The case of poor postpartum mental health: a consequence of an evolutionary mismatch – not of an evolutionary trade-off

Biology and Philosophy 38 (3):1-21 (2023)
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Abstract

Postpartum mood disorders develop shortly after childbirth in a significant proportion of women and have severe effects. Two evolutionary explanations are currently available. The first is that poor postpartum mental health is a consequence of an evolutionary trade-off – a compromise of neurological changes in the maternal brain during pregnancy which, on the one hand, maintain pregnancy, and on the other, increase the likelihood for postpartum women to develop psychopathology. The second explanation is that poor postpartum mental health is a disease of civilization. This theoretical paper demonstrates that both explanations ignore the crucial event of childbirth. I elaborate on environmental features of childbirth, a physiological process that is substantially different in the current versus evolutionary childbirth and postpartum setting, and argue that maternal brain neuroplasticity and biochemical alterations are not an evolutionary trade-off, but an adaptation. Additionally, the incidents of poor postpartum mental health are better viewed as a maladaptation of the typical modern environments – an evolutionary mismatch. Thus, the potential to suffer from poor mental health in postpartum is an external, contingent happening, dependent on contemporary childbirth and postpartum environments, and not due to any essential property women possess as a result of evolutionary compromise. In fact, women are probably adapted to feel like superwomen right after birth, a state of mind that is an aid in adapting to motherhood. Distinguishing between evolutionary concepts in the context of pregnancy, birth, and motherhood is vital for developing more accurate preventions and interventions.

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