Rock-a-by Baby

Feminism, Self-Help and Postpartum Depression

Verta Taylor

• Publisher: Routledge
• Year: 2016
• eBook ISBN: 9781134716739
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

Although self-help has been an integral strategy of the women's movement, the burgeoning self-help publishing industry and growing popularity of talk shows encouraging personal confession have provoked vicious attacks on self-help from many feminists. Rock-a-By Baby examines the postpartum depression support group movement and exploring the relationship between gender, the ideas and strategies of women's self-help groups and feminism. Taylor uses interviews and personal letters, talk show transcripts, organizational newsletters and a survey of postpartum group leaders to illuminate conflicts played out in the arena of women's self-help.

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INTRODUCTION

THE FEMINISM IN WOMEN’S SELF-HELP

ASK ALMOST any English-speaking American what lullabies she knows and the answer is likely to be “Rock-a-by, Baby” Sung to put babies to sleep, the words in this familiar lullaby convey an alarming image:

Rock-a-by, baby, on the treetop,

When the wind blows, the cradle will rock,

When the bough breaks, the cradle will fall,

And down will come baby, cradle and all.

How ironic that the classic American lullaby, by juxtaposing suggestions of care and harm, so thoroughly expresses the contradictions of motherhood. Is it any wonder that one of the women I interviewed for this book, overwhelmed by genuine unhappiness after the birth of her baby found herself rocking her baby to sleep crooning, “I hate you, I hate you”?

Perhaps the ultimate expression of maternal contradictions can be found in the condition of postpartum depression. The clinical signs of postpartum depression are comparable to depressive episodes in general and include feelings of inadequacy, sadness and despair, anxiety and nervousness, appetite and sleep disturbances, an inability to concentrate, compulsive thoughts, loss of interest in sexual activities, and an absence of feelings for the baby. The birth of a baby is mythically believed to be joyful and exciting. Why is it, then, that both popular and medical writings have long acknowledged a link between childbirth and psychiatric illness? In her literary masterpiece, The Yellow Wallpaper, Charlotte Perkins Gilman narrates the story of a nineteenth-century woman who has been taken to the country by her physician husband to recover from an undefined illness following the birth of her first child. She feels trapped by the role assigned women and is further incapacitated by her husband’s medical advice, which reflects conceptions of proper womanly behavior. Gilman’s story recounts the emotional anguish of the narrator as she struggles to maintain her sanity while being haunted by the image of a woman imprisoned behind the sickly colored wallpaper in her bedroom. She spends her illness stripping the wallpaper in order to free the woman, an act that serves as a metaphor for Gilman’s own struggle to break loose from the constraints of motherhood that are so closely intertwined with gender.

In the nineteenth century, there was a fairly universal consensus among physicians that psychiatric disorders associated with pregnancy and childbirth, referred to as “puerperal insanity,” were common enough to account for about 10 percent of asylum admissions. The symptoms of this “disease”—aversion to the child and husband, meanness, obscenity, incessant talking, excitement, and sleeplessness—were virtually the opposite of the feminine traits of the period. Now it is tempting to view puerperal insanity solely as an attempt by the male-dominated medical establishment to reinforce gender inequality by defining and regulating behavior that violated orthodox conceptions of femininity as illness. The fact is that women, as patients seeking and demanding treatment, also played an active role in creating the disease, although they were by no means equal partners in the medicalization of their suffering. By translating women’s desperation and rebellion against maternal constraints into symptoms of disease, the male medical establishment managed to silence women. As gynecologists in the early twentieth century gradually abandoned the view that women’s diseased reproductive organs accounted for female insanity, and as the field of psychiatry advanced new and presumably more scientific theories of mental illness, puerperal insanity became a suspect classification and soon disappeared altogether from the medical literature. Indeed, since 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual, the official handbook of mental illness, has excluded psychiatric illness connected to childbirth as a distinct diagnostic category on the grounds that “there is disagreement about the importance of childbirth as the precipitating factor.”

In the 1980s, the pendulum began to swing back toward the nineteenth-century view of postpartum psychiatric illness. Studies uniformly reported a relatively high incidence of psychiatric disorders following childbirth, with short-lived episodes of the “baby blues” occurring in about 50 to 80 percent of women; moderate depression in 10 to 20 percent of women, and major depression, psychosis, and psychotic depression in roughly 1 to 2 percent of women. Concurrently, the popular discourse on pregnancy, childbirth, and motherhood on television talk shows, in dramas, popular fiction, women’s magazines, and the self-help literature increasingly highlighted the sadness, ambivalence, guilt, anxiety, anger, depression, and mental illness associated with motherhood—conditions that had dropped out of the storyline during the pronatalist decades of the 1950s and ‣60s. The spotlight was placed on postpartum depression when Princess Diana, in her much touted November 1995 television interview, admitted suffering such severe “postnatal depression” that she not only could not get out of bed to perform her duties as “wife, mother, and Princess of Wales,” but inflicted injuries on her own arms and legs.

It is not surprising that the negative side of motherhood came to the fore in the 1980s and ′90s. After all, these were the decades when the concept of the modern woman successfully combining child care with employment gained a foothold. In fact, the labor force participation of white married women with children reached the high levels characteristic of African American women. By 1990, 53 percent of all mothers with a child younger than one year old worked outside the home, compared with only 31 percent in 1976. An even higher proportion of college graduates (68 percent) combined work and childrearing. For the first time, the majority of women struggled to balance work and family commitments. As a line from popular rap group Arrested Development put it, “Mama’s always on stage.”

Even as women enjoy greater opportunities in the work place, motherhood is becoming the focus of some of the most heated political controversies of the day—maternity policy, medical and family leave, abortion, adoption, welfare for single mothers, and the ethics of the new reproductive technologies. Mothers, traditionally revered in the public discourse, are now being portrayed as much more complex, even wicked, beings. One has only to think of the story of Susan Smith from South Carolina, who strapped her two children into her car and rolled it down a ramp into a lake, drowning both children, and who then used her history of depression, abuse, and abandonment to avoid the death sentence; or of headlines trumpeting the news of mothers who sacrifice their babies’ lives for the pleasures of crack cocaine. From single welfare mothers accused of draining the national coffers to surrogate mothers demanding custody of babies promised to adoptive parents, suddenly mothers are being blamed for many of the ills facing society Such a transformation in the discourse of motherhood is not only a result of media sensationalism. Certainly another contributing factor is the cultural divide—opened by the New Right’s alliance with the Republican party—between conservative advocates of “traditional social values” and liberals who defend social programs that allow for a diversity of family forms.

The conflict over the appropriate roles for women is played out not only in the arenas of politics and social policy but also in vociferous debates among women themselves about the relative importance of their status as childbearers in determining their social identities. One of the major sites where this contest is taking shape and where women are forging new ways to mother is in the myriad of self-help groups throughout American society. The focus of these typically all-female groups can be as specific as childbirth education, breast feeding, or lesbian mothering, or as general as parenting and motherhood. Such groups not only promote a collective female consciousness that is reinforced by small group meetings, but they also frequently question traditional gender relationships within the family, sharing the conviction expressed by feminist philosopher Joyce Trebilcot that “mothering must now be defined and controlled by women.” Although women’s self-help groups have been largely overlooked in scholarly discussions of social movements, studying them is important in helping us to understand the significance of women’s collective action for the reconstruction of the female role.

What is especially interesting about the modern dialogue over postpartum illness is that, unlike in the nineteenth century, the male-dominated medical establishment is not taking the lead in the campaign for medicalization. Rather, women patients and medical practitioners (physicians and nurses) are the main forces behind the national campaign that aims to raise public awareness of postpartum psychiatric conditions, to provide mutual support to women who suffer emotional distress associated with childbirth and the overwhelming responsibilities of caring for and raising a child, and to pressure medical and mental health institutions and the society at large to take seriously the emotional problems of new mothers.

Coming to terms with the contradictions of motherhood embodied in the experience of postpartum illness is the goal of what participants refer to as “the postpartum depression self-help movement,” which consists of two separate but interacting national social movement organizations, Depression After Delivery (D. A.D.) and Postpartum Support International (PSI). Both groups were formed in the mid-1980s, coalescing out of the experiences of women who suffered serious postpartum psychiatric illness and were unable to find sources of treatment and support that confirmed their own self-diagnoses. Although the founders of both D.A.D. and PSI had long histories of feminist activism, it is significant that they launched their support groups during a period that scholars of the women’s movement have characterized, following Judith Stacey, as “postfeminist.”

For all sectors of the women’s movement—national groups fighting for women’s rights in the political arena, such as the National Organization for Women and the National Abortion Rights Action League, and loosely organized smaller groups struggling for gender equality outside the conventional political system—the 1980s were years of retrenchment. The decline of the movement was, in part, a response to the New Right, which contributed to the defeat of the Equal Rights Amendment in 1982 and mounted the attack on legalized abortion. Opposition to feminism hardened with the explicitly antifeminist policies of the Reagan administration and a virulent backlash against feminism in popular culture, both of which contributed to a general waning of public support for feminism. While it may have fragmented the broad feminist coalition that had emerged by the 1970s and caused some groups to retreat from political engagement, this shift to a more hostile national political climate did not spell the death of feminism. Rather, it transformed both the form and the strategies of women’s movements. By the mid-1980s, feminism was beginning to spread to different constituencies of women who were applying the goals and strategies of the women’s movement to a variety of “women’s problems” that had not been central to the movement of the 1960s and ‣70s. As new generations of activists continued to be drawn to feminism in the 1980s, they found new arenas for political action as they struggled to define a feminism that would reflect the specific disadvantages of gender in their own lives.

The postpartum self-help movement gathered steam through widespread media attention that began when Nancy Berchtold, the founder of D.A.D. appeared on the Phil Donahue Show in connection with a book about postpartum depression written by journalist Carol Dix entitled The New Mother Syndrome. Then in 1988, a nurse from Los Angeles—who had killed her nine-month-old son during a postpartum psychotic episode and was found not guilty by virtue of temporary insanity—began to appear with activists on nationally televised talk shows and news programs. Widespread media attention, especially to the possible link between postpartum illness and infanticide, helped Depression After Delivery to grow into a network of more than 250 support groups tied together in some cases by statewide or regional associations. Today the movement operates a “warm line” that links women with support groups located in most regions of the country, national and regional conferences, newsletters and publications, and a network of lay and professional leaders and experts whose perspectives on postpartum illness are sanctioned by the movement. Its membership consists mainly of women who have suffered major depression or psychosis connected to childbirth, a small number of husbands of women who have endured major depressions and psychoses requiring hospitalization or prolonged outpatient care, and a handful of medical and mental health professionals and researchers interested in the treatment and study of postpartum disorders. The movement has also attracted women, both imprisoned and acquitted, who have killed their children in connection with postpartum psychosis and are interested in legal reform as well as emotional support. Also in some localities, the parents and spouses of women who have committed suicide in the throes of postpartum mental illness have founded support groups.

The movement’s three main strategies—consciousness-raising, direct service, and lobbying—have come directly out of the women’s health movement of the 1970s and are deployed not only to provide emotional support to participants but also to work for long-term institutional changes in the medical and mental health systems, the law, family policy, and the society at large. Furthermore, like most self-help movements, its tactics are heavily cultural and revolve around disputed meanings—in this case the debate over whether postpartum illness should be treated as a bona fide medical condition—and contested identities, namely the changing meaning of motherhood. Scholars of the women’s movement use the term “discursive politics” to underscore the extent to which feminism, in the contemporary context, is perhaps best understood as a shared discourse and identity to which women feel accountable, rather than a set of particular organizations. This is not to imply, of course, that feminists do not engage in action in the “real world” to effect change. From political scientist Mary Katzenstein’s perspective, however, a great deal of the work of the women’s movement does not take the form of conventional interest-group politics but involves “rewriting through language texts and symbolic acts their own understanding of themselves in relation to … society.”

Over the past decade, self-help, recovery, and support groups that draw upon the discourse of feminism have gained increasing importance as sources of emotional support and settings in which women seek to redefine the female self Self-help, or women joining together to solve common problems not being addressed by existing organizations and social practices, has always been integral to the women’s movement, because such practices serve to anchor feminism in women’s most elemental everyday experiences. In the women’s movement of the 1970s, the feminist rallying cry that “the personal is political” justified self-help strategies as the foundation of a fundamentally separatist and radical feminism aimed at reclaiming power from male-dominated institutions. But by the 1990s, self-help had taken on quite a different cast. When Gloria Steinern, often looked upon as the standard bearer of second-wave feminism, published a best-selling self-help confessional of her journey to self-esteem entitled Revolution from Within, it came under sharp attack by feminists of varying stripes. Activists and scholars as diverse in their disciplinary training as historian Alice Echols and psychologists Celia Kitzinger and Rachel Perkins stamped women’s self-help an apolitical variety of cultural feminism or identity politics. Critics have argued that by defining women’s problems primarily in individual terms and offering psychological and medical frames for their resolution, self-help strategies divert attention away from the more significant political and economic barriers to women’s equality. Self-help, they argue, encourages women to put a feminist veneer on such activities as recovering from addiction and abuse, getting in touch with one’s inner child, and restoring one’s self-esteem, while stressing private and therapeutic solutions over public and institutional challenges to the inequalities of gender, race, and class.

Some popular writers have gone so far as to suggest that self-help culture works against feminism’s most fundamental tenets by promoting what Naomi Wolf calls “victim feminism” and what Wendy Kaminer and Carol Tavris label a “cult of victimhood.” By this, they mean that women’s self-help grossly exaggerates gender oppression and motivates women to retreat from the challenges of equality into an all-female world that valorizes traditional notions of femininity. Feminist critics cast an especially skeptical eye on twelve-step self-help programs which, they argue, promulgate ideas that reinforce women’s subordination. The admission of personal powerlessness and the need for outside help of a spiritual nature, which is a central component of most twelve-step organizations modeled on Alcoholics Anonymous, can run counter to the feminist goal of empowering women. At the same time, the vast literature on code-pendence, spurred by the formation of Al-Anon in 1951 by wives of alcoholics, has helped set the tone for women to challenge conventional ideas about their place. There is undoubtedly some truth, along with a good deal of snobbery, behind critics’ condemnation of self-help as exploitative, superficial, and perhaps even a dangerous throwback to traditional feminine roles. But this is only the most obvious piece of a more difficult puzzle.

In this book, I take issue with the one-sided negative view of self-help that currently dominates the scholarly literature. The problem with most critical analyses is that they speak mainly to the voluminous popular self-help literature that occupies such a large amount of space in today’s neighborhood bookstores, especially titles promoting those twelve-step principles. Or they target, as Naomi Wolf does in her book Fire With Fire, the form of self-help dished out on syndicated daytime talk shows, which increasingly serve as platforms for women to speak openly about such topics as domestic violence, child abuse, marital conflict, and sexual harassment.

In a recent national survey of support group participation in the United States, Robert Wuthnow found that nearly half (45 percent) of the adult female population claims to be involved in a support group. And women’s support groups, according to pioneer self-help researcher Alfred Katz, make up a large proportion of the 500,000 to 750,000 contemporary self-help groups comprising at least 10 to 15 million members operating in the United States today Both Wuthnow and Katz report, however, that therapy-oriented twelve-step groups—the subjects of the most virulent attacks by feminists—are not the most popular. Women form self-help groups not only to deal with problems pertaining to the abuse of alcohol and drugs, but also to come to grips with other problems and personal stresses—parenting, sexual violence, eating disorders, illness, bereavement, marital and relationship problems, divorce, retirement, and looking after a sick child or relative. In every region of the country, whether in small towns or major metropolitan areas, local newspapers routinely announce the names and locations of support groups focusing on every problem imaginable. Hoping to expand participation in church activities, religious leaders increasingly capitalize on the popularity of self-help by organizing support groups that address a host of individual problems ranging from parenting and the loss of a spouse to the abuse of alcohol and an overemphasis on work. Missing from the current feminist debate over the self-help enterprise is an understanding of the many types of women’s self-help movements that operate in the 1990s and the ways they have been informed by feminism.

There is a growing scholarly interest in understanding the significance of the burgeoning self-help industry for what it tells us, on the one hand, about the postmodern fragmentation of community and identity and, on the other, about modern forms of association that have emerged to fulfill individuals’ need for a renewed sense of community, new self-definitions, and a spiritual dimension to their lives. For example, the popularity of support groups for new mothers is undoubtedly connected to the isolation of mothers in nuclear families, a growing problem in modern urbanized societies characterized by high geographic mobility and the weakening of extended families. The seemingly curious rise in therapeutic self-help groups can be attributed to a combination of two tendencies in modern societies: first, for people to turn to anonymous authorities for help with their emotional problems, and second, the changes taking place in American social policy toward mental health care in the 1980s that have reduced individuals’ access to outpatient and inpatient care. Even as the broad-based community mental health system built in the 1960s was bein...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgments
• Preface
• 1 Introduction: The Feminism in Women’S Self-Help
• 2 The Cradle Falls: Postpartum Illness and the Contradictions of Motherhood
• 3 Size the Day: The Emergence of a Self-Help Movement
• 4 Getting and Giving Support: Women’s Self-Help Communities
• 5 The Metamorphosis of Feminism in Women’ Self-Help: Collective Identity in the Postpartum Support Group Movement
• 6 The Revolution from Within: Gendering Social Movement Theory
• Appendix: Postpartum Support Groups
• Notes
• References
• Index