Family is one of the cornerstones in our social system but modern families face unprecedented change with very little support. This is never truer than when a family is expecting a baby. The birth of an infant still ushers in high levels of anxiety and depression in mothers, high levels of marital dissatisfaction, a spike in domestic violence and a raft of issues related to identity for women as new mothers. Many modern couples aspire to create an equal or egalitarian family but the birth of an infant often exacerbates, or introduces for the first time, quite gendered roles.
It is a daunting time for women to become mothers. There is an expectation that women will develop and pursue careers, and by the time many women have their first child, in their early thirties, they are well into their working lives. Before having children, workplaces want the skills and talents that women have to offer, but because they have been slow to respond to calls for flexibility, after they have a baby it is harder for a mother to see where they can fit. Tensions between work and family are contributing to a decline in the health and wellbeing of women.
There is a potent mix of social and cultural factors that accompany birth that can fuel a disorientation of the self. According to Beyond Blue one in ten women experience depression while pregnant and one in seven do in the post-natal period. The rate of anxiety is much higher. The response to Perinatal Depression in Australia has been highly medicalized – many mothers are prescribed medication or referred to a psychologist – while there is strong evidence of a need for social support too.
There has been a revolution in birth practice during recent decades with a new focus on continuity and woman-centred care. Much literature examines the need for improved postnatal services but there remains a dearth of research on the early years after the birth.
The postnatal phase officially ends at six weeks after the birth and the follow-up maternal and child health services are patchy. The care that is provided is primarily concerned with infant health and wellbeing, which is often to the exclusion of wider social and cultural factors that impact on maternal health and wellbeing. Women understand this and most often do not share their personal concerns with their nurse. This is something that women do intuitively while they console themselves with the fact that now they are a mother they need to become selfless.
In the recent election campaign politicians promoted various paid parental leave policies so as not to lose the skills and talents women have to offer. An early childhood focus is informing the renamed Child and Family Health services that are increasingly concerned with health surveillance and welfare issues. Sociologists agree that the work that women do within families contributes to social capital but at the same time recognise that conflicting pressures are contributing to poor health outcomes. The Human Rights and Equal Opportunity Commission and the Workplace Gender Equality Agency are focusing on workplace change but give little attention to related health and welfare services.
There is a need for a central agency to oversee and bring together these disparate agendas with a firm focus on the health and wellbeing outcomes for women. We need to consider how services can be improved to ensure they meet the needs and interests of women as mothers and men as fathers. It is imperative.