# Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development

> **NIH NIH R21** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $111,530

## Abstract

PROJECT SUMMARY. Life threatening events surrounding childbirth and maternal psychiatric morbidity, are on
the rise in the US and disproportionally affect under-represented minority women. Maternal psychiatric morbidity
can adversely impact the health of child by undermining maternal bonding. Maternal bonding is the basis for
secure attachment in the child, stimulating protection and nurturing crucial for the child’s development. Failure
to achieve bonding in the early postpartum period can result in adverse developmental problems in the child and
in extreme cases lead to abuse and neglect, the prevention of which is a stated NICHD mission. Currently,
knowledge of the brain mechanisms mediating maternal mental illness and problems with maternal care is almost
completely lacking. There is no study examining the maternal brain following traumatic childbirth. An important
factor to consider is exposure to racial and ethnic discrimination that involves threat to the psychological integrity
of the self and how this adversity is implicated in maternal mental illness and the underlying neural abnormalities.
The proposed study is the first of its kind to use quantitative neuroimaging approaches to determine the neural
basis of maternal response to a stressor and how this is altered in women suffering from childbirth-related
posttraumatic stress disorder (CB-PTSD), a condition endorsed by nearly 1 out of 5 women who undergo
traumatic childbirth. This study is also pioneer in attempting to reveal the association between racial and ethnic
discrimination and brain responsiveness mediating optimal maternal care. Here, we will implement a valid
protocol to determine the altered neural activity in mothers with CB-PTSD using functional neuroimaging.
Commencing in the hours following parturition, we will identify 60 women at risk for CB-PTSD, among them
women of color, and they will be assessed in the early postpartum for CB-PTSD symptoms and neural activation
as visualized by fMRI evoked by childbirth imagery and infant distressed cues. Neural activations will be
correlated with scores on measures of maternal behavior and child development and perceived racial/ethnic
discrimination. Maternal CB-PTSD will be measured with psycho-diagnostics and psychometrics; maternal
bonding will be quantified by psychometrics and observational assessment of the bonding behavior; and child
development via standardized observational methods. We expect our findings will advance scientific knowledge
of the neural mechanisms mediating impairments in maternal bonding in women suffering from postpartum
psychopathology and discrimination. Identification of novel neural markers of maternal impairments in CB-PTSD
in the very early postpartum could help distinguish CB-PTSD from other postpartum pathologies and encourage
specialized psychological interventions. In conclusion, this study furthers the Agency’s mission for children to
achieve healthy and productive lives. It may serve as a pl...

## Key facts

- **NIH application ID:** 10330226
- **Project number:** 3R21HD100817-02S1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Sharon Dekel
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $111,530
- **Award type:** 3
- **Project period:** 2020-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10330226

## Citation

> US National Institutes of Health, RePORTER application 10330226, Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development (3R21HD100817-02S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10330226. Licensed CC0.

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