Take the blame out of parenting
Depression and anxiety call for support, writes Ashley Miller.
There are no words that can express the tragedy of the death of a young mother. When 32-yearold Florence Leung was found dead in November, leaving behind her husband and infant son, her friends called for more understanding and support for women suffering from postpartum depression.
This week, her husband released a poignant plea to other new moms on Facebook: “You are Not alone. You are Not a bad mother. Do not EVER feel bad or guilty about not being able to exclusively breastfeed.”
As a mother and a psychiatrist, this plea is the same one I have been making since I became a new mother myself, 12 years ago this week. I had been taught in medical school that “breast is best” and educated about all of the downsides of formula feeding and soothers. Like the diligent student I was, I attended prenatal classes where the benefits of breastfeeding were emphasized, but not a word was mentioned about mental health or postpartum depression and anxiety.
Being a new mother is one of the most vulnerable times in a woman’s life, and how we are cared for can be the difference between life and death.
After my son was born, breastfeeding was a struggle. I went to a lactation consultant who treated me in a very mechanical way that left me in tears — the exact opposite of what an anxious new mother needs.
Fortunately, I found a second lactation consultant. She was warm and reassured me that I was doing a good job. Her calm presence allowed me to settle enough to feed my baby. This gentle, supportive approach was so touching that I went back two years later to thank her.
That’s why it is heartening that just this year, the U.S. Preventive Services Task Force changed the wording of their breastfeeding guidelines for primary care physicians to decrease the pressure some women may feel to exclusively breastfeed. Over the years, I’ve interviewed dozens of women about struggles related to “perfect parenting pressure.” Many of the women I’ve spoken with say what hurts the most are the disapproving glances they get from other mothers for bottle feeding. I’ve also treated many women for postpartum depression and anxiety. We have excellent reproductive mental health services and postpartum supports in the province of B.C., but the pressure to be a perfect parent still exists. That is why I believe we need to tackle this issue at a cultural level. This responsibility rests with health care providers, but also with all of us. We all need to firmly understand that postpartum depression and anxiety are real and serious illnesses. They are no one’s fault, certainly not the mother herself. No matter how many happy social media posts or cute baby outfits, any mother could be struggling with feelings of intense self-doubt and self-blame. Any mother could be dealing with guilt and the pressure to do everything “right.” The stigma of postpartum anxiety and depression is still so rife that women may not seek treatment at all. And in order to seek treatment, you also have to realize you have a treatable problem. When I had postpartum anxiety, my husband knew there was something wrong, but he couldn’t convince me. I thought it made sense to be so worried about the health of my tiny, vulnerable little being. But I was so focused on his well-being that it didn’t occur to me that my well-being was on the line. In my physician-mom circles, the message is getting around: mother’s health and mental health matter. No guidelines, regardless of how well-meaning, can replace a case-by-case approach to what is best for each mother, baby and family. As our society becomes more and more isolated, we don’t often have our mothers, sisters and aunts nearby to care for new moms while they care for new babies. The pressure on fathers to do it all becomes unmanageable too. So, next time there’s a new mother in your social circle, think about how you can provide practical support (food, cleaning, child care), emotional support (non-judgmental listening), or maybe even a graceful recommendation of support services. Florence Leung’s husband’s message rings out loud and clear: There are no words that can express the tragedy, but there are words, attitudes and actions that may prevent another.