Judgment days: The worrying rise of the motherhood police

by Joanna Wane / 19 May, 2017
 

From listeria hysteria to “breastfeeding ayatollahs”, modern motherhood has become one long guilt trip through an ideological minefield. Joanna Wane looks at the middle-class backlash – and the increasing pressures on pregnant women as science researches life in the womb.

When it was time to start thinking about a birth plan, corporate lawyer Louise O told her obstetrician she wanted the baby out with minimal pain and minimal damage.

In that case, he said, she might want to consider a caesarean.

She’s booked the operation for early December at National Women’s in Auckland where almost 35 per cent of babies are now born by c-section, the highest “zipper-club” rate in the country.

“I don’t think I’m too posh to push, but I don’t feel it’s something I have to go through to achieve motherhood,” says the 33-year-old, who based her decision on a statistical analysis of the risks for mother and baby of a vaginal birth versus an elective caesarean.

“It’s a day I want to get over as soon as possible. I have the rest of my life to learn to be a mother.”

When the job’s done, she’ll crack open the celebratory case of Rockburn Stolen Kiss rosé she has stashed in her office cupboard. Not that she’s gone cold turkey. In fact, she’d feel comfortable having a glass of wine most nights if it didn’t give her heartburn.

In her first trimester, she craved fries and cheeseburgers, and became so addicted to iced animal biscuits she had a box-a-day habit. Shellfish, pâté and Mr Whippy ice cream are off the menu because of the risk of listeria (which in rare cases can cause miscarriage), but not other “banned” foods on the official advisory list, such as salmon sushi and hummus, that can cause food poisoning if they’re not fresh.

And despite disapproving looks, she still drinks a coffee or two each day (high doses of caffeine have been associated with congenital abnorm­alities).

Louise hasn’t bothered with antenatal classes either; breastfeeding is something she figures you need to learn on the job and she doesn’t buy into the way formula feeding has been demonised. Instead, she’s project-managed her own pregnancy and has already picked out a sleep-training programme – sceptical of claims that leaving a baby to cry can cause brain damage.

“If you leave a baby in a Romanian orphanage to cry for days and never be picked up or cuddled, of course you’ll end up with problems. For a child in a middle-class home who’s fed and loved and looked after and left for 10 minutes at a time, it’s just ridiculous,” she says.

“Driving in a car is more risky than a c-section or letting a baby cry, but no one is going to stop doing that. Well, I’m not. I can hardly walk to the letterbox!”

Despite flipping her middle finger at what she calls “the Mumfia”, Louise says she isn’t so deluded to think you can impose a rigid routine on a young baby, or become an expert after reading a few books. (For the record, her favourite is Expecting Better, by Emily Oster, an associate professor of economics at Chicago University’s Booth School of Business, subtitled “Why the conventional pregnancy wisdom is wrong and what you really need to know.”)

Still, she believes the earlier you set firm boundaries against other people judging your parenting, the better. “I’ve probably ticked every ‘bad mother’ box. But when I looked at the studies that the official advice is based on, a lot of the conclusions just weren’t convincing, and a lot of the recommendations seemed to be ideologically driven,” she says.

“I don’t think mothers sacrificing years of their lives to sleeplessness, or persevering with breastfeeding if it’s painful or they’re back at work and struggling to express, is ultimately beneficial for them or their children.”

We’ve withheld Louise’s full name for her own protection. With views like that, she might get lynched. If she lived in the United States, she might even get arrested.

Several US states have brought in laws to criminalise behaviour by a pregnant woman that’s considered a threat to her unborn baby. Most are aimed at controlling alcohol and drug use. However, some court orders have imposed mandatory diet restrictions – one day, reckless eating habits that predispose a child to diabetes may be considered as negligent as having a child with fetal alcohol syndrome. In Idaho, a bill was narrowly defeated that would have opened the way for women to be prosecuted for miscarrying after vigorous exercise (not likely to be a problem for Louise).

French philosopher Elisabeth Badinter calls modern motherhood a “tyrannical state”, with women pressured to run their pregnancies like dietary boot camps, made to feel guilty unless they give birth naturally, and terrorised by “breastfeeding ayatollahs”, for whom baby bottles are a synonym of selfishness. “Being pregnant was a lot like being a child again,” writes Emily Oster in Expecting Better. “There was always someone telling you what to do.”

Oster (who doesn’t favour elective caesareans) describes pregnancy as a world of arbitrary rules – that aren’t always supported by the facts. In the US, some bars have signs warning pregnant women won’t be served. However, while there’s no question heavy drinking can cause serious damage, Oster’s analysis finds no “credible evidence” to show a glass of wine or so a day has any impact on a baby’s cognitive development. 

In New Zealand, pregnant women are increasingly coming under scrutiny, too – from society, if not by the law, says Professor Robyn Longhurst, an expert in pregnancy and mothering at Waikato University’s faculty of arts and social sciences. “It used to be thought the baby in utero was impervious and safely enclosed in this safe space. Now there’s much more of a window on the womb mothers are subject to and expectations on the appropriate way to behave, even before they’re pregnant.”

Guilt and feeling constantly judged are themes that have emerged repeatedly in Longhurst’s own research with pregnant women and new mothers – whether it’s what they should eat, whether they’re too young or too old to have children, whether they work too much or don’t work enough, how they should exercise and how quickly they should be back to their normal weight. (A study at Victoria University found some first-time mums were so insecure that seeing photos of glamorous celebrity “baby bumps” made it more difficult for them to bond with their newborns.)

“In the past 10 or so years, we’ve seen this very strong idea that mothers need to operate within a really narrow frame and if you happen to step out of that, then you’re no longer a good mother,” Longhurst says. “Now with social media like Facebook there’s a whole new set of guilt around living up to other people’s expectations, because everything is so publicly on view.”

The backlash against our deification of the perfect mum permeates websites like the Bad Mothers Club and online forum Bad Mothers Anonymous, where women post “confessions” about seditious thoughts and behaviour you’d never admit to your coffee group. “Bad mom” parodies with images of pregnant women sucking on fags are not only deliberately provocative, says Longhurst, they’re also making a serious point.

“It’s just relentless what mothers have to endure, trying to manage all the competing advice they get – often uninvited advice from complete strangers, which can be not only profoundly irritating but in fact quite harmful. I’ve seen women in a very bad place because they feel like they haven’t measured up.”

Guilty Mum Syndrome, parenting columnists call it. Google “mother guilt” and more than 57 million hits flash up. Guilt over having an epidural. Guilt over using disposable nappies. Guilt over wanting to go back to work. Guilt about daycare. And each week you can add another worry bead to the rosary.

Got a child who struggles with maths? Low levels of thyroid hormone during pregnancy could be to blame. But don’t fret. Stress can affect your fetus, too, and babies born to anxious mums may also be more susceptible to asthma. If that’s enough to give you a headache, think twice before reaching for the paracetamol (one of the few drugs considered safe to take during pregnancy). Research at Auckland University, released in September, linked its use to a higher risk of children developing ADHD. 
It’s even dangerous to go for a drive to clear your head; a new report from Spain suggests exposure to chronic traffic pollution makes it more likely you’ll give birth to a child with weak lungs.

Professor Mark Henaghan.

Pregnant women have always had a target on their back, reckons Professor Mark Henaghan, the dean of Otago University’s faculty of law.

“Society tends to be judgmental about people in a minority,” he says. “Pregnant women are very easy to pick on and they’re vulnerable. But when you talk to scientists, our understanding of what’s good and what’s not changes over time.”

In the 1800s, dwarfishness or deformity was blamed on the “folly, misconduct or neglect” of mothers, gin was used as a cure for flatulence, and going outside when you were pregnant during an eclipse was believed to give your baby a cleft palate.

Henaghan has watched with concern the creep of “fetal rights” legislation in the United States and also in the UK, where a local council is seeking compensation for a six-year-old girl left brain damaged by exposure to alcohol in the womb – sparking a test case now being brought to the Court of Appeal.

The general position in Commonwealth countries is the law shouldn’t interfere with decisions pre-birth that are personal to the mother, says Henaghan. Exceptions here include a case known as Baby P, where a protection order was made over an unborn child to protect it from the mother’s violent boyfriend, and a 2002 ban on the filming for a porn movie of a woman giving birth at Waikato Hospital. Hamilton coroner Gordon Matenga also put the issue up for debate when he recommended the rights of unborn children be reviewed, after conducting an inquest into the death of a baby following a home birth where the mother had refused strong medical advice to have a caesarean.

Sanctions on pregnant women – such as restrictions on smoking or drinking – would not only be illegal under our anti-discrimination laws, according to Henaghan, but impossible to enforce. “Once you start moving down that track, it does become invasive very quickly. It’s punitive and I don’t think it works.”

Criminalisation is also opposed by groups like Alcohol Healthwatch, which supports community-led initiatives and compulsory health warnings (a voluntary labelling code being trialled by the liquor industry has been extended to July 2016). Health promotion adviser Christine Rogan says Fetal Alcohol Spectrum Disorders are considered the leading preventable cause of mental retardation in the developed world, affecting an estimated one per cent of newborns. In her view, the evidence is unequivocal that there’s no safe amount to drink during pregnancy – but women need to be supported, not stigmatised.

“It’s a terrible conundrum to think we might be pitting the rights of an unborn child against the rights of a mother to have autonomy over her being. It’s a dreadful slippery slope we need to avoid at all costs,” she says.

“But being a parent does mean you have to make sacrifices. In the old days, that might have started at birth. Now we know it starts at conception and probably even before then. These are biological facts. It’s about trying to find a way of managing them well.”

These days it’s not enough to feel guilty about ruining your children’s lives; you may have already messed up your grandchildren, too. New Zealand scientists are right at the forefront of research into the fledgling field of epigenetics, which shows those crucial months between conception and birth send ripples through multiple generations. A mother’s diet during pregnancy, for example, can trigger genetic changes that increase the risk of obesity, diabetes and cardiovascular disease not only for her children but for their children, as well.

Associate Professor Peter Dearden, an evolutionary geneticist and the scientific director of Genetics Otago, says “measurable and statistically significant” changes in the population can be seen across three generations (up to 12 generations in fruit flies). So far, however, the individual impact is subtle, and increased health risks are probably “vanishingly small”.

Associate Professor Peter Dearden.

And it’s not just mothers under the microscope. As North & South reported in a 2012 story, “The Father Effect”, epigenetic influences also pass down the paternal line. The latest research points to the period before conception being critical, too. 

In August, an article in the scientific journal Nature warned about the “long shadow of the uterine environment” being used to scapegoat mothers, and increase the “surveillance and regulation of pregnant women”. Dearden, too, cautions against knee-jerk reactions based on limited early data. He says breastfeeding is already used as a “big stick to beat women with”, despite a lack of evidence to show it’s “enormously better”.

As the science on epigenetics draws clearer links between cause and effect, he believes the challenge for society will be deciding the threshold of “acceptable risk” before some kind of intervention is justified. In the meantime, fashion and social mores will have the greatest influence on behaviour – in the same way it’s become almost scandalous for pregnant women to smoke.

“The risk of a high-cholesterol diet is well-known and quantifiable, yet we haven’t seen legislation on individuals or manufacturers over that,” he says. “The message needs to be pregnancy is an important time; medical advice and health warnings should be taken seriously, and anything you and society can do to help is important. But it shouldn’t be used to victimise women.”

Emma Purdue, the “sleep nanny”, with her daughter, Caitlyn.

People have always had strong (and often uninformed) opinions about pregnancy and mothering; the difference these days is so many feel compelled to share them.

“Everyone has an opinion, from the size of your cleavage to your beliefs around childbirth and breastfeeding,” says an Auckland marketing executive who’s pregnant with her first child. “It’s like, ‘When did I suddenly become open to your judgment?’ You feel like a bit of a freak.”

Often it’s women who are the worst perpetrators; on parenting forums, mums snipe at each other in just about every thread. On one site, a Wellington woman posted about being set upon by the “sushi police” in her lunchroom at work, with a pregnant colleague calling her irresponsible for risking the life of her baby. “Listeria hysteria” has become so extreme one childbirth educator says some women won’t even make themselves a fresh salad at home and live off peanut butter sandwiches. “Sometimes no commonsense is applied.”

New mums told North & South they’d been lectured by strangers for letting their baby use a dummy and had lied to their Plunket nurse about tummy time (Plunket guidelines say it’s important for muscle development, but a new school of thought contends that you shouldn’t put babies in a position they can’t get into themselves).

Some had tried cloth nappies because disposables clutter up the landfill – a million of them a day in New Zealand, according to environmental advocacy group Zero Waste – then felt guilty for giving up after the first week.

One woman, a trained midwife, had the odd glass of shandy when she was pregnant (for the “hoppy vitamin B”) and found a pamphlet on fetal alcohol syndrome left on her desk. Another was told leaving a baby to cry undoes everything they’ve learnt during the day. One even felt bad for not checking the house she and her husband had bought was in a good school zone.

“A lot of my guilt comes from not doing anything,” says Kelly, who gave up reading baby books after having her twins because the conflicting advice left her paralysed by indecision.

A mother of three who had an emergency caesarean after a 36-hour labour was told by someone in her book club she must be too posh to push. After a struggle to breastfeed, she was devastated when her baby lost interest at three months. “In the antenatal classes, they didn’t even talk about bottle feeding, because that’s not the natural way. So when it doesn’t work out, you’re left wondering what’s wrong with you.”

The “natural way” went so wrong for one new mother she needed surgery to remove an infected abscess from her nipple. Another first-time mum had so little milk she used a pump to express every three hours day and night, producing as little as 2.5ml at a time. “I remember spilling it once at 2am and just sobbing. Every drop was like gold.”

Eventually, she bought a special contraption with tubes and a bottle that hung around her neck, so she could feed with bottle and breast at the same time. A GP friend in the UK told her studies showed little difference between babies fed on formula or breast milk, but she persisted for six months. “It was worth it for me, emotionally, but I’m not sure if it was worth it for him,” she says. “Formula is demonised and it shouldn’t be. I did feel a failure, but it’s hard to know how much of that was put on me by myself and how much by society.”

In Wellington, a 40-year-old woman who had her first baby in March says the hospital was so short-staffed the midwives had no time to help her with breastfeeding. She got in touch with a lactation consultant and initially kept nursing after she returned to work at her real-estate agency, when her daughter was four months old. “I’d be sitting on the toilet, returning emails and expressing,” she says. “It was really glam. Six weeks ago I decided that, actually, I needed to stop now.”

She’s the only one in her antenatal group already back at work and admits she feels judged for that, too. “I get lots of questions about how I feel leaving her with someone who’s not a family member. It makes me feel bad. But I love what I do and it’s different when you’ve got your own company.”

Emma Purdue – the “sleep nanny” – was infiltrated by the motherhood police when she went into business two years ago. Her Facebook page is regularly hit by trolls who post comments warning mothers away and links to articles that claim letting children cry is “normalised abuse” and can cause lasting psychological damage.

A former high-school science teacher whose husband is in the Air Force, Purdue began researching the scientific literature on how to help babies sleep after the first of her three children was born – and quickly became the go-to girl for all the other mums at Whenu­a­pai airbase. She now has a team of 10 sleep consultants around New Zealand, plus one in Switzerland, and she’s launching into Melbourne, Perth and Sydney in January.

Her sleep programmes range from a graduated controlled-crying plan to working alongside parents who can’t bear their baby to cry at all (that takes patience, perseverance and up to three weeks). While levels of the stress hormone cortisol do rise when a baby is distressed, Purdue says that has to be balanced against the pressures on a depressed, anxious, sleep-deprived mum. In extreme cases, she’s referred women to mental health support services. “Eighty per cent of clients cry from the sheer relief someone is finally listening to them and doing something about it.”

Fiona Kelsen, a retail manager in Napier, reckons she was on the verge of developing post-natal depression when she got in touch with Purdue. Her baby, Hannah, was feeding for 12 hours a day, and taking two and a half hours to settle at night – leaving little time or energy for her older daughter.

Kelsen, who says she had an “absolute fear” of letting Hannah cry or feel abandoned, began by weaning off feeding her to sleep. By the second week, she was putting her down awake; by the third week she was able to quietly leave the room as her baby settled. “It was absolutely like magic.” Purdue is now helping Hannah adjust to a bottle so her mum can go back to work.

Christchurch lifestyle coach Karyn Riley, who specialises in time management and life balance, finds one of the most common questions she’s asked by women with young children is when they should return to work. “That word ‘should’ is a guilt-ridden word if there ever was one. You just have to listen to your own values and intuition,” she says. “I don’t understand other people’s need to comment and judge.”

Compared to a decade ago, she’s found women are going back sooner and for longer hours, often due to financial pressure. The jury is still out on the much-debated pros and cons of putting under-twos into daycare. But Riley says the eight-year-old daughter of one of her clients declared she didn’t want to have children because it looked so stressful and her mother never seemed happy.

Anna McDougall.

Anna McDougall, who’s pregnant with her third child, says there’s an obvious divide at the school gate between the mothers who work and those who don’t. “It’s quite weird; you don’t get invited for coffee because they go straight after drop-off and you have to run to work.”

She lives in Wellington and finds views are mixed towards working mums, particularly from older women – although her own mother was a sole parent who enjoyed her job, as well as relying on the money. “Some people think it’s sad the kids don’t have me at home; others think it’s a great example for my boys.”

Working women have been described as suffering a “double guilt burden”, feeling like they’re bad mothers because they work and bad employees because they have a family. McDougall, who’s a chemical and process engineer, does project management on contract and loves the stimulation of her job. “But I’d like to have more time at home than work and that’s not happening.”

Both her sons started daycare when they turned one, although her oldest is now at school. She likes the social interaction there, but admits she’s felt uncomfortable to see babies only a few months old being dropped off for the day.

“The worst thing is doing the 5.30pm pick-up after work when everyone’s tired and all you want is to have dinner and get them to bed,” says McDougall, who’ll take a break with her new baby then work school hours when her second boy turns five. “It feels awful because you’re not savouring it. But if you step out [of the workforce] for a few years, it can be hard to get your foot back in the door.”

Amid all the middle-class angst over bringing up baby, childbirth educator Jennie Valgre reckons the real question women should ask is why they expected parenting to be so easy. She says many have completely unrealistic expectations and the issues they struggle with around sleeping and feeding are normal newborn behaviours.

“Someone who’s getting up a couple of times in the night a few months down the track and resenting that is sleep disturbed. A woman who’s waking to feed her baby every hour – that’s sleep deprivation,” she says. “Whatever you do, some babies won’t listen to the Gina Ford book, or the Tracy Hogg book or any of these other baby whisperers who don’t spend any time parenting their own children. Those books don’t know that baby.”

Valgre’s baby-first philosophy is right at the other end of the spectrum to the mother-led approach embraced, at the start of this article, by Louise. She says women who feel judged for using formula or having a caesarean should spare a thought for mothers who practise attachment parenting and choose to co-sleep or breastfeed until their children are three or four. “Crikey, they’re heavily judged too.”

Perhaps, she suggests, middle-class mums simply don’t want to give up their pre-baby lifestyle. In 10 years of teaching antenatal classes, she’s seen women spend thousands of dollars on their wedding or a pram, but not put the same time and effort into researching pregnancy and birth.

“I’d love women to know more about epidurals and the long-term health implications of some interventions in labour and birth, so when they do make decisions, they’re truly informed ones,” she says. “Would they still rush for that c-section when it’s not clinically indicated, or would they ask if the risks are enough to outweigh the benefits?”

With such a divide over the “right” way to be a mother, sleep consultant Emma Purdue says it’s no wonder some women are left feeling that whatever they do is wrong.

“Parenting has become so controversial,” she says. “You’re trying to make the right decision and follow your instincts, but everyone else has an opinion and you end up not even knowing what your instincts are anymore. It’s women judging women, and it’s horrible.”        

 

 

This was published in the December 2012 issue of North & South.


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