Among the excitement and celebrations of childbirth, there are lesser known effects like distress and inner turmoil that fall under the disorder known as postpartum depression. In “Life in the Throes of Postpartum Depression,” the New York Times shares the stories of four mothers’ struggle with mental health after delivering their babies. These mothers suffered anxious thoughts and histrionic emotions. Other symptoms of postpartum depression include feelings of anger, withdrawing from loved ones, worrying about hurting the baby, and feelings of numbness and guilt.^[1] The contextual struggles of these women include work-family balances, poor communication with pediatricians, and inaccessible therapy. Postpartum depression can be analyzed through the sociological viewpoint in terms of a female’s internalization of emotions, but from a contextualized perspective, the social stress process model plays a larger role in the role transition of becoming a mother. 

Although the Center for Disease Control reports that 1 in 8 women experience postpartum depression,^[1] social stigma and underdiagnosis causes postpartum depression to be overlooked. The existing public stigma towards people with mental illness is amplified by the expectations of motherly responsibilities, which encourages the concealment of a disorder such as postpartum depression.^[3] Concealment inhibits exposure to this disorder and even more importantly, the treatment of this disorder, which then allows the current stigma to persist. Mothers may also attempt to conceal their depression as a means of protecting their children. A mother from the New York Times directly acknowledged the stigma and worried that people would “…take her children away.”^[5] This mother then goes onto therapy and medication, reporting that a main part of her recovery was being vulnerable. In relation, Emma McGinty,^[3] PhD, in the Health Policy and Management Department of Johns Hopkins Bloomberg School of Public Health studied how exposure to successful treatment is an essential part of lowering stigma and promoting help seeking. 

Overlooking Postpartum Depression 

Additionally, postpartum depression is a type of intropunitive disorder. By internalizing symptoms, these types of disorders are more easily concealed. Women are found to be more commonly diagnosed with intropunitive disorders than men.^[2] This makes it difficult for women to receive treatment unless a healthcare provider or an external source brings up the topic first. However, an OB-GYN physician admitted to the New York Times that they are not always able to mention mental health due to how busy they are. Additionally, one of the women suffering with postpartum depression reported that she had filled out the mental health form when seeing a pediatrician, yet nothing came out of it.^[5] These specialists are focused and trained on obstetrics and pediatrics, often causing them to overlook mental health. Another woman felt undeserving of help due to the extensive amount of time required to get placed with a therapist. She felt that, “There are people out there who need it more than I do.”^[5] Therefore, postpartum depression tends to be overlooked by both physicians and the mothers themselves. 

Sociodemographics and Risk Factors 

Some mothers are more likely to be affected by postpartum depression than others. Multiple studies found that the same factors predict postpartum depression: income, occupational prestige, marital status, education, age, and number of children.^[1;6] These risk factors are known as socioeconomic status when examined through the lens of the social stress process model. Level of education influences the types of careers a person may obtain, which then influences their annual income. Lisa Sergre conducted sociodemographic interviews with new mothers and found that financial poverty is the single largest predictor of postpartum depression.^[6] Financial poverty causes increased stress surrounding the series of monetary burdens throughout pregnancy and motherhood, such as hospital bills, feeding another mouth, and the cost of baby supplies. Costs for treatment of postpartum depression would be an additional strain, with prices around $350 per month. One of the mothers interviewed compared the fee to “like having another car payment”.^[5]) The high cost of therapy thus prevents mothers from seeking treatment, reiterating the issue of concealing and internalizing the disorder. In addition, maternity leave is a cause for lower household income. This causes a role conflict in finding balance between working to provide for her family versus having time and energy to be a mother. 

Secondary Stressors 

In fact, there are many struggles with the role of being a new mother. A role transition takes place in becoming a mother and navigating new responsibilities. There is also role-blurring, the overlap of work and household roles, known to affect women more than men.^[4] Women carry a larger mental load than men, and having a baby adds many more chores onto that to-do list.A spouse acts as a buffering effect, acting as both emotional support and instrumental support by helping out with household chores and being the primary source of income In contradiction, additional children may act as secondary stressors. Having a new child requires adjusting how much financial aid and quality the other children can receive, and since the newborn typically receives the most attention, the other children are likely to have negative responses. 

If a mother were to seek treatment, this would be another sacrifice of time that could be spent with her family. One of the mothers from the article struggled with committing to a treatment program because they took “full days, from 10 a.m. to 3 p.m.”^[5] Likewise to how the cost of treatment acted like another car payment, the time for treatment acted like another job.  If the spouse is at work while the mother is seeking treatment or in the case of a single mother, a nanny would be required to look after the children. This would be an additional cost and would also play a stressor in the search for a compatible nanny. Although placing the responsibility of a child into someone else’s hands or even spending any time away from them would be a cause of anticipatory stress for the mother. Most of the mothers interviewed by the New York Times expressed a sense of panic whenever separated from their baby. These mothers often lost sleep due to fear that something would happen to their baby in the meantime.^[5] Anticipatory stress is dangerous because there is no limit to which one can worry about the unknown. Like all other mental illnesses, accessibility to treatment and strong social support are crucial to helping mothers overcome postpartum depression. Another similarity is that attitudes towards these disorders can change over time and place as a result of being socially constructed. With the fluctuating environment of reproductive rights, further research must be done on how postpartum depression has been affected over time (i.e. pre- and post-Dobbs v. Jackson Women’s Health Organization) and over place (i.e. state by state). Although macro-processes like federal and state laws are factors, so are micro-processes like social support. Providing care and support can make a life-changing difference for new mothers. 

References 

[1] Depression among women. (2023, May 22,). Centers for Disease Control and Prevention. Retrieved 09/04/2023, from https://www.cdc.gov/reproductivehealth/depression/# 

[2] Loring, M., & Powell, B. (1988). Gender, race, and DSM-III: A study of the objectivity of psychiatric diagnostic behavior. Journal of Health and Social Behavior, 29(1), 1-22. https://10.2307/2137177 

[3] McGinty, E. E., Goldman, H. H., Pescosolido, B., & Barry, C. L. (2015). Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination. Social Science & Medicine (1982), 126, 73-85. https://10.1016/j.socscimed.2014.12.010 

[4] Pearlin, L. I., & Bierman, A. (2012). Current issues and future directions in research into the stress process. Springer Netherlands. https://10.1007/978-94-007-4276-5_16 

[5] Pearson, C. (2023, June 27,). Life in the throes of postpartum depression. The New York Times.

[6] Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression – the relative significance of three social status indices. Social Psychiatry and Psychiatric Epidemiology; Soc Psychiatry Psychiatr Epidemiol, 42(4), 316-321. https://10.1007/s00127-007-0168-1