Study examines how pregnancy shapes perception and identity

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.May 9 2024

In a recent study published in npj Women's Health, researchers investigated the cognitive constructs of the self during pregnancy compared to never-been pregnant women.

Their findings indicate that first-time pregnancy is associated with higher levels of body agency, visibility, and estrangement, along with poorer accuracy in learning new associations, suggesting significant shifts in self-representation and agency during pregnancy.

Article: Sense of self in first-time pregnancy. Image Credit: BaLL LunLa / Shutterstock

Background

During pregnancy, the body undergoes dramatic changes to accommodate the development of the fetus.

At the same time, widespread transformations occur at both a cognitive and social level to prepare for birth and subsequent parenthood. For example, pregnant people are placed in an unfamiliar social role – that of 'mother.'

These are bound to profoundly impact the pregnant individual's sense of self and identity. However, little is known about how one's perception of self changes during pregnancy.

About the study

Researchers investigated how pregnancy influences the self-model, which encompasses self-concept clarity, sense of agency, general self-efficacy, body representation, and self-biases in learning. These are considered essential for understanding the self and choosing one's actions.

Researchers hypothesized that pregnancy induces significant shifts in self-representation, leading to differences between pregnant and non-pregnant women across multiple measures.

To test this hypothesis, they recruited first-time pregnant and never-pregnant participants through word of mouth and an online platform.

The participants were assigned female at birth, over 18 years old, not menopausal, fluent in English, with normal vision, no previous pregnancies or children, and no neurological disorders.

Participants completed demographic surveys and questionnaire measures assessing self-concept clarity, general sense of agency, general self-efficacy, and body experiences during pregnancy.

They also performed two cognitive tasks: shape-label matching and intentional binding. Statistical analysis was conducted using Bayesian statistics, including independent samples t-tests and repeated measure analysis of variance (ANOVA), to compare measures between groups and across trimesters for primigravida participants.

The analysis included planned comparisons as well as exploratory analyses to examine potential trimester effects, with default prior distributions for Bayesian analyses.

Findings

The study compared 100 primigravida (first-time pregnant) and 102 nulligravida (never-pregnant) participants across various measures related to self-concept, sense of agency, general self-efficacy, body experiences during pregnancy, and cognitive tasks.

Only one participant reported being gender non-conforming; all others were cisgender females.

Participant demographics revealed no significant age difference between groups but showed differences in education level, mental illness history, employment, and study hours. Results indicated no difference in self-concept clarity between groups or across trimesters.

While there was no difference in the positive sense of agency between groups or trimesters, evidence suggested higher negative agency feelings in pregnant participants, particularly in the first trimester. Feelings of negative agency are associated with the experience of being out of control of one's actions.

General self-efficacy showed minimal differences between groups and trimesters. Primigravida participants reported significantly higher body experience scores than nulligravida participants across all three trimesters.

Specifically, pregnant participants felt more self-confidence, competence, pride, femininity, and attractiveness during the second trimester than non-pregnant individuals.

However, they also felt more estranged from their bodies, in terms of less ownership and control and a lack of boundaries, and felt that their bodies were evaluated, touched, and stared at more, particularly in later semesters.

Cognitive task results indicated that pregnant participants had lower accuracy in associating self-related stimuli and longer reaction times compared to nulligravida participants. However, these effects varied across trimesters, with impairments observed mainly in the first and third trimesters.

There were no significant differences in intentional binding effects between groups or trimesters, indicating consistent perception of agency across pregnant and non-pregnant individuals.

Overall, the study provides insights into the psychological experiences of pregnancy and their impact on self-perception and cognitive processes.

Conclusions

The results of this study demonstrate how pregnant women may experience feelings of reduced control over their lives.

Body experiences during pregnancy, including feelings of body estrangement and visibility, were significantly different between pregnant and non-pregnant women, reflecting changes in self-perception during pregnancy.

Cognitive task results indicated a cognitive bias towards self-related stimuli in both groups, but accuracy in recognizing self-associated shapes was poorer in pregnant women.

Trimester analysis suggested dynamic changes in self-related constructs throughout pregnancy, with notable differences observed in the first and second trimesters.

The study's strengths include its comprehensive investigation of various facets of the self-model during pregnancy and the inclusion of trimester analysis. However, limitations such as the lack of a multiparous cohort and the predominantly cisgender female sample were acknowledged.

Further research directions include exploring the postpartum period's impact on the sense of self, considering diverse gender identities in pregnancy research, and comparing body experiences across primigravida and multiparous cohorts.

Overall, the study highlights the complexity of self-experiences during pregnancy, influenced by physiological and psychological transformations. Trimester effects suggest unique developmental stages in the self-model during pregnancy.