**1.1 The nature of motherhood**

The transition to motherhood after childbirth for first-time mothers (primaparae) involves not only initial physical but also emotional and psychological changes in the months following birth [2, 3]. This period may be named matrescence, "the time of mother becoming" [4], with this term depicting the transition to motherhood and the sense of the "birth of a mother" [4–6]. The concept of matresence covers the physical, emotional, hormonal, and social transitions to becoming a mother, which may also be considered a "rite of passage" [4, 5]. This builds on mental shifts in identity during pregnancy and the psychological birth of a mother after labor and delivery, where a new motherhood identity is formed [6] through caretaking and ritual [4]. A postpartum metamorphosis occurs in an unfolding "blueprint" plan as anticipation and expectation meet reality [6] and family roles and interactions change [4]. Even the role of the baby within the extended family system may need to be reviewed [6], and the baby acts in a transformative role in maternal psychological development [7].

Feelings of maternal attachment often develop gradually [8] and are related to parenting confidence. First-time mother talk about the impact of the child on their sense of self and becoming selfless in the bonded relationship, with one first-time mother stating, "in order to be the mother she wanted to be, she had to make changes to the person she had become" [9]. Mothers construct their own identities related to self-perception as they change to become a mother after the birth of their first child, which is related to their identity as a woman, the myth of perfections, apparent negativity towards mothering, and conflicts in maintaining what they saw as "the real me" [10]. Not only this, but women's experience of their physical body during pregnancy and after birth undermines body image satisfaction and sets up an incongruence between mothering and wife/partner roles, affecting perceptions of satisfaction with their own body self-image [11].

In fact, changes in self-concept for first-time mothers flow through from early pregnancy right through to the time of birth and include themes of control, support, and forming a family [12]. A conceptual analysis of the defining attributes of the maternal role results in four attributes which are: nurturing, protecting, caretaking, and managing household affairs [13]. Within this typology, the maternal role can lead to the balanced fulfillment of multiple roles, maternal role strain, and role conflict [13]. Further, results of a meta-analysis suggest that maternal transition incorporates the disruptions of changes to engagement, growth, and transformation of commitments, daily life, relationships, "self", and work [2]. The theme of self incorporates facing the past, facing oneself, and coming to feel like a mother, and relational wellbeing also needs to be addressed [14]. Previous experiences need to be acknowledged, including losses and the conflicting emotions inherent in daily mothering activities [2]. Creative techniques which address the embodiment of mothering and its
