Is Fear the Last Taboo of American Motherhood? - The New York Times

ORDINARY INSANITY
Fear and the Silent Crisis of Motherhood in America
By Sarah Menkedick

The day before my 1-year-old son went into anaphylactic shock, I joked to a friend that I was finally past the anxiety stage. To be fair, I am a first-time parent and have no institutional memory of motherhood. Once my twins turned 1, I became briefly confident, maybe even a little cocky.

Then Samuel ate a Lärabar and started to throw up. Angry hives clustered around his mouth, then covered his forehead. He sputtered, struggling to breathe.

The clarity of that fear made me efficient. I snuggled Samuel into a carrier and raced to the hospital.

Like most parents, perhaps mothers especially, I had been haunted by the terror of what if since becoming pregnant. Intrusive thoughts bounced around my skull like toxic earworms. My overworked adrenal glands pushed me through sleepless nights and the boredom of those early days. The fear seemed necessary.

I never thought to question the anxiety of my postpartum life. Even before the pandemic, there seemed to be catastrophes lurking around every corner — milestones hit or missed, toxic chemicals in everything from milk to toothpaste, carcinogens in synthetic fibers, the risk of SIDS. Was worrying beneficial, an evolutionary mind trick designed to prepare us for the worst? Or was it not only a waste of time but harmful?

Postpartum anxiety is the subject of Sarah Menkedick’s searing new book, “Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America,” her second on motherhood. Fear is what she calls “the last major taboo of American motherhood.”

Anxiety is epidemic — over 40 million Americans struggle with the condition, a number that is surely only growing at the moment — but it’s especially pervasive in pregnancy and the immediate postpartum period. Ninety-five percent of new mothers experience O.C.D.-like intrusive thoughts, according to one study Menkedick cites, while another estimates that 17 percent of mothers live with clinical levels of anxiety. The banality of anxiety in motherhood is what makes it so dangerous, especially in a world so filled with fear. Who will bat an eye at a mother who washes her child’s hands raw during a pandemic?

Many hospitals don’t have protocols in place for treating postpartum anxiety. The bulky DSM-5, considered the bible of psychiatry, doesn’t have an entry for it. One anonymous researcher told Menkedick that “no one wants to fund research on postpartum women.” As the author puts it: “Mothers should be invisible, should be in control and self-sufficient. … They should be able to just handle it, just be natural.”

Menkedick is a skilled storyteller and her accounts of women from varied socioeconomic and racial backgrounds drive home how little society has to offer mothers. One told Menkedick that she’s “terrified of everything”; another wore ankle weights to keep herself from sleepwalking and hurting her baby; yet another was placed on a 72-hour hold at a psychiatric ward geared toward people detoxing from drugs because there was nowhere else to put her. None received proper help until they either found it themselves or hit dangerous levels of anxiety.

Menkedick’s own postpartum anxiety started with an obsession over mouse poop that filled her with a “hot tingling of horror.” The anxiety bloomed into a fear of toxins — food preservatives, glyphosate, lead. “My whole life felt like a held breath,” she writes. Yet it took two years for her to finally be diagnosed with severe O.C.D. “I couldn’t separate it out from the set of ‘normal,’ culturally and medically and socially solicited behaviors appropriate to new motherhood. I couldn’t draw a line where my fear crossed over into the darker territory of illness,” she says.

Yet she is less interested in exploring the line between what’s “normal” and what’s illness than in showing how fear and anxiety have long been used as tools of oppression — often by so-called experts — to police, blame and silence mothers throughout history. “Fear is the principal means used to hold women to specific societal standards as mothers,” she writes. “To question fear would be to question everything, the entire institution of American motherhood.”

Her wide-ranging narrative touches on everything from neurobiology to politics and psychology, and it mirrors what anxiety feels like: starting in one place and then spreading and spreading until it colors everything, like a stain. We learn about the ancient world’s view of motherhood as a source of power, inextricably bound with war, death and famine. We’re told how the brains of mothers adapt and grow in size postpartum, especially in regions associated with processing emotional reactions, leading to increased alertness to stimuli, like the sound of a child’s cry. Menkedick contends with the legacy of slavery and its mark on the bodies of black women, who today are three to four times more likely to die of pregnancy-related causes and have double to triple the odds of developing postpartum depression. She tackles psychoanalysis and hysteria; witches and midwifery; the origins of welfare and the creation of the Social Security Act; forced sterilization and the rise of the American eugenics movement.

You can understand why Menkedick admits in her acknowledgments that she worried the book would be “too big.” Sometimes it is — her disparate threads sometimes feel like digressions and occasionally fail to cohere — but more often than not that bigness is a virtue. What you won’t find is a prescription for change. “Ordinary Insanity” offers little in the way of solutions. Menkedick’s goal, she writes, is to give a voice to the stories that have long been suppressed or ignored.

On her daughter’s third birthday, Menkedick weeps as she lies next to her. “For her, but more, I believe, for myself: for a resilience I never knew I had.”

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