I was seven weeks into motherhood. It was not going well. People had told me that motherhood was so worth it. It wasn’t.
The Health Visitor was due for a routine one-off check to decide if I might have postnatal depression. The questions are standardised and scored (think teen magazine) and the higher your score, the more likely that you are depressed. Points do not mean prizes.
To me, the questions seemed to relate to some distant memory of life. Was I “looking forward to things as much as ever”? The Health Visitor looked at me expectantly whilst I wondered what that could possibly mean to someone in the midst of a newborn baby life hurricane. I was looking forward to my partner finishing work and taking the baby away. Does that count? Were other new parents spending their evenings at exhibitions and slam poetry nights?
Was I “blaming myself unnecessarily for things”? I answered no. I certainly was blaming myself: for being a bad mother, for not feeling the right things, for not instantly becoming an eternal fountain of breastmilk, for not treasuring every moment. But my self-blame was necessary, because all of those things were my fault. That’s how I saw it.
We rattled through the questions and I was left bemused. She told me I scored 12, and that you need to score 13 to be referred to the GP. That was it. Box ticked.
But that shouldn’t have been it.
Expectations about modern motherhood are out of control but completely excluded from any assessment of postnatal mental health. Tina Miller, Professor of Sociology at Oxford Brookes University, has conducted two studies about transitions to motherhood, each twenty years apart. She told me about how she has seen an increase in motherhood expectations: “The idea that you feed and clothe your child and protect them as best you can and love them is really quite out of date. Now that’s not enough. Now you need to be at the sensory group for your three-week-old baby and doing skin-to-skin and baby massage and plenty of tummy time”. The pressure to perform these activities is intense and, of course, people are eager to make money from our anxiety. I took my daughter to a sensory class and at the first session we were told by the instructor that we had only a few months to “sort our baby’s eyesight out”. The inference was clear. If we missed class, our baby’s vision would suffer.
So, when a new mum gets asked, “have things been getting on top of you?” which ‘things’ are we talking about? Are we asking them whether they have been overwhelmed by the prospect of making tea? The prospect of keeping their new baby alive whilst working through a triple booked schedule of classes for fear that they will stunt their baby’s development if they miss out? Or, as if that wasn’t more than enough already, are we asking about all of that plus the added race-related stress for mothers of colour, navigating how the world sees their child and combating negative racial images?
The fact that societal pressures are excluded from our measurement of postnatal depression is no coincidence. Natasha Mauthner, Professor of Social Science Philosophy and Method at Newcastle University told me that, “postnatal depression measurement devices are not innocent, they’re not just objective means of coming up with a diagnosis. They have assumptions embedded within them about depression, about motherhood. They portray motherhood and depression as individual conditions”.
We choose not to ask mothers about whether they have support from their partners, whether they feel pressure to perform in a certain way, whether their birth was traumatic, whether motherhood is making them re-experience grief for previous baby losses. We choose not to ask about whether the mother is facing abuse or financial precarity.
Why?
Because we don’t want to know.
It is inconvenient to engage with the idea, as Professor Miller puts it, that “currently women are set up to fail in a whole range of ways”. We don’t want a conversation about the institution of Motherhood. We just want mothers to quietly get on with it. We want to treat all problems as being in the mother’s head, because that’s easier for us to ‘fix’ or brush aside.
Overlooking the broader context of mother’s lives means that we can ignore the fact that the risk of pregnancy loss is 40% higher for black mothers than white mothers and that approximately one in four pregnancies end in loss. We can ignore the fact that a study in California found that new mothers with lower socioeconomic status are twice as likely to have postnatal depression than those with higher socioeconomic status. We can ignore the findings of a year long study by the charity Birth Rights, documenting how in 2018 black women in the UK were four times more likely to die in pregnancy and childbirth than white women while Asian and mixed race women were twice as likely, and how ‘systemic racism, not broken bodies’ are at the root of these differences.
What do we do instead of facing up to these realities and the questions about systemic injustice that they raise? Professor Mauthner explains how “we’re pathologising feelings and emotions that don’t conform to the idealised and romanticised portrayals of motherhood that are really very, very deeply embedded within so many aspects of our culture”. That’s not to say that postnatal depression isn’t real or that a diagnosis is pointless. Mauthner writes about how helpful a diagnosis can be. The issue is, we skip right over the possibility that some of the underlying problems are societal.
Narrow, uncritical discussions about motherhood and postnatal depression let us all down. No one can meet the standards modern mothers are set. White middle class mothers may come closest, but still everyone falls short. We are told that there is only one way to mother and that it should come naturally to us, filling us with joy. It’s gaslighting on an industrial scale.
So, what can we do? Well, we can start by asking better questions. Questions are important. They indicate what we care about and expect. We can ask each other what we think about how motherhood operates. What pressure we feel. How things could be better. And then, most importantly, we could listen to understand each other’s responses.
If you would like to read more of Beverley’s work, click here