Commentary: New mums need courage to fend off unrealistic expectations from family and work
The period just after a baby is born can be the most challenging in a woman’s life. Add family expectations and work to this mix and things can spiral, says NUS’ Dr Shefaly Shorey.
SINGAPORE: Elizabeth Quek is one of the rare women who has given four weeks of her maternity leave to her husband. In Singapore, partners can claim up to four weeks in what is known as shared parental leave.
Despite having a supportive husband who was willing to shoulder quite a bit of the demands of caring for a baby, when it was time for both parents to get back to work, the couple began having arguments.
“I had to become the default caregiver. But I would say, 'why aren't you taking care of her? I need to work.' And he would be like, 'I have so much work to do too'. So that’s where we ended up getting into arguments,’’ said Elizabeth on CNA’s Heart of the Matter podcast.
Elizabeth began feeling upset, overwhelmed and found it hard to cope. Like her, Sara (not her real name), one of my research participants, found the period after her childbirth to be a rough ride.
She felt overwhelmed with breastfeeding and was constantly reminded by her family members that she should breastfeed for at least six months after her daughter’s birth.
She started feeling anxious and developed a nagging fear of going back to work. She was especially concerned about how she would cope with breastfeeding while working.
She would cry every night from the lack of rest and giving in to the demands of her newborn. She started blaming herself for not being a good mum and started to have feelings of guilt about not enjoying motherhood.
(She felt a sense of "despair" each time she had to breastfeed. But there’s one thing that made all the difference in this difficult journey, this new mother says on this week's Heart of the Matter podcast.)
Both Sara’s and Elizabeth’s stories are common – in fact, they epitomise the experience of hundreds of women I have met in my research work.
The transition to motherhood is a stressful period for new mothers – with women being extremely vulnerable to biological, emotional, and familial changes.
Especially for working women, motherhood may pose additional stressors of juggling with parenting roles and employee roles.
Though the research around employment status and postpartum depression is inconclusive, in my own research study of 138 women, 43 per cent were working mothers and majority of them felt overwhelmed with newborn care tasks and work-related demands.
Nationally, postpartum depression affects one in 10 mothers, and it can be hard to diagnose as women do not seek timely help. Many women often have no idea they have early signs of depression, nor do anyone in their family and close social circle.
This is something Elizabeth mentioned in the podcast. “My friends didn't really talk about their experience and how difficult it was to be a mother until, I started opening up about my journey. Then they responded. So my hypothesis is that mothers normalise the stress they go through – that mothers have to be sacrificial and you just endure it.’’
Even among women who recognise they are feeling emotionally down, getting timely help and treatment is rare. Those affected often feel reluctant to seek help due to the social stigma around mental health, especially during what is supposed to be one of the most joyous times of their lives – motherhood.
In my experience speaking to these women who don’t get help tend to dismiss their symptoms as “normal feelings” and keep to themselves. But the problem, if untreated, can become so deep that it can lead to devastating consequences.
One such worst-case scenario played out last year, when a 35-year-old mother jumped to her death from her flat on the 10th storey, with her five-week-old daughter in her arms.
SCREENING IS USEFUL BUT MISSED OPPORTUNITIES REMAIN
In Singapore, pre and post-natal check-ups are an essential part of the system. If doctors detect signs of depression they can request for more support for these mothers.
That’s a good step but depending on screening alone is not enough. There are mothers who default on their hospital visits. And even among those who don’t, many brush away concerns.
Sara was one such mum. Despite feeling overwhelmed, she did not seek help as she was concerned about being judged to have fallen short as a mother.
READ: Commentary: When parenthood comes knocking, life's never the same again no matter what route got you there
As part of my research, I’ve discovered that it is important to bring mental health awareness and interventions to new moms who need them, instead of expecting them to seek it on their own. As a mother myself, I can understand that the focus is seldom on self-care as the entire world revolves around the new baby.
One experiment we are working on is a large-scale peer-support programme in which trained peer volunteer mothers, who have experienced and recovered from postpartum depression, are matched to at-risk mothers to talk over the mobile phone as and when needed.
We matched Sara to one, who happened to have similar breastfeeding experiences, and shared she only breastfed her baby for two weeks. When Sara learnt that the baby grew up to become a healthy teenager, she mustered the courage to tell her husband she wanted to stop breastfeeding.
He was supportive and communicated their decision to their extended family members. Sara managed to feel better as she had more time for herself, and her husband started to help with the feeding after work. In Sara’s own words, “Life became normal.”
My study showed that those who received peer support over the phone in the first three months after giving birth, had a 20 per cent reduced risk of developing postpartum depression.
A non-judgmental listening ear and a friend to talk to provide emotional comfort, reassurance and reduced negative feelings and loneliness at a vulnerable time for new mothers fearing being viewed as incapable.
FATHERS PLAY A CRITICAL ROLE
This type of support can complement other sources of aid. Fathers play a crucial role in the well-being of the new mothers. They can take care of other household responsibilities like preparing meals and bathing the baby.
Fathers should keep in mind that merely listening to their wives’ needs without trying to solve all their problems can be beneficial. Small, encouraging words to acknowledge their wives’ efforts go a long way.
They also play a vital role in ensuring that family members do not write off the mother’s symptoms, or confuse her with outdated advice.
Interestingly, research has shown that partners of depressed new mothers are at higher risk of developing postpartum depression themselves.
A local study on 200 fathers conducted between 2016 and 2018 found that the early postpartum period is a stressful time for dads. The study revealed that at the six-month mark, at least one father was reported to be at risk of depression.
One way to avoid falling into this trap would be to engage in “couple time” so that fathers and mothers can support each other, especially when mothers go back to work.
EASING BACK TO WORK
One of the toughest transitions for mothers is getting back to work – while their babies are still very needy. This can exacerbate feelings of inadequacy. Many in my research group feel they have to live up to expectations of being a good mother and a committed employee.
But these can be unrealistic – because every family is different and workplaces can vary greatly in their demands. New mothers need to learn how to enjoy their motherhood at their own pace and be clear about what they can and cannot do.
I tell new mothers that it is fine to ask for lighter responsibilities for the first few months at work to re-accustom yourself to your role after spending time away. Ask that you leave on time and for flexible work arrangements.
To ease in, you can also consider taking half days instead of the full set of maternity leave.
Sara has found her footing and is a much happier working mother now. For her, speaking to someone who walked the same path before made a big difference and this should be an important lifeline for all mothers because they shouldn’t have to travel this road alone.
Dr Shefaly Shorey is an Assistant Professor at the National University of Singapore’s Alice Lee Centre for Nursing Studies. She has done extensive work in the areas of family and women’s health, with a special interest in perinatal health.