An exploration of changes in perinatal empathy: A matched-cohort longitudinal study

Abstract

The term empathy describes the capacity to access and respond appropriately to others’ thoughts and feelings. Deficits in empathy are presumed to impair social functioning and limit one’s ability to understand and establish emotional connections with others. The question of how life experience may modify empathy abilities remains relatively underexplored. The current thesis takes as its ‘case’ a particularly pivotal life event, one that is rich in social implications: the birth of a woman’s first child. Mother's nurturance of her infant is typically explained through the lens of evolutionarily and biologically-based instincts designed to promote survival, or through attachment theory which describes caregiving qualities thought to contribute to emotionally-secure and well-adjusted children. This study seeks to extend our understanding of the development of women’s nurturing and affiliative behaviours within the context of empathy. Motherhood represents a major life event which provides motivation for women to engage with their infant in empathic ways and witness immediate and long-term benefits of appropriate child development and behaviour. The empirical literature is relatively silent on how empathic processing is affected in the context of pregnancy and early motherhood. The scholarly empathy literature is framed around a ‘deficit model’, suggesting that empathy during pregnancy and the postpartum period is hampered through a range of pathways. The literature on cognitive impairment, disrupted sleep conditions, and depressed mood accord with the ‘deficit model’. While this is the dominant model structuring both research and theoretical thinking, a persuasive argument can be advanced for a biologically and socially programmed ‘enhancement model’ of empathy appropriate for women during the perinatal period. The nature of empathy during this period is unclear in light of competing influences of aversive conditions likely to diminish empathy and expressions of ‘hardwired’ and psychosocial elements thought to promote empathy. The aim of this thesis is to conduct the first longitudinal assessment of first time mothers to investigate the nature, magnitude, and mechanisms of changes in empathic processing during pregnancy and postpartum. Data was collected at two time points in 57 nulliparous women and 53 women who had never been pregnant. First testing occurred in third trimester and second testing at three months postpartum. Control group women were tested five months apart. The primary measure of empathy was the performance-based Multidimensional Empathy Measure of cognitive and affective empathy. Other empathy measures included the Reading the Mind in the Eyes Task and self-reported Interpersonal Reactivity Index and Affective Theory of Mind Scale. Executive function, mood, sleep, and facial emotion recognition were evaluated using a comprehensive battery of behavioural and selfreport measures. Data from the two groups were compared using a series of ANOVA’s, and regression analyses were performed to investigate potential influences on empathy capacity. Results provide some initial evidence that cognitive empathy is diminished in new mothers. However, there is little in the evidence to explain the mechanism for the deficit. There was no evidence that the deficit was related to negative mood although it is difficult to make direct inferences given the confounding finding of greater depressive symptoms reported by control women compared to perinatal women. Executive function deficits were not displayed by perinatal women, and elements shown to impact on empathy were not unique to the perinatal women. Furthermore, affective empathy (performance-based and self-reported) was not impacted by the experience of motherhood. The findings do not comprehensively support the ‘deficit’ nor ‘enhancement’ model of empathy which theorise that elements of pregnancy and early motherhood contribute to empathy change. However, the study offers an early suggestion that the ‘result’ between the positives and negatives of childbirth in relation to empathy may incline towards deficit. This deficit may change however, when biological changes, sleep disruption, and other impacts such as financial and social impacts (such as isolation) associated with childbirth settle in time. The juxtaposition between a deficit and enhancement model posed in this thesis suggests that a mother’s capacity for empathy may be a sum product of drivers of enhanced empathic understanding and drivers that mitigate against empathy. Future research could track two groups of women for several years to examine how the development of empathy may accrue to new mothers. Interventions involving virtual reality offer promise for the future to provide targeted training for at-risk mothers identified as experiencing difficulties in empathy.