Sunday, November 24, 2013

Post-partum depression or impossible pressure?

Translation from an article about post-partum depression I read in the Hebrew Nashim ("Women") magazine:

M., a religiously observant woman, was 25 when her second son was born. The maternity leave at home with the baby passed by quickly, and after three and a half months [note: the length of maternity leave in Israel is 14 weeks] she had to return to work.

"I went back to work unwillingly [she says] - I wanted to extend my maternity leave, but I wasn't allowed to. I worried very much. I worried about how the children will cope in daycare, and I was under pressure to arrive at work on time."

The disquiet gradually took over the rhythm of her days. "I went out of the house every morning in great stress, came back in the afternoon stressed, everything was very pressured. In addition, there was a lot of criticism of my performance at work. There were many demands and endless remarks, and I felt I can't deal with it anymore. One evening I came home after a long conference at work, sat down in the living room and just began to cry. I cried and cried, my baby woke up and I felt I can't pick him up. I felt I have no power left. The house looked awful after about two weeks of no laundry being done, no cleaning and no cooking. But I couldn't cope, nor did I want to.

"The next day, I told my husband I have no strength to get up. He took the children to daycare, and I just stayed in bed and didn't stop crying. My husband tried to make me feel better, but it didn't really work, so he called my parents... and my mother said it might be post-partum depression."

Note: I am no expret, but if I may express my humble opinion, a depression that begins several months after birth - just when the mother is pressured to leave the baby and go to work - can hardly be called "post-partum depression". There's no doubt this poor woman was severely depressed, but I would rather say she suffered from "post-maternity leave, back to work" depression. 

So what was done to help M.?

"The psychiatrist understood right away work is a huge stress factor for me..."

So far, so good... and...

"And gave me a month of sick leave and a recipe for anti-depressants. Of course I had my prejudices about depression meds, but I decided to try them. In the first two weeks I felt awful, I had terrible mood swings and all I wanted to do was sleep. I was either a zombie or really mad. But after a month I felt much better."

Today, a year later, M. is still on anti-depressants, still sends her children to daycare and still rushes out to her stressful job every morning.

Am I the only one who is outraged by this story? How come nobody told this woman that what she feels is perfectly normal? We are biologically programmed to be with our babies until gradually, very gradually they begin to grow into toddlers and children and young adults, and go on to their own separate lives. We are not designed by G-d to send a 3-months-old helpless baby to the care of a stranger, and feel as though this is the normal course of events!

Sidenote: I realize there are many, many different people in the world in many, many different circumstances. I also realize many women in the aforementioned situation (baby in daycare, stressful job) cope well. However, it is normal not to cope well. If somebody told me I must leave my babies when they are just 3 months old and go out to a highly demanding and stressful job every day, I would likely very soon be depressed. Should I just then go on anti-depressants, or perhaps it is time to revise my life and see what can be changed? 

Sometimes people must go on anti-depressants to cope with situations that come to pass, such as the loss of a loved one, sickness in the family, etc. The situation itself cannot be changed in such cases, and if there is no other way to deal with it, medications have their proper place. But consider a woman who is trapped in an abusive marriage with a violent man who is unfaithful to her on top of all. If she goes to counseling and asks for anti-depressants so that she may continue to cope with this sick situation, what will she be told? I am almost certain that the advice she gets will be, take the kids and go and it is almost certain you will be fine! 

But when a woman only longs to be home with her baby, and instead is pressured to go to work and so doesn't perform well at her job and doesn't cope well at home, she is given anti-depressants so that the stressful situation can go on.

Try as I might, I can't wrap my mind around this. Why didn't anybody suggest to her, "perhaps you might just stay home?" - I'm not talking for the rest of her life, but perhaps at least until the baby is a toddler. If money is an issue, perhaps an alternative source of income can be found at home (not to mention that daycare and formula cost a lot of money!). But no; this option wasn't even mentioned. Not by the woman herself, not by her husband, not by her mother, not by the psychiatrist and not by the journalist, whose only aim was to show how "there is no shame in treating post-partum depression". No; it was unthinkable that the young mother wouldn't work. It was unthinkable that she might just need to stay home with her baby.

I think it was a lousy example of post-partum depression but, in contrast, a very good example of how modern feminism-infused society places horrible and unhealthy stress on women, children and families. 


Miriam said...

I totally agree that in many cases ppd is aggravated or in some cases brought on by the stresses of a woman going to work and/or putting her baby in child care.

However, you should know that it is perfectly normal for ppd to begin any time in the year after birth. It is still post partum, and in fact, it is much more common to hit later on (in the are of 3-6 months after birth) than to come immediately.

I speak as the mother of 5 children who went through ppd 3 times - it never came immediately, and I did not go to work (I did some part time work from the house, but very part time, 1-2 hours a day) nor did I send my children out to day care.

MDiskin said...

I'm in the U.S., where staying home is just another choice, even though most moms seem to work outside the home. Is this choice so heavily disapproved of that it's not even seen as a rational or viable choice? Why is this, in your opinion? It kills me to see any mother suffering so when it's so obvious that what she needs and wants is just to be at home with her children. It's what children have always needed, everywhere.

Also: it's hard not to feel bitter toward a doctor who equates wanting to stay home with a form of mental illness.

Mrs. Anna T said...

Miriam, what I meant to say is that, in this woman's case, the depression was clearly triggered by the work-related stress and having to leave her baby. That was why I referred to it as "post-maternity-leave-depression", rather than PPD.

MDiskin, in Israel women are very very very strongly conditioned to go to work. Don't forget that Israel is also the only (as far as I know) country in the world which practices mandatory military service for women - 2 full years. A religiously observant woman may receive a release from military service, but on a general level it is the default option for every 18-year-old girl. I think it is an outrage.

harper said...

Quite right.

Lady Anne said...

Would I be correct in thinking this doctor was a man? believe any female doctor would know instinctively that Mom needed - *physically* needed, not just psychologically needed - not be home with her baby.

Are things so bad in Israel that women *must* work outside the home? Or is it just an iron-bound custom?

momto9 said...

Mrs anna T...that poor woman would totally be me if I was placed under such pressure! I agree with you that often these impossible standards are what bring on depression in women!

Anonymous said...

14 weeks is an impossibly short time for a post-partum recovery and to take proper care of a newborn.
It's just not enough time.
And it's just unrealistic to request her to start working full time and with full demands so soon.

But I disagree with this affirmation "how modern feminism-infused society places horrible and unhealthy stress on women, children and families": this is the exact opposite of feminism!

Modern feminism wants to achieve a proper tutelage of maternity, with long and flexible maternity leaves so that the woman doesn't have to experience this kind of pressure and can be helped by her husband (or companion).
In Sweden, which is considered a very "feminist" country, the maternity leave is 16 months and can be flexibly split between mother and father, same as in Norway; in Estonia mothers are entitled to 18 months of paid leave, starting up to 70 days before due date.
In other country, such as Austria or Italy, the fully paid maternity leave is 4 or 5 months, and then there is the "optional" leave in which the woman keeps her job but receives 30% of her wage (and even then, they are allowed to re-enter at work part-time with full wage until the baby is 1).

Such a short maternity leave isn't the work of feminism, but the product of a society which doesn't take enough account of the material issues linked to maternity and to the female workforce... it needs more feminism, not less! ;)


Mrs. Anna T said...

Lady Anne, no, that doctor was a woman (should have specified that. In Hebrew there's a grammatical distinction between the male and female form). I actually think the opposite - a man might have been more understanding, whereas a female psychiatrist, who is by definition a career woman, is almost certainly unaccepting of the idea that another woman might just have to stay home with her baby.

Also, see my comment above - yes, things in Israel aren't very bright financially, but it *is* possible to make do on one income. However, there are very strong expectations from women to work.

Mrs. Anna T said...

Anna, I think it's practical to give such long maternity leaves in countries where women tend to have few children. In Israel - and particularly among religious women, who were the subject of this article - if a woman took maternity leave of 1 year for each baby, most likely she would be pregnant again, or on the point of falling pregnant again, at the end or soon after her maternity leave. That would mean the woman spends roughly half or more her time on maternity leave until her early 40's. In terms of work force, that would just be impractical, and so women are taught to "harden themselves up". Of course, many don't, and stay home with their babies anyway, being housewives or finding alternative sources of income. There are even a couple of crazies who homeschool. :o)

Anonymous said...

But a person at 40 is *young*, in terms of workforce, if you consider that she will retire at around 60-65.
Even if she has spent, say, 10 years on and off maternity leaves (which is a LOT!), she still has all the time to get back on track and to be professionally valuable and successful.
Besides, the possibility for both parents to use part of the parental leave can make fathers help take care of the children (especially after the start of the weaning), distributing more equally the time off work.

The idea that women should "toughen up" (because, hey, men don't take time off to make babies, do they?) and put in front of the choice "career vs family" is the opposite of feminism, IMHO, and it is based on the fake assumption that babies are just a "woman's business" and men are not involved at all. A child is of the whole family, and giving the possibility to raise them without trauma AND to be able to work should be the society's responsibility (or at least goal).

Mrs. Anna T said...

True, the age of 40 isn't the end of a person's career, but a woman who has had a large family of children almost certainly hasn't achieved the same in her career as a woman who only had one or two. We are only young once. We face choices of what we do with our most vital years.

I have a dual feeling about "baby leave" for fathers. In some families it might be a convenience; but for others, it might just be an additional pressure button on the woman ("your baby is fine, right? She's with her father, right? So stop making a fuss and go back to work"). I didn't even start weaning until 1 year. A woman DOES need that time with her young child.

Just saying... a woman who chooses to have just one child or two, can take 1-2 years off her career and still be professionally successful. A woman with a large family can juggle it all and work part-time, but she most likely won't have a high-powered career.

Mrs. Anna T said...

Also, just wanted to stress that having children changes everything. It changes YOU. You are no longer the same. Your way of thinking, your attention span are different. Your heart is in another place.

maria smith said...

It's easy to underestimate the changes that a mom goes through in the first year of her child's life. There are so many expectations, both socially, economically, as well as the mom's own expectations of what a happy/good mother looks like.
Sometimes going back to work is necessary, in which case making the time you spend with your little one a quality as possible, and remember that happy children can be raised under hundreds of circumstances.
Also, any way you can cut your work load, such as hiring a cleaning service or in some way reducing your housekeeping load can be very helpful.