place structurally to do all the reorganisation are, like, driven by pregnancy hormones. So you have as much control over them as you do over, you know, the onset of labour or how big your boobs grow or, you know, that's a pretty biologically driven process i mean we can only but support ourselves and all of the other ways that we know how to make sure you know you've got no sleep and you've got lots of good food and all of those kind of health and well-being things that we know would support us are also going to support our brain i think once the baby arrives then you know this i do talk about in baby rain there's kind of like three sort of three kind of main themes in terms of women who have a easier time of it or healthier outcomes versus those that don't who are around, sleep and around around social support and then just this sort of self-identity.
Sarah:
[39:26] So sleep is really hard to come by um and that's when that we're not you know we didn't evolve to parent align we're co-parenting mammals but we still think that we you know we have to we have to do it all if there's some way to sort of share the care you can't obviously do that if you're breastfeeding and you're trying to establish breastfeeding but if there's some way to there is a psychiatrist i spoke to in the book who says she gets her patients to like kind of do these really super detailed like maps and timetables of the day every member in the family to kind of map out and plan out when there are times in which more sleep can be scheduled in. Yeah. Because if you've got more capacity for sleep, you've got more capacity for everything. Everything is harder without it. It's not necessarily easier with it, but it's harder without it. Yeah.
Sarah:
[40:18] But understanding how sleep cycles work is also really important. And I know lots of new mums or women, like the kids and the baby go to bed and then they don't want to go straight to bed because they just want some alone time. And the only time is at night when everyone else is asleep. But what we do know is when you fall asleep, the first sort of third of the night or maybe the first two or three hours of a night are when you fall into your deepest sleep. and that's your deep, restorative, healthy sleep. Now, you know when you fall into that and you're in deep, deep sleep and you've been asleep for like one hour and then the baby wakes up. It's so hard to wake up. But if you've got that locked in and then you move into your shallower sleep, your more dreamy sleep and the baby wakes up and you've had six hours sleep, or even five, it's much easier to wake up and it feels less disturbing. So if we can somehow, and if you're a single mum or by yourself, it's going to be very hard but if you're not then there are other adults who can help facilitate you getting that good solid block those first few hours undisturbed sleep because then everything is easier but that requires like the cavalry right those social support networks and I wish that women didn't have to sort that out themselves yeah I wish it wasn't up to the women to ensure that there was the people there to help because that's another thing that we have to organize Yeah.
Mel:
[41:43] That's right.
Sarah:
[41:44] But that's our lot, it seems, sometimes, that we also have to ensure that we have organised the helpers instead of them being embedded or organised. Yeah.
Mel:
[41:53] Well, we have to reorganise society so that we can prioritise our brain reorganisation. Of course, we're responsible. But in your book, you know, you talk about in baby brain that these,
Mel:
[42:06] the major changes happen in the maternal brain in the third trimester, you were saying.
Sarah:
[42:11] The biggest structural reorganization changes, yeah. And we think that then the brain becomes very plastic, which just means it's very, it's like really easy for it to learn by experience. That's why I kind of think it puts you in a state where the learning curve isn't so steep as it would be as if the new baby arrived and you haven't gone through that pregnancy.
Mel:
[42:35] Yeah. And you touched on it earlier. If that process is interrupted, so let's say even hypothetically a woman has her baby at 32 weeks or 34 weeks earlier than a full gestation. Like we already know about the impact of early term birth on a baby's brain. Do you know anything about the impact on a woman's brain? Sarah, shaking her head for anybody else.
Sarah:
[42:59] Yeah, no, we haven't got that data. We haven't got that research in yet. I think it would be ethically quite difficult to, you know, you've got a mum who's given birth to a baby who's 12 weeks preemie. Can we scan your brain?
Mel:
[43:14] Yeah, I mean, I just want to say.
Sarah:
[43:16] Yeah, I'm not sure we've got, we haven't got that data. Yet that doesn't mean it's not going to turn up it's i mean i'm just trying to think of the the ethics and the logistics of getting those new mums who are going to be so vulnerable anyway is you know they're going to have to be pretty altruistic to want to offer themselves up just have their brains scanned just oh can we see what happened to your brain when you've had a preemie baby or you've lost a baby we don't know the the only data that we do there's some data because because women are often rightly so interested in what happens if they lost a baby very early in pregnancy. Yeah. Um.
Sarah:
[43:57] So there is some cool research that's very sparse looking at this phenomenon of microchimerism because the placenta isn't just like kind of a, you know, a wall between the mother and the baby. It's kind of like this biological interface that allows some things through and not others. And it does allow some of the baby's cells to come into your bloodstream, which now we kind of understand because now I think like you can even get a blood test to find out the sex of your baby. Is that correct? And also, people don't understand the placenta has a biological sex. You've got to, because it's from this fertilized egg, and then half of it becomes the baby, the other half becomes the placenta. So you've got a male placenta or a female placenta, which I think is very interesting. And we think the male placenta is maybe slightly more vulnerable to, like, insult or, you know, stress or whatever in utero, which is why male babies are slightly more vulnerable to neurodevelopmental disorders. And they're often born a little bit smaller and they're often, you know, little girls are often a little bit more robust at birth than little boys. It might be to do with the biological sex of the placenta, but that's pretty new research, but I think it's fascinating. But anyway, the placenta, male or female, does allow the passage of cells through. And some of these fetal cells, because they're so immature.
Sarah:
[45:19] They're almost like stem cells and they can kind of embed all throughout your body and your brain and your heart and your lungs and then can be detected throughout your life because they all kind of become integrated and become like a functional part of you so if you had a male baby even if you lost it very early there are some cases where older women autopsies have been done or tissue being taken obviously you can't take tissue from your brain when you're still alive that has got x y like these individual cells just kind of spetched through that have got XY chromosomes that came because she had a male pregnancy. Yes. And then sometimes the woman was like, well, I only had daughters, and they were like, would you ever lose a pregnancy? And she will have, and it would have been a male.
Mel:
[46:06] Yes.
Sarah:
[46:07] So there is this lovely idea that you carry a little bit of each of your child within you, even if you lost them. So it may not have completely reorganized your brain, but there's still a little bit which who knows what the kind of the, what's the adaptive evolutionary benefit for that? Maybe there's not one for everything. Maybe it's just so when we found out it comforted us.
Mel:
[46:29] Yeah. Yes.
Sarah:
[46:31] I think I'm going to go with that. I always posted about that on Instagram and
Sarah:
[46:35] someone said, you know, you should be far more scientific and I think you're making far more of this. And I was like, oh, well, if it makes someone feel better who's lost a pregnancy.
Mel:
[46:43] Then so do it. I think each pregnancy and each baby does change us as people. And, you know, and I've heard people say, and it's true, you know, even a mother of a baby who didn't survive is still a mother because you had a baby, you know. But you did, yeah, and you alluded to, you know, just the, when we interrupt that change by either a preterm birth or miscarriage or pre-labor caesarean section, that there's, I guess, a loss of that finishing off of the transformation that happens in women's brain.
Sarah:
[47:28] So the research, this is kind of one study that's looked at, is there a difference between the method of delivery? So if someone went through labor versus not? And the changes are kind of, but it's not massive, but you can pick it up. The changes, the structural changes are kind of greater in the woman who had labor and delivery. So there's something about that biological process, which kind of, they called it the final push, which kind of also changes that brain structurally.
Mel:
[47:59] Yeah. When Dr. Sarah Buckley, who does a lot of research on oxytocin, talks about the hormonal gap of caesarean section where there is that oxytocin gap. But then there's been some research in the oxytocin field that talks about how you can fill hormonal gap. And for women who've had caesarean sections, they can fill the oxytocin gap by things like extended skin-to-skin and breastfeeding.
Sarah:
[48:28] Yeah, because breastfeeding, you know, is a pretty – Like, I mean, you know, you've got oxytocin and prolactin kind of working together, you know, for however many years you want to breastfeed. So I think there is that, like, kind of gap. But I think, you know, I reckon the dose of oxytocin could be eventually accumulated if you were breastfeeding or skin to skin. And, you know, there's plenty of people who have wonderful, amazing parents who didn't give birth. I just think we need to be careful about how we present the data because some people can get quite... People tend to personalise this kind of stuff and you have to be compassionate.
Mel:
[49:16] Of course. Does it change each pregnancy? Do we get cumulative changes? If we have more babies, do our brains get better and better and better? No.
Sarah:
[49:27] I think the biggest change is that first pregnancy. That's where some of the earlier studies mucked up the research a bit because they were sometimes looking at first-time mothers, sometimes looking at women that had three or four babies. And so they weren't, like, doing the science very carefully. But it does appear – the biggest change is that first pregnancy.
Mel:
[49:54] Right?
Sarah:
[49:54] Like, that's – your brain is now a mother. And the pregnancies after that, there doesn't seem to be the same massive reorganisation. And it's also interesting because there's been a little bit of research looking at kind of those early stages, is those kind of first few weeks of motherhood when particularly with the first baby, you're very, very hypervigilant as well and your nervous system is kind of quite dialed up. Also possibly because you haven't quite figured out how to look after the baby yet, so it doesn't want you to like forget the baby's there, so you're like really on. And how that manifests is all of those intrusive thoughts that so many of us had, particularly with our first baby's going to fall down the stairs or out the window or on the floor or out of the car or we just are filled with like the disaster scenarios I guess it's almost like we're trying to rehearse how to keep the baby safe and our mind is trying to make meaning of the fact that we're very very hypervigilant which I think is again a kind of an adaptive mechanism to keep us on while we're figuring out this this motherhood business because people don't typically have it as much for second or third or subsequent babies. We don't see women reporting the same.
Sarah:
[51:11] Feelings of catastrophe and having the same intrusive thoughts and also we don't see that same nervous system kind of hypervigilance um and the the you know the kind of the thing that's really important is that you typically should kind of dial off over you know kind of weeks or months and if it doesn't that's a very strong risk factor for developing postnatal anxiety and then depression right so yeah it's it's completely normal yeah but you hope that you'll you're not still you know six months later consumed with a thought about something terrible happening to your baby in a minute of the day it's pretty normal in the first few weeks so.
Mel:
[51:50] We're initially dialed in and wired to be hyper vigilant to the safety of our babies but it should heat off over time
Sarah:
[51:57] Yeah, and it's not usually as strong with the second baby. Right. You're usually just a bit more like casual, and then I'm sure once you get up to baby three or four or five, they don't probably, you would never consider that they would fall out the window. Because by then, you know what to do. You know how to keep them safe.
Mel:
[52:19] Yeah. And in your book, you talked about the maternal motivation system. And we know how our brains change, but why do they change? How does this change benefit the woman and the baby? You've alluded to the fact that our brain has to change so that we are wired to care for our newborns.
Sarah:
[52:40] Yeah, I mean, I suppose, and I've tried to be really careful with a lot of the language because, and I kind of wanted to go a bit deeper and kind of interrogate it, I suppose, in terms of these ideas about maternal instinct and maternal motivations and maternal behaviours because you don't want to assume that simply because you had a pregnancy that you know how to look after the baby and you're going to be a brilliant mother because we have to figure it out. Not everyone is. And I often get people say to me, oh, well, my mother was neglectful or abusive and she carried me. Like, why didn't her brain make her look after me appropriately? And that's because so much of that, as I say, needs to also be learned. But I was really interested in some of these ideas around maternal instinct and the motivations to care and what they mean. So first of all, I just wanted to sort of survey everyone asking them, what does that word even mean? And it has very diverse meanings for people. Some people mean it to be...
Sarah:
[53:44] Like, I desperately wanted to have a baby before I had one. That kind of almost like biological clock. Some people were like, I never wanted a baby, so I never had one. Other people were like, I desperately wanted to have babies, and I knew. So some people took that to mean maternal instinct. Others took it to mean like the moment you first laid eyes on your baby, what that felt like, and whether you were like, I knew I loved them. I knew who they were straight away, whereas other people are like, I don't know, shit, like they had no feeling, like they're just detached, which is also normal um and then others took it to mean down the track you know you've got a kid coming home from school and they walk in the door and you know they've had a terrible day before you've even consciously registered that you just feel it and you're in your chest because you're a mother and that's your maternal instinct um so i was kind of interested in and understanding all of those different meanings and what we understand about the biology under them.
Sarah:
[54:43] And then, you know, humans are so complicated and we vary so much. We bring our own stories and our histories and everyone else's tales and we know quite a lot about the maternal brain from other animals. Mice and rats in particular are super interesting because I talk about this one study where they develop this kind of mouse-pup delivery system. So one of the main kind of maternal behaviours that rodents display is kind of they gather their pups up from wherever they are in a lab, it's in a cage, kind of bring them all together in the nest. And then if you put a pup in different parts of the cat, they'll just always constantly be gathering the pups. And sometimes they'll be doing so much gathering that they'll see their own tail and they'll gather the tail and they'll see their own foot and they'll gather their own foot in. And so this researcher years ago developed this pup delivery system whereby every time the mother kind of gathered the pups and we would kind of put them in this delivery chute. And so he said he got and she would gather the pup and then the pup would go back in the chute and gather the pup. So there was this constant conveyor belt of her few little pups. And he said the experiment stopped because he got bored and tired. She kept gathering and gathering and gathering. she was just utterly motivated and driven and.
Sarah:
[56:06] To nurture and care for her babies. And then they would do things like put electrical grids. So she would get electrical shocks on the way to get the pups. And she would still go and get electrical shocks to gather the pups back.
Sarah:
[56:18] So, you know, as mammalian mothers are very, very, very driven to care and nurturing and keep theirs safe. And different mammals have different ways of deploying those behaviors. So a dolphin mother isn't going to be gathering her babies, but it's a large part of the maternal behaviours, like a mother dolphin and a baby dolphin, will be about recognising each other's squeaks. So there's a lot of auditory recognition there. And herding animals like sheep.
Sarah:
[56:52] You know, the herd of a flock of 100 sheep and 20 of them gave birth on the same day. So how's the mother know the baby the mother and the baby go together well that's all about smell recognition so the mother learns the smell of her baby lamb as she has her her process of labor and delivery puts her olfactory brain in this massive state of plasticity and learning and as she's like licking all of the birth fluids and you know the placenta and everything off her baby she learns her baby's smell and then the baby learns who she is basically by default he just goes around randomly around all the mums and then the one that's not his mum kicks him away or ignores him and he learns which one's his mum because she's the only one that pays him attention so there's different animals depending on the ecology will deploy different behaviors and will be motivated to behave in certain ways.
Mel:
[57:56] Yeah.
Sarah:
[57:57] We, all humans everywhere on the whole planet, are very motivated and driven by, to respond to baby's cries. So, wherever in the world, if the baby cries, we've got to pick it up and we cuddle it and stop it crying. That seems to be almost one of our maternal behaviours that we deploy and we love cute things. We love cute puppies. We love cute cartoons. We love, you know, big eyes and there's this whole field of study about cuteness and how we are driven towards cuteness and babies are super cute. They smell cute. They sound cute. Which is good because they are really annoying and disruptive and make life very difficult but we're still driven to care for them despite everything, all the chaos that they bring.
Mel:
[58:48] Well, and you mention in your book that, so I've written a sentence here that I wanted to remember, that pregnancy triggers neuroanatomical adaptations that prepare a woman's reward circuit to maximally respond to cues of her infant, thereby increasing the incentive value of their newborn. So they get like a dopamine hit and it's an addictive process to respond to your baby.
Sarah:
[59:15] Yeah, it does. They are almost addictive. And you know that smell that a newborn baby has? Because the smell is – and so we've got all of these cues which just make us want them. And so the reward system essentially teaches us what was really good or bad last time so we do it again or don't do it again. And so the first few times you experience something that's just so, like, smell of a new baby, it's just so, you could eat them. It's so captivating and it just feels so good that you're just, like, constantly then driven to your baby. And that's despite there being aversive cues, like they're pooey nappies and they're crying and you're sleep-deprived in the chaos.
Sarah:
[59:58] They have something that's our maternal brain, part of that plastic process, makes our reward system so super sensitive to the tiniest little reward we get from them. We will respond despite the aversion. And that's perhaps what could go wrong. And, you know, some women who don't attach properly, especially women who some really interesting work's been done over many years from a group in Israel looking at women who, let's say, have serious depression and give birth to their baby, even from day sort of one, two, three in the hospital they've been studied, and they won't necessarily, they'll find early motherhood hard, and they won't necessarily as attach to the baby as closely, and they're able to kind of see those consequences play out if there's no intervention. So, you know, it's really important to understand And what are these drives and what is happening so when it goes wrong, we can intervene early and there's no long-term consequences.
Mel:
[1:00:59] So then we know, like, the pregnancy changes that happen in our brain kind of prime us to parent our baby. Does the act of parenting change our brains? What impact is there on the non-birthing parents? Or if you're fostering or adopting or maybe through surrogacy or something?
Sarah:
[1:01:20] Yeah, yeah, yeah. So that's super interesting. The first sort of look was at the dads, the male partners of the mothers from that first study. And initially, in comparison to the mothers, it was like, there's no change. The mothers' brains were so big, the fathers were just like, flat line. But then they looked just at the fathers and they got some more data and they kind of looked more closely. And then when you just looked at that data set, you were able to see,
Sarah:
[1:01:48] well, there are some subtle differences between different dads. And it's kind of interesting because the degree of change seen in the brain is what we would call dose-responsive, so how much they parent.
Sarah:
[1:02:02] So how much interaction they have with the baby, how hands-on they are as a father, and they've kind of quantified the degree of care or involvement. And obviously, you know, the father can be there for conception only and never be seen again, or he could be the primary caregiver. And so the more caregiving that is done the greater the change which like the more like you know you hit a golf ball once versus being a professional golfer your brain will be different so we see that with anything the more you perform any task the more changes you'll see um are the changes like super specific towards caregiving or are they just changes that have come about by performing a task regularly is kind of i suppose where we're at what we're trying to figure out because there's very different parts of the brain change and the males i haven't looked closely yet because the data came out when i was in antarctica um on the lesbian mums and to see but i know that there's not a significant change in comparison to the birth mothers yeah um i don't know what this if they've compared those non-birthing mothers to the.
Sarah:
[1:03:12] Uh fathers um they have done some study comparing like adoptive mothers versus birth mothers in terms of not looking at structure but like doing eeg so putting like this cap on and recording brain waves and that's pretty interesting because that's showing the response to the baby is the same you couldn't differentiate between the two so you know the debate the adopted mums love the babies just as much as the birth mums so that was that was really nice that research um but you know it's pretty it's it's it's so new all this work is just it's just sort of um sort of coming out yes.
Mel:
[1:03:53] That's so interesting i mean i feel like those are the questions i had from just my reading of one of your books baby brain um do you feel like there's anything we haven't touched on in the work that's in there
Sarah:
[1:04:07] Yes um i think it's a really it's a very exciting time i i touched very briefly i suppose what we haven't really talked about is that the kind of the long-term effects of motherhood and parenting on the brain and that we we definitely see traces of pregnancy or motherhood and the brains of women and much you know even women in their 80s now we've got big data big data sets we've got machine learning an AI, we can ask some pretty sophisticated questions and do some pretty sophisticated data analysis that we couldn't do years ago. And so now, you know, AI is able to pretty reliably say mother, not mother, mother, not mother, even someone who was in the 80s. So the traces last. There is a little bit of research suggesting that women who have had a pregnancy and raised children are perhaps slightly protected against unhealthy brain aging or against dementia.
Sarah:
[1:05:07] It doesn't stop you getting it just lowers your risk slightly so long as you don't have more than four babies and we don't know whether that's the big doses of hormones of pregnancy because the dose of estrogen you get in one pregnancy is greater than the dose that you get in the entire rest of your life combined so that's a very significant amount of hormone um that you're receiving in one go and we don't know whether those massive doses if you have three or four babies build resilience against aging or whether it's motherhood and like all of the constant up leveling and gamification of your family that you have to do that is like building cognitive of reserve, but once women have more than four babies, that sort of benefit seems to wash away, but that could be because having more than four is really stressful.
Mel:
[1:05:58] And malnourishing sometimes, to have that amount of pressure on your body.
Sarah:
[1:06:02] A hundred percent, yeah. So...
Sarah:
[1:06:05] We're starting to, you know, so there's lots of interesting sort of research emerging.
Mel:
[1:06:11] I think it's really exciting. A new research focus and thankfully on women and at this really important stage of our lives. Thank you for writing the books. I know it probably felt really challenging at the time, but we appreciate it.
Sarah:
[1:06:27] Yeah, the second one was Baby Marie was fun to write. I think the challenge was the first book because I'd never done it before. And then the second, it was like, and after that, I was like, I'm never doing this again. It was exactly like having a baby. Then I put it about tears and I'm like, oh, I could do that again. Like I kind of, it's that after all. So the second time was much easier because I knew what was happening. But it's fun. But now I'm on a long service leave.
Mel:
[1:06:56] I'm on a long break. I'm going to put the names and links to your books underneath in the show notes of the podcast. and so people can click on through and find any of Sarah's stuff if this is of interest to you. She's having a break but you can still consume all of her book. Yeah, you can. Yeah, you'll get more of the story as well. We kind of glazed over as much as we could in this episode but for all the details, have a look at the books there and they will be in the show notes. Thanks for being here.
Sarah:
[1:07:23] Sarah? Oh, well, thank you so much. It was great fun. I like the vibe. It's good.
Mel:
[1:07:28] Vibe. Yeah, I mean, people seem to like it. We try. Amazing well that's been this episode of the great birth rebellion podcast and we will see you next week to get access to the resources for each podcast episode join the mailing list at melanie the midwife.com and to support the work of this podcast wear the rebellion in the form of clothing and other merch at the great birth rebellion.com follow me mel at melanie the midwife on socials and the show at the great birth rebellion all the details are in the show notes
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