In this article:
What Is Executive Dysfunction, and How Does It Show Up in Pregnancy?
Executive dysfunction refers to disruptions in your brain’s “management system,” the part that helps you plan, focus, organise, shift between tasks, and follow through.In pregnancy, this often manifests as:
- Forgetting appointments or tasks despite reminders
- Difficulty completing basic routines (like cooking or bathing)
- Avoiding or delaying tasks you want to do
- Losing track of time, or how long you've been stuck
- Getting overwhelmed by small decisions (which bottle, which soap, which email?)
These aren’t character flaws. They’re signals from your body and brain that your cognitive load is heavier than usual, and it’s time we start treating them as valid.
Why This Matters During Pregnancy
Executive dysfunction can quietly erode your daily functioning and mental well-being. Here’s how it can affect your pregnancy:- Reduced prenatal care adherence: Missed supplements, skipped check-ups, or delayed follow-ups may occur due to forgetfulness or mental fatigue.
- Overwhelm and shame: You may feel guilty for “not doing enough,” especially in cultures where pregnant people are expected to “glow” and manage everything.
- Disrupted self-care: Nutrition, hydration, and rest routines can fall apart when task initiation becomes difficult.
- Poor decision-making: Impulsivity or indecisiveness may affect everything from financial prep to choosing birthing options.
- Relationship strain: Partners or family may misread your delays or zoning out as disinterest or moodiness.
Why It Happens: Causes and Risk Factors
Executive dysfunction in pregnancy doesn’t come out of nowhere. Multiple physiological and psychological changes play a role:- Hormonal shifts: Rising progesterone and oestrogen levels can alter neurotransmitter balance, affecting memory, focus, and motivation.
- Sleep disruption: Poor sleep quality or insomnia, common in all trimesters, affects attention and mental flexibility.
- Emotional load: Anxiety, guilt, or fear about the baby, labour, finances, or changing roles can tax your prefrontal cortex, the centre of executive function.
- Neuroplasticity: The maternal brain undergoes structural changes to support attachment, but this can temporarily shrink areas involved in abstract thinking and memory.
- Mental health conditions: Depression, perinatal OCD, or underlying ADHD can worsen or present for the first time during pregnancy.
- Pre-existing neurodivergence: Pregnancy may amplify difficulties in executive functioning if you’re autistic, have ADHD, or experience sensory processing differences.
Is There a Clinical Test for It?
There’s no blood test or scan that detects executive dysfunction. It’s a descriptive term, not a formal diagnosis. But professionals may assess it based on:- Behavioural questionnaires: Tools like the BRIEF-A (Behavior Rating Inventory of Executive Function) assess task management issues.
- Clinical interviews: Mental health providers or neuropsychologists may explore patterns of inattention, memory lapses, or overwhelm.
- Contextual signs: Difficulty following prenatal plans, forgetting medications, or emotional burnout can all signal dysfunction, even if unlabelled.
Note: If your executive dysfunction overlaps with symptoms of depression or anxiety, it's important to get screened properly to ensure you receive holistic care.
What Helps: Tools for Management and Support
There’s no single fix, but there are layered, realistic strategies that can reduce the intensity of executive dysfunction in pregnancy:- Externalise your brain: Use sticky notes, phone alarms, dry-erase boards, or shared calendars. Don’t rely on memory.
- Micro-tasking: Break chores into laughably small steps. Don’t “clean the room.” Just “put one shirt in the laundry.”
- Use visual cues: Keep medicines or water bottles in visible spots. Place important items by the door.
- Routine stacking: Tie tasks together, take iron supplements right after brushing, and drink water after each toilet trip.
- Decision limits: Reduce choices. Keep two types of breakfast foods. Stick to one brand of detergent. It saves mental energy.
- “Body double” with a friend: Just having someone present, online or in person, while you do a task can improve focus.
- Reframe your self-talk: Instead of “I’m lazy,” try “My brain needs scaffolding right now.”
- Delegate where you can: Don’t carry the full planning load, ask partners or family to handle reminders or prep.
Always speak to your healthcare provider if symptoms are intense, persist beyond the pregnancy, or affect your functioning severely.
Struggling to stay on top of things in pregnancy means your brain is in transition. Executive dysfunction is common, under-recognised, and treatable. By shifting blame away from yourself and building smarter, gentler routines, you can stay grounded in what matters most.
FAQs on Why You Keep Forgetting Things During Pregnancy
- Is executive dysfunction just “pregnancy brain”?
No. “Pregnancy brain” typically refers to mild forgetfulness. Executive dysfunction affects planning, focus, motivation, and task-switching, more serious than occasional memory lapses. - Will this go away after delivery?
For some, yes. But for others, especially if underlying conditions like anxiety or ADHD are present, it may continue into postpartum and require support. - Can executive dysfunction harm my baby?
Indirectly, it leads to missed medical care or malnutrition. But with awareness and support, it can be managed without serious consequences. - Does it mean I have ADHD?
Not necessarily. Pregnancy itself can mimic ADHD symptoms. But if the dysfunction is severe or long-standing, talk to a professional about screening.
