We hear about post-natal depression, anxiety and mental health difficulties so often that people stopped asking “why” these difficulties occur and started treating these as something expected. Here and there at pre-natal classes, from mothers and friends we hear that “baby blues” is something to “watch out for” but common and “normal” as a woman gives birth and transitions to a role of a mother.
Several explanations of post-natal mental health challenges were given and are widely supported by the community. Most of blame is placed on lack of sleep, lack of support (from a partner or extended family) and generally recognising that transition into parenthood is a major one in life that will cause an upheaval in any lifestyle, relationships and, well, everything that you knew before parenthood, in some ways.
However as I continue to hear about mental health issues and particularly depression in young parents (and predominantly biological mothers) I wonder why no one mentions own childhood experiences of these parents and the impact of these experiences on their parenting.
A horrifying article came out a few weeks ago prompting me to write this post. Here is the link. In this story, where a woman who is suffering from post-natal depression kills her baby and herself, there is a harrowing description of mental health services she turned to in search for help. They prescribed medication, sleep hygiene practices, suggested more rest and relaxation, all but failing to investigate her feelings about parenthood and the baby and reasons behind these feelings. We cannot blame health practitioners or even her partner who tried to help and offered support, because two things happened here. One the one hand, there was an assumption that it is somehow “normal” that some mothers struggle after birth of their baby. It didn’t seem unusual that a period of sleepless nights and exhaustion would lead to a depression, hence no one asked “why”. On the other hand, everybody, including the mother were following the established practices of supports provided in these cases. She did try anti depressants, her partner helped more with the baby, she tried more self-care and rest, and they probably generally expected things to get better after a while, again subscribing to common belief that “baby blues” will get better over time.Read more
No one considered mother’s failure to attach to her baby and how much suffering that must have caused.
No one has asked her how she was growing up? Was she welcomed to this world by her mother, was she held and nurtured, looked at with love and adoration?
Where did the disconnect and alienation from her son come from, and why was it so persistent?
As a result she never asked these important questions of herself. She simply felt like she must be a terrible mother, not a person “cut out” to be a mom, not someone who deserves a baby, since she is unable to feel close and motherly towards him. We can only speculate, because we simply don’t know what was happening for her, and of course, the practitioners that she encountered on her way did not ask these questions either.
Pre-natal classes and doctors and midwives that support women in pregnancy and prepare them for the birth often fail to recognise childhoods of these women and role trauma plays in parenthood. When women are at their most vulnerable period of life, they are showered with advice on how to care for the baby and how to care for themselves. However the advice on how to care for themselves is often limited to basic advise like “find time to shower and eat well”. Even if a mental health concern does surface for a young mother, the screening tests would only ask questions about her moods and about having enough sleep and food. They would not dive into their own history. That’s probably left to a mental health specialist to explore later on, if they will. The article I shared here was a tragic story where no one around the woman took time and effort to alert her about the dangers that motherhood can present not because it is exhausting and challenging to care for a baby, but also because those who did not have a fabulous experience as a baby themselves, will likely struggle to provide that to their own children.
We do not need to reform all pre and post natal mental health care approach. We do not need to invite trauma counselling into midwifery appointments. We just need to include a little more information about how our childhood memories (implicit and explicit, verbal and pre-verbal) are activated and can powerfully overtake us when we have kids. A simple statement, raising awareness, that could spark thoughts and considerations for parents and invite them to explore and be ready for these memories and feelings to come up. Perhaps starting to explore and understand would already build a necessary knowledge prior to the birth. Perhaps having the knowledge would stop a mother from thinking she is “just a bad mom”. Perhaps alerting to these issues would make parents (and other family and professionals around them) aware of the deeper issues that lurk beneath the surface of mental health for young parents and stop suggesting that “simply getting enough sleep” would resolve the depression.
As a society we only recently started recognising trauma and its effects on our lives. Now nearly every social and public health service strives to demonstrate trauma-informed care approach. Often trauma care if assumed to be required only in the case of “vulnerability” or “something bad and very traumatic” happening in a person’s life, thus failing to recognise how seemingly normal experiences of our own childhoods will affect us, despite looking from he outside like “normal childhoods”. There is an additional pressure to “be normal” if you do not come from a family of alcoholics or drug addicts and did not suffer form any from of explicit abuse. What about coming from a family or strict parents? Religious parents? Critical parents? Parents who showered you with gifts and love but never allowed any anger or criticism towards themselves? Parents who were immature and childlike themselves? Regardless of how positive, “normal” or negative our experiences in childhoods were, I advocate for their explorations, because regardless of what they were, they still affect us greatly. I prefer to call it existential framework, and opposed to trauma-informed care simply because it is existential and human to be affected by out experiences, and it is very self-nurturing and respectful to explore and give weight to their effect on us.