Brain during pregnancy: neurocognitive changes and maternal neuroplasticity beyond the mommy brain

Valeria Medina, a neuropsychologist at NeuronUP, takes a rigorous, practical approach to present scientific evidence on brain and cognitive changes and neuroplasticity during pregnancy.

Introduction: What is mommy brain and what is its scientific basis?

“Mom brain” or mommy brain is a popular term that has been used in recent years to describe difficulty concentrating, remembering information, or staying focused during pregnancy and the postpartum period. 

Up to 80% of pregnant women report subjective memory complaints (McCormack, Callaghan, & Pawluski, 2023), which has fueled a cultural narrative suggesting that pregnancy leads to widespread cognitive decline. Claims like these not only oversimplify what happens during this stage but can also be stigmatizing. The aim of this article, therefore, is to review recent scientific evidence on the neuroanatomical, hormonal, and cognitive changes that occur during pregnancy in order to rethink how we view “mommy brain.” 

Neuroanatomical changes and neuroplasticity in pregnancy 

Neuroplasticity and hormonal influence

Pregnancy is one of the periods of greatest brain plasticity in adult life. This reorganization is driven by a hormonal cascade that completely transforms the neurophysiological environment and prepares the body and brain for motherhood.

During pregnancy, levels of estrogen, progesterone, oxytocin, prolactin, and cortisol rise significantly. These hormones not only regulate things like appetite or body temperature but also directly affect brain regions involved in cognition, mood, and social behavior (Grattan & Ladyman, 2020).

For example:

• Oxytocin and prolactin are linked to bonding and stress management; their increase supports maternal behavior and attachment between mother and child.
• The cortisol released helps regulate blood pressure and blood sugar. However, chronic exposure to high cortisol levels can disrupt executive functioning and compromise certain attentional processes, since these high levels can cause fatigue, anxiety, and irritability.
• Endocrine adjustments promote synaptic reorganization that increases sensitivity to social cues, such as the baby’s crying or emotional expressions, and improves associative learning, which has adaptive value in the context of parenting and attachment (Callaghan et al., 2022).

Structural reorganization of the brain during pregnancy

At the structural level, neuroimaging studies have consistently shown that changes in gray matter volume occur during pregnancy, especially in areas involved in social cognition, such as the medial prefrontal cortex, the precuneus, and the temporoparietal junction (Barba-Müller et al., 2019). 

Rather than being seen as loss or decline, these changes seem to represent a kind of synaptic pruning that optimizes the functioning of certain neural networks that matter most at that time. For example, the reorganization of structures linked to the salience network, which is involved in detecting relevant stimuli and dynamically adjusting attention and connects structures such as the prefrontal cortex, amygdala, parietal cortex, and thalamus, promotes greater sensitivity to social and emotional cues in the environment. This is crucial for the survival and care of the newborn.

The longitudinal study by Pritschet et al. (2024) followed pregnant women from the first trimester until after delivery. It observed a progressive reduction in gray matter volume in frontal and temporal regions, including areas associated with executive functions such as the dorsolateral prefrontal cortex. It also documented changes in the functional connectivity of major networks such as the default mode network and the central executive network (which connects areas such as the dorsolateral prefrontal cortex and the posterior parietal cortex), suggesting that the brain is readjusting to meet the emotional, social, and cognitive demands of motherhood. These changes intensified in the third trimester and, in some cases, persisted up to two years after delivery, indicating prolonged neuroplasticity. Changes in cerebrospinal fluid volume and in the shape of the brain’s ventricles were also observed. All of these adjustments could reflect more refined information processing and a more efficient reorganization of cognitive resources.

Cognition during pregnancy: what do we really know?

So, if the brain changes during pregnancy, what happens to cognitive functioning? The answer isn’t so simple. Many women report feeling more absent-minded, experiencing “brain fog,” finding it harder to concentrate during pregnancy, or forgetting things more often. In other words, there is a clear subjective cognitive complaint, but when objective neuropsychological tests are used, the results tend to be inconsistent.

A meta-analysis by Davies et al. (2018), which analyzed data from more than 1,200 participants, found slight difficulties in cognitive functions such as memory, executive functions, and overall cognitive performance. This was more noticeable in the third trimester but did not reach clinically significant levels.

Longitudinal studies such as Logan et al. (2014) support this idea: although some women may experience mild difficulties, especially in tasks involving verbal memory, this is not a widespread “decline.” Crawley, Dennison, and Carter (2003), for example, found no objective differences in attention or memory between pregnant and non-pregnant women, although they did note that pregnant women rated their own performance more negatively.

One of the most sensitive functions appears to be working memory. In the study by Janes et al. (1999), pregnant women scored somewhat lower on tasks involving this cognitive function; these differences were small and did not affect other types of memory. Likewise, the study by Younis et al. (2025) agrees on the working memory difficulties but adds that there are difficulties in prospective memory, which is the most consistently affected function (especially in everyday situations such as remembering appointments or pending tasks). It also described moderate difficulties in verbal-auditory episodic memory and processing speed, especially from the second trimester onward. 

As mentioned, the changes are neither widespread nor clinically significant, but in most cases, these perceived difficulties can contribute to the “mommy brain” symptoms that many women report during this stage. 

It’s also important to keep in mind that factors such as sleep quality have a greater influence on performance than pregnancy itself. Interestingly, however, the study by Callaghan et al. (2022) shows that on some tasks with greater ecological value for this stage, pregnant women may even perform better; for example, they have been found to perform better on spatial memory tests involving baby-related objects. This suggests that the brain may be redirecting resources toward functions that are more useful in that stage of life.

The relationship between brain changes and cognitive functions

As mentioned in the previous sections, there is scientific evidence of brain, hormonal, and neurotransmitter changes that occur during pregnancy, as well as of cognitive changes during the same period. Are the two phenomena related? The answer is yes: brain changes during pregnancy correlate with the cognitive functions often described as “impaired” during this period. For example, the slight drop in executive function scores on neuropsychological tests coincides with a reduction in volume in the dorsolateral prefrontal cortex, as documented in the study by Pritschet et al. (2024). 

In addition, the changes observed in the temporal cortex (related to memory processes), also reported in the same study, coincide with the memory difficulties described in research such as that of Younis et al. (2025). Finally, the temporoparietal junction, which also changes during pregnancy (Barba-Müller et al., 2019), is linked to attentional processes. Although no clinically significant differences are observed compared with non-pregnant women, these attentional difficulties contribute to the “brain fog” often reported during this stage.

Mothers’ subjective complaints, or the fact that people around them notice cognitive changes, may be because less priority is given to paying attention to everyday activities that were more demanding before pregnancy. So, rather than a decline, it seems that the brain adapts to prioritize other tasks, such as emotional regulation, sensitivity to social stimuli, what is happening in the pregnant mother’s body, and the worries that may arise during pregnancy, which leads to a redistribution of cognitive resources.

Activities of Daily Living (ADLs): definition, classification, and exercises

Are brain changes during pregnancy permanent?

Brain changes don’t stop at delivery. In fact, the postpartum period is just as intense in terms of neuroplasticity. Several studies have shown that the remodeling of brain structures continues after the baby is born, especially in structures related to attachment, motivation, and emotional regulation.

For example, Barba-Müller et al. (2019) documented volume increases in subcortical regions such as the amygdala, hypothalamus, and nucleus accumbens. These areas are closely linked to emotional response and maternal behavior. In other words, the brain keeps adapting to allow a fast, sensitive, and empathetic response to the newborn’s needs. Moreover, not all births shape the brain’s trajectory in the same way. Mothers who had a scheduled cesarean section without going into labor have been found to show greater cortical increases in the transition from pregnancy to postpartum than those who went through vaginal birth. This suggests that labor could act as a neurobiological turning point, marking the start of a new stage of brain reorganization that is possibly mediated by the inflammatory, hormonal, and immune processes of that experience (Paternina-Die et al., 2024).

A particularly interesting finding is the one described by Servin-Barthet et al. (2025), who observed that a greater return of brain changes to baseline between late pregnancy and six months postpartum was associated with higher oxytocin levels, promoting stronger maternal attachment and reducing feelings of hostility toward the baby. This reinforces the idea that brain transformations are neither neutral nor random but have a clear functional purpose: to support bonding and caregiving. 

In addition, some studies report an increase in brain size, a decrease in ventricular volume, and localized tissue growth in the postpartum period. This has led to two possible interpretations:

• On the one hand, a restoration of the volume “lost” during pregnancy.
• On the other hand, an enhancement, in which gray matter not only returns to baseline but even exceeds pre-pregnancy levels (Luders, Kurth, Sundström Poromaa, 2022). 

In either case, the postpartum period also seems to be a stage of reorganization in line with the demands that arise as the baby develops.

Contrary to what one might think, this neuroplasticity is beneficial for mothers and children since the greater the neuroplasticity, the stronger the bond between them tends to be (Hoekzema et al., 2017). 

Even so, it’s important to emphasize that these changes don’t happen in the same way for everyone. Factors such as postpartum depression, chronic stress, sleep deprivation, or a lack of social support can interfere with cognitive recovery. Some studies indicate that in women with a greater emotional burden, perceived cognitive difficulties may last beyond the first year (Crawley et al., 2003; Logan et al., 2014). However, how the brain reorganizes again will depend on the mother’s situation and context, the resources she has, and her personal history.

Conclusion: beyond “mommy brain”

This article has covered the neurobiological and cognitive changes most consistently documented in the scientific literature on pregnancy. Nevertheless, most studies published over the years find no evidence of widespread neuropsychological decline (or change). The fluctuations observed, when they occur, are mild, temporary, and specific to certain functions, usually executive functions. 

So why do so many women feel this way? Generally, because there is a brain reorganization that can lead to certain changes in cognitive functioning, especially in everyday tasks whose priority changes when there are new demands to focus on. Although in most studies these variations don’t reach clinical significance, because they appear from early stages, such as the first trimester, they can feel like sudden and noticeable changes, amplifying the perception of change beyond what the objective data actually show. 

It’s key to understand that these changes in cognitive functioning are not necessarily negative, although they are often presented that way because new tasks are being prioritized. By emphasizing the possible mistakes or lapses of pregnant and postpartum women, we risk overlooking the new skills that emerge to better care for, protect, and look after both their own bodies and the baby once it is born. In addition, external factors such as mental load, constant multitasking (especially for women who have to return to their activities soon after giving birth), or a lack of rest can intensify that feeling of “underperforming,” when in reality it isn’t explained solely by brain changes but by a context that also deserves attention.

What we know today is that pregnancy doesn’t mean decline but transformation and adaptation to new situations. The brain reorganizes strategically to respond to new demands, strengthening functions related to empathy, social sensitivity, and affective learning that are essential for caring for a baby, even while it is still in the womb. For the same reason, these changes may represent an adaptive enrichment of the cognitive and emotional system.

Rethinking mommy brain through science is a way to recognize the brain’s capacity to adapt and to combat stigmas still present in social and clinical discourse. Understanding that the brain doesn’t weaken during pregnancy but transforms for a beneficial purpose is a fundamental step toward a more realistic, empathetic, and respectful view of the maternal experience.

References

• Barba-Müller, E., Craddock, S., Carmona, S., & Hoekzema, E. (2019). Brain plasticity in pregnancy and the postpartum period: links to maternal caregiving and mental health. Archives of women’s mental health, 22(2), 289–299. https://doi.org/10.1007/s00737-018-0889-z
• Callaghan, B., McCormack, C., Tottenham, N., & Monk, C. (2022). Evidence for cognitive plasticity during pregnancy via enhanced learning and memory. Memory, 30(5), 519–536. https://doi.org/10.1080/09658211.2021.2019280
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• Grattan, D. R., & Ladyman, S. R. (2020). Neurophysiological and cognitive changes in pregnancy. In E. A. P. Steegers, M. J. Cipolla, & E. C. Miller (Eds.), Handbook of Clinical Neurology (Vol. 171, pp. 25–55). Elsevier. https://doi.org/10.1016/B978-0-444-64239-4.00002-3
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• Logan, D. M., Hill, K. R., Jones, R., Holt-Lunstad, J., & Larson, M. J. (2014). How do memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women. Journal of clinical and experimental neuropsychology, 36(5), 528–539. https://doi.org/10.1080/13803395.2014.912614
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