Pathologizing Maternal Mental Health
Clearly we have an epidemic in maternal mental health.
The Center for Disease Control (CDC) reports approximately 20% of women in the United States experience postpartum depression. And while a statistic of 20% of Mothers experiencing perinatal mood disorders does indeed represent an epidemic (a disproportionate level of the population being affected), this statistic only accounts for Mothers who have self-reported, and it only accounts for Mothers who have had ‘live births.’ Therefore- this statistic does not take into account Mothers who have not ‘self-reported’ nor those who have had: miscarriages, stillbirths, or abortions. Meaning, the statistic of Mothers in the United States who are experiencing postpartum depression is much, much, much higher.
HOWEVER, with a current GLOBAL focus on “Maternal Mental Health” and the ‘prevention’ of perinatal mood disorders via campaigns, classes, legislature, and the like, we are not only collectively missing the point, we are also collectively treading in dangerous waters. These are frequented waters within the world of women’s health, and specifically women’s mental health – known as THE PATHOLOGIZATION OF WOMEN’S HEALTH.
In the 5th century BC, Hippocrates first coined the term “HYSTERIA”, from ‘hystera’ or uterus, claiming that ‘Hysteria’ was a mental disorder that pertained only to women and included the symptoms of: nervousness, hallucinations, emotional outbursts, and various sexual urges, amongst many others.
This view of an inherent dysfunction of women’s mental health spread through indigenous Europe via the movements of the Inquisitions and the rise of Allopathic medicine. Later this distortion was exported to the Americas via colonization and the medical establishment. The American Psychiatric Association didn’t drop the term ‘Hysteria’ until the early 1950s and ‘Hysterical neurosis’ didn’t disappear from the DSM (often referred to as the ‘Bible of modern psychiatry’) until 1980.
Medical rhetoric has a surprising ability to socially construct marginalized bodies (be them mental or physical).
In present day America, at least one in four women takes a psychiatric medication, compared with one in seven men. And it is women who are nearly twice as likely to receive a diagnosis of depression or anxiety disorder than are men.(1)
Over the past 16 years, working within holistic women’s health, my clients have shared with me the frequency in which they are prescribed anti-anxiety or anti-depressant medications or both from their Primary Care Physicians (PCPs), OBGYNs, and/or Psychiatrists for one or more of the following reasons:
- They feel ‘angry’ before they begin to menstruate each month
- They feel like their world is falling apart before they begin to menstruate each month
- They feel ‘depressed’ after giving birth
- They feel ‘apathetic’ or ‘disconnected’ after giving birth
- They feel like they ‘don’t know who they are’ while peri-menopausal.
- They feel like they want to leave their long-term marriage/job while peri-menopausal
Women’s emotionality is a sign of HEALTH, NOT DISEASE. When we look at the symptoms – the ‘depression’, the ‘anger’, the ‘apathy’, the ‘disorientation’, the ‘sadness’ as a PROBLEM or DIS-EASE and then ‘treat’ the problem or dis-ease, WE ARE MISSING the deep, potent messages that are coming through the symptom.
WHY are we feeling ‘depressed’? WHY are we feeling ‘angry’? WHY are we feeling ‘apathetic’ or ‘disconnected’ or like ‘our lives don’t fit us any more’? When we are able to sift through these questions, we are able to encounter the ROOT of the manifesting symptom. It is here at the ROOT, which we are able to discover THROUGH our emotions (etymology meaning: to move out, to move away, to remove, to stir up), that we find our POWER to create change in our lives. Our emotions are the energetic requirement to be able to create change.
When it comes to the postpartum period as experienced within the modern world, it is not surprising that Mothers are not feeling empowered, exalted, nourished and connected, and rather are feeling DEPRESSED, ANXIOUS, DEPLETED, OBSESSIVE, AND COMPULSIVE:
- To begin with, most births happening in the world today – outside of midwifery care – are NOT physiologic births. Physiologic labor and birth is one that is powered by the innate human capacity of the woman and fetus. This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes (2). When there is ANY interruption in the physiologic process of labor, birth, and the early postpartum, there will be a resulting consequence in the bonding and attachment within the family system (Baby/Mother/Father-Partner), and this consequence often manifests as: depression, anxiety, disconnection.
- Many Mothers experience obstetrical violence during their labor and birth experiences (obstetrical violence occurs at an intersection between Institutional violence and violence against women during pregnancy, childbirth and the post-partum period and it occurs both in public and private medical practice WORLDWIDE) (3). Obstetrical violence experienced during labor and birth has the potential to manifest as anywhere on the spectrum of ‘perinatal mood disorders’, including Post Traumatic Stress Disorder (PTSD).
- Cross-culturally, postpartum traditions are based upon the foundation of COMMUNITY. Newborn Mothers are never to be left alone. This is from not only a practical standpoint (community is needed to cook food/clean/tend to other children to enable Mother’s recovery), but also from the perspective of MENTAL HEALTH. From the American Psychological Association (APA): “Loneliness has been associated with a wide variety of health problems including depression, high blood pressure, diminished immunity, cardiovascular disease, and cognitive decline.”As humans we have been living within extended family living structures until the Industrial Revolution which forced families into urban living/nuclear family contexts and colonization which tore families apart. Within our extended family living, it was our traditions, our cultures, our stories, our music which SUSTAINED US, sustained LIFE. In today’s modern reality, many postpartum women are home, ALONE, with their babies or, because of need, are forced to go back to work and place their baby in daycare facilities. BOTH of these realities create the ripe conditions for what we call ‘perinatal mood disorders’.
- The symptoms of: thyroid disfunction, micronutrientdeficiency and autoimmune conditions often manifest as depression or anxiety or both.(4)
- This list could go on, and on, and on…
Perinatal mood disorders at epidemic levels are the SYMPTOM and not the problem itself.
While modern humans exist in environments that are radically different from those in which we evolved, our human genome is essentially the same as it was over 1,000 years ago. The physiologic requirements for postpartum healing is the same NOW as it was THEN. By biologic design, postpartum women are hard-wired to be sensitive to our environments, a tremendous ASSET in the growing and care-taking of life.
The ROOT of the problem to what is collectively called ‘perinatal mood disorders’ is the dis-function and dis-harmony within our human environments, manifesting through the vulnerable bodies of postpartum women.
Women’s bodies are microcosms of the Earth.
Presently, about one half to one third of the world’s top-soil has been depleted. And while the effects of soil erosion go way beyond the loss of fertile land, the most visible effect of topsoil depletion is the decreasing crop yields. Soils are the basis of life.
‘Postnatal depletion disorder‘ is a term recently coined by Dr. Oscar Serrallach of Australia, stating: “There is a lot of overlap between postnatal depletion and depression in terms of symptoms and biochemical findings.” Maternal health is foundational to society’s health.
What is speaking to the collective at this time THROUGH the bodies of MOTHERS (re: epidemic levels of perinatal mood disorders) speaks of LIFE OUT OF BALANCE.
Our survival as humans on this Earth depends on our re-orientation with the reality of our INTERDEPENDENCE – in our daily lives.
While bringing awareness to the reality that many modern Mothers are interfacing with is an important step towards a necessary, collective SHIFT – focusing on Mothers as the source of the problem IS THE PROBLEM in and of itself.
May we give thanks to the MOTHERS, for it is through the bodies of MOTHERS that humanity is being alerted to the urgency of our collective need for change. May the suffering that many modern Mothers are experiencing not be in vain.
Rachelle Garcia Seliga, CPM
Click HERE to receive our free booklet, ‘Reproductive Mental Health and Postpartum Wellness’.
(1) Julie Holland, MD – Article: Medicating Women’s Feelings
(2) Supporting Healthy and Normal Physiologic Childbirth: A Consensus Statement by ACNM, MANA, and NACPM from NCBI
(3) International Day of Action for Women’s Health: www.May28.org
(4) Kelly Brogan, MD – Article: Postpartum Depression Screening: Prevention or Problem?