Facilitators and regulators: conscious and unconscious processes in pregnancy and early motherhood

A model is presented, based on clinical experience, mother-child observations and survey data, delineating two different maternal orientations towards babies and motherhood. The essential difference in orientation is that the Facilitator mother adapts to her baby while the Regulator mother expects the baby to adapt. On a behavioural level these two orientations are manifest in differing maternal practices: the Facilitator mothers exclusively, responding spontaneously to her baby's needs as they arise, whereas the Regulator establishes a routine to foster predictability and shares mothering with her partner or other caretakers. This paper explores three areas within the different maternal orientations of the Facilitator and Regulator: conceptualization: conscious beliefs and expectations of motherhood and babies; practice: observable differences in adaptation to pregnancy, labour, birth and early weeks of motherhood, and differential postnatal vulnerability to psychosocial provoking factors; unconscious processes: identifications, phantasies and defences underlying these practices. The psychogenesis of the two maternal orientations is explored. It is suggested that unconscious identifications between various aspects of the mother's internal world and the foetus determine the maternal orientations, with the Facilitator mother employing idealization and manic reparation to sustain her maternal beliefs while the Regulator engages in manic defence and dissociation. Conscious and unconscious processes operate in conjunction with current socio-economic circumstances to determine maternal practice.