A mother hold her newborn to her chest and kisses the baby's forehead.

ADHD during pregnancy and early motherhood

What is ADHD?

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition disorder characterised by persistent inattention, hyperactivity, and impulsivity, which can significantly impact daily life and functioning. This can be especially challenging during pregnancy and early motherhood.

Challenges during pregnancy

Pregnancy requires a lot of organisation and emotional control, which can be tough for those with ADHD. Hormonal changes can make ADHD symptoms worse, leading to increased forgetfulness, mood swings, and trouble focusing on prenatal care routines.

Challenges during early motherhood

Caring for a newborn can be overwhelming, especially with ADHD. Tasks like managing time and keeping routines can be difficult, affecting both the mother and the baby’s well-being. The demands of caring for a newborn can strain executive functioning skills, making tasks like time management and maintaining routines particularly challenging.

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ADHD symptoms

Inattention: Trouble focusing, making careless mistakes, not listening when spoken to directly, not following through on tasks, disorganisation, avoiding tasks that need mental effort, losing things, getting easily distracted, and being forgetful in daily activities. ‍
Hyperactivity/Impulsivity: Fidgeting, tapping hands/feet, not being able to stay seated, feeling restless, difficulty playing quietly, always being “on the go” as if “driven by a motor”, talking excessively, blurting out answers before the question has been asked, trouble waiting for turns, and interrupting others.

Diagnosis

ADHD symptoms must be present before age 12 for a diagnosis, but many people are diagnosed later in life. This can be due to various reasons like growing up before ADHD was well recognised, using strategies that mask difficulties, life changes making coping strategies less effective, or misattributing symptoms to other conditions.

ADHD in women

ADHD is often underdiagnosed in women because they tend to show inattentive rather than hyperactive symptoms, which are less likely to be noticed. Women with ADHD often develop coping strategies that align with social expectations, which can mask their symptoms. Research suggests ADHD symptoms can vary across the menstrual cycle due to hormonal fluctuations.

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Additional challenges during pregnancy and motherhood

Increased Demands: Pregnancy and early motherhood require more planning, organisation, multitasking, time management, and working memory. Scheduling and attending appointments, managing feeding and settling routines, responding to changing infant needs, and following care guidelines can become overwhelming. ‍
Hormonal Changes: Hormonal fluctuations can affect ADHD symptoms. ‍
Medication Changes: Adjustments in medication during pregnancy can change symptom patterns. ‍
Mental Health: Women with ADHD are at higher risk for depression and anxiety, especially postpartum. Research indicates that having ADHD increases the risk for both depression and anxiety disorders postpartum, over and above other well-established risk factors.

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Strengths of ADHD during pregnancy and motherhood

While ADHD presents unique challenges, it can also be a valuable asset in early parenthood and during pregnancy. Parents with ADHD often bring creativity, energy, and a unique perspective to parenting. Their ability to think outside the box can lead to innovative solutions and a dynamic, engaging environment for their children.

During Pregnancy

Adaptability: The ability to adapt quickly to new situations can help manage the unexpected changes and challenges that come with pregnancy. ‍
Resourcefulness: ADHD often fosters a resourceful mindset, enabling expectant mothers to find creative solutions to pregnancy-related issues. ‍
Enthusiasm: The natural enthusiasm and excitement that come with ADHD can make the journey of pregnancy more joyful and engaging. ‍
Strong Intuition: Many individuals with ADHD have strong intuitive abilities, which can help them tune into their bodies and their baby's needs during pregnancy.

During Early Motherhood

Creativity: ADHD can enhance creative thinking, allowing parents to come up with fun and imaginative activities that stimulate their child's development. ‍
High Energy: The energetic nature of ADHD can be a great match for the high demands of parenting, helping parents keep up with their active children.
Hyperfocus: When something captures their interest, individuals with ADHD can become intensely focused, which can be beneficial for bonding activities and learning new parenting skills. ‍
Spontaneity: The spontaneous nature of ADHD can make everyday life more exciting and adventurous, creating memorable experiences for the family. ‍
Empathy: Many people with ADHD are highly empathetic, which can help them connect deeply with their children and understand their needs. ‍
Resilience: Managing ADHD often requires developing resilience and problem-solving skills, which can be invaluable in navigating the ups and downs of parenthood.

Embracing these strengths can help create a nurturing and stimulating home where both parent and child can thrive. By focusing on the positive aspects of ADHD, parents can build a supportive and enriching environment for their families.

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Support strategies

Organisational Tools: Use apps to track schedules and appointments, break tasks into smaller steps, establish designated locations for essential items, and set reminders for time-sensitive tasks. ‍
Support Systems: Communicate needs, accept help from a partner, family, and friends, and consider hiring help if possible. Taking notes or bringing a support person to appointments can alleviate demands on working memory. ‍
Self-Compassion: Practicing self-compassion and kindness can counteract self-criticism, feelings of shame, and social comparison.

Finding support

Connect with Others: Join groups of parents with ADHD for support and understanding. Connecting with other parents with ADHD can provide an understanding and accepting environment where others have lived experience of their unique needs. ‍
Professional Help: Consider therapy with professionals who understand ADHD. Neuroaffirming therapy focuses on strengths and creating supportive environments rather than trying to “fix” behaviours. Key principles include focusing on strengths, creating supportive environments, addressing co-occurring mental health challenges, and improving quality of life while respecting neurodivergent identity.

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References

_{American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). American Psychiatric Association Publishing.}_{https://doi.org/10.1176/appi.books.9780890425787}
_{Andersson, A., Garcia-Argibay, M., Viktorin, A., Ghirardi, L., Butwicka, A., Skoglund, C., Bang Madsen, K., D’onofrio, B. M., Lichtenstein, P., Tuvblad, C., & Larsson, H. (2023). Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder. Journal of Affective Disorders, 325, 817-823.}_{https://doi.org/10.1016/j.jad.2023.01.069}
_{Banks, T., Ninowski, J. E., Mash, E. J., & Semple, D. L. (2008). Parenting behavior and cognitions in a community sample of mothers with and without symptoms of Attention Deficit/Hyperactivity Disorder. Journal of Child & Family Studies, 17, 28-43.}_{https://doi.org/10.1007/s10826-007-9139-0}
_{Freeman, M. P. (2014). ADHD and pregnancy. American Journal of Psychiatry, 171(7), 723-728.}_{https://doi.org/10.1176/appi.ajp.2013.13050680}
_{Nussbaum, N. L. (2012). ADHD and female-specific concerns: A review of the literature and clinical implications. Journal of Attention Disorders, 16(2), 87-100.}_{https://doi.org/10.1177/1087054711416909}
_{Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3), Article 27250.}_{https://doi.org/10.4088/PCC.13r01596}
_{Quinn, P., & Wigal, S. (2004). Perceptions of girls and ADHD: Results from a national survey. Medscape General Medicine, 6(2), 2. PMID: 15266229; PMCID: PMC1395774}
_{Roberts, B., Eisenlohr-Moul, T., & Martel, M. M. (2018). Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology, 88, 105-114.}_{https://doi.org/10.1016/j.psyneuen.2017.11.015}