Spotlight: Interview with Sarah Menkedick

Author of Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America

For Maternal Mental Health Awareness week, we connected with one of our favorite writers, Sarah Menkedick, whose new book, published last month, includes interviews with hundreds of women about the silent epidemic of anxiety and fear impacting new mothers.

What inspired you to write Ordinary Insanity?

I was inspired to write the book by my own struggle with anxiety. Mine began in pregnancy and intensified postpartum, and it took me years – years! – to recognize it as anxiety and not simply “good mothering.” When I finally sought help, and began talking about my experience with other women, I realized this kind of anxiety was everywhere: ubiquitous, devastating, and taboo. I wanted to understand where it had come from, why it is so pervasive, and why it is so undiagnosed. 

Why do you think we don’t talk about anxiety as it relates to motherhood more openly?

There are so many reasons for this! The whole book is in some ways an answer to this question. The first is that unlike depression, anxiety is not necessarily easily recognizable as anathema to good mothering. That is, when we see a woman crying all day, uninterested in her baby, in the fetal position in bed, it’s easy to say, “Wow, that’s problematic.” But it’s a lot harder to flag anxiety as such: I talked to women who visited their provider’s office twice a week to listen to their baby’s heartbeat because they were so scared, and no one ever said to them, “You know what, this isn’t normal.” In many ways, we sanction anxiety: it is a mark of good mothering, of adhering to the (often extreme) medical, social, and cultural norms. It is a way of showing that you are following the policy of Zero Risk during pregnancy and postpartum that is actually impossible and pathological, but that women will almost destroy themselves trying to achieve. Anxiety becomes a way of separating “good” from “defiant” or “bad” moms, and as such it is a way moms ultimately police themselves. It is also taboo to talk about the dark side of motherhood: about the intense fear, the grief, the loss, the hate and the sadness, and so those experiences and feelings manifest in anxiety, in an obsession with constant control.

You spoke to hundreds of women and heard their stories. What were some of the things you learned that you wish every mother knew on their journey?

I wish women could empower one another to speak up for themselves: to say, “No, you know what, I’m going to take the risk, because I want to live my life.” By “the risk,” I’m referring here to what are often really trivial things: changing a light bulb, having a turkey sandwich, drinking a glass of wine. But also even larger things: taking a trip abroad, like one woman I talked to. She’d had a really devastating loss in her first pregnancy, and she had planned a volunteer trip to the Philippines when she found out she was pregnant again. Everyone in her family, her doctor, everyone told her not to go. She went. She is a black woman and had felt so disempowered in her first pregnancy. And in the Philippines she discovered her own resilience; she discovered connections between women. She discovered the illusion that this system we have in the U.S. will protect us from grief, loss, sadness with all of its costly tests and interventions, an illusion particularly painful for women of color. We have such an extreme approach to risk in pregnancy that so many women end up boxing themselves in further and further until they’re unwilling to do almost anything at all. 

I also wish more white women could recognize that our long history of trying to appease and appeal to white men has largely failed all women, and instead we need to work with all women, particularly the most disadvantaged women, to rebuild maternal care from the ground up. 

What are some of the maternal expectations that you found cause the most anxiety and what can we do to help mamas?

I think the expectation that motherhood is always a happy event, and that there is a “normal” motherhood experience and then a “pathological” one or one that involves “disorder” is actually really unhelpful and damaging. What I have found in my research and in my conversations with so many women through the course of reporting the book is that many, many women experience loss, grief, anxiety, and regret in the process of becoming mothers, and that there is no such thing as a “normal” happy transition in which some sort of switch gets flipped and voila, a woman is a mom! Some women might ease really gracefully/smoothly into motherhood. But many, many others will struggle, and for some that struggle might escalate into a clinical disorder, and for many that struggle might be something they just silently grapple with for years. IT DOESN’T HAVE TO BE LIKE THIS. Becoming a mother is a moment of intense vulnerability: neurobiologically, medically, socially, personally. This doesn’t mean mothers aren’t super strong and super fierce. But it means they need and should demand and be given support. It means attention to mental health is paramount at this time. It means all women should be counseled that if they have any pre-existing condition – a history of anxiety or depression, previous sexual trauma (and this is the majority of American women!) – this time might be really difficult for them. It means the expectation that mothers be their children’s sole caregivers and their children’s therapists and totally financially and personally and psychologically absorbed in their children without any needs of their own, and that this is all a “natural” phenomenon is frankly, well, insanity.

We celebrated Maternal Mental Health Week earlier this month as a part of Mental Health Awareness Month. What are some of the resources that you suggest mothers tap into for support?

Of course, Poppy Seed Health is wonderful for mothers! Maternal Mental Health Now, an organization I’ve collaborated with, has great resources for mothers (particularly in California) and does a lot of advocacy. The Motherhood Center in NYC is also a good resource, and Every Mother Counts has a lot of more general information about maternal mental health. There are lots of wonderful local organizations/midwives, so as dumb as it sounds, I’d Google around where you live! Mater Mea and Health In Her Hue are great resources for women of color.