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Black and white photo of mother and baby
Getty Images / Tina Tiller

OPINIONSocietyMay 3, 2022

Mothers are being sidelined in the conversation about maternal mental illness

Black and white photo of mother and baby
Getty Images / Tina Tiller

Over and over, potential effects on children is foregrounded while the actual welfare of the person who’s sick is all but ignored.

This is an edited version of a post first published on the author’s newsletter, Emily Writes Weekly. It discusses suicide; please take care.

Over the weekend an excellent report on perinatal mental health was released by the Helen Clark Foundation. Āhurutia Te Rito | It Takes a Village takes up the challenge of a report released last year that revealed suicide was the leading cause of death during pregnancy and the postnatal period in Aotearoa. Wāhine Māori were three times more likely than non-Māori to die by suicide.

I’ve been writing about the maternal suicide rate for six years. For six years I’ve seen reports come and go and people say “not one more mum” and “this has to stop”. It never does. Nothing seems to change.

As Holly Walker, who authored the Āhurutia Te Rito report, says: “Our maternal suicide rate is seven times that of the UK, but there are no other statistically significant differences between the two countries in terms of maternal mortality. This suggests there is considerable scope for improved intervention.”

It can get better. So why doesn’t it?

I am convinced that the reason why it never changes for the better is because the things we know would actually help mothers and birthing people with perinatal depression and anxiety are put in the too-hard basket. The government, ministry managers and health professionals all set the narrative – one that keeps the focus on the individual, not the system.

Take for example the comments by a DHB psychiatrist on a current affairs show over the weekend.

After being introduced as being on the “frontline”, dealing with seriously ill mothers, the psychiatrist immediately de-centred the mother from the conversation, telling the interviewer she likes to call maternal mental health services “perinatal health services”. I support the use of the term perinatal over maternal because not all birthing people are women, but I find it interesting that in this case the term was used to shift the focus to babies and partners, mostly cis men.

“I think it’s really important to make the point that not all women who experience mental illness or have drug and alcohol problems are poor parents,” she said. From then on, the conversation became about how a baby is affected by their mother’s distress in pregnancy.

These quotes are taken from the article that ran on online about the interview, titled ‘Perinatal distress can affect children and non-birthing parents – psychiatrist’.

“The long-term impact of depression and anxiety in parents means there are a lot more behaviour problems when the children are toddlers and it can impact a child’s language and school readiness.”

“[Perinatal depression] can also cause depression when the child is a teenager, so it is important to notice the warning signs and intervene early.”

The topic remains taboo, the report said – ironically just after claiming depressed mothers are likely irreparably damaging their children. Gee, I wonder why mums don’t talk about their mental health? Where could the stigma come from? Why would people consider it taboo? It’s a complete mystery.

woman holding her baby while looking overwhelmed and depressed
Getty Images

I felt sick watching the interview. I felt sick reading the article. And I shared on Instagram why. Overnight I had hundreds of messages from mums. Some had healed, others were still fighting to be alive.

Almost all of them talked about the pain that health professionals cause when they de-centre mothers and blame them for the effects of their disease on their children.

When I was very sick in pregnancy, every article that said “your baby can feel your stress from the womb” or “having depression means your child will have attachment issues” made me feel like my child would be better off without me.

I hunted down the reports later, when I was in a better space, and was astounded to see how over-egged they’d been. But back then I believed it all. Hook, line and sinker.

I was the problem. I was the one making my baby sick.

The way this topic was covered on that current affairs show – how it’s almost always covered – does exactly that. It talks about mothers as if they’re not watching, not listening. It speaks over them. It shames them. It blames them.

I want to share some of the comments I was sent after sharing the interview. This is the message mums are getting:

“When I saw that interview I just thought, it’s too late. I’ve destroyed my baby already”.

“This is the message I got when I was struggling. That if I didn’t fix myself, my baby would be psychologically damaged forever. I couldn’t fix myself so the logical next view for me was that if I was dead, my baby would be better.”

“I’ve suffered with depression since I can remember. Sometimes my kids are the only things that keep me here and moving forward. If I’ve already irreparably fucked them up, what’s the point in trying?”

“I still remember being horrifically depressed as a young single pregnant woman, dealing with stalking and abuse from my ex-partner, and being told SO MANY TIMES…that I needed to ‘relax’ because my emotions would negatively affect my baby. Not only did it make me feel even worse, and already like I was a terrible mother before my baby was even born, but it really cemented the fact that now that I was pregnant I didn’t matter any more. I was just a vessel for a baby. I didn’t exist as a person any more and was completely worthless outside of my ability to grow a baby”.

These are the stories I hear every day.

For so long, those of us who work supporting mums have been saying the same things. Things that are all through this new report: We need social housing prioritised for our mums. We have to urgently prioritise wāhine Māori in suicide prevention efforts. We need engaged midwives who aren’t burning out because they’re treated so poorly – because they’re the ones who can spot antenatal depression or anxiety or PND as it’s starting. We need ACC to cover birth injuries and birth trauma.

One recommendation from the new report is this: “Provide fast access to affordable, culturally appropriate therapeutic support to parents with early signs of distress, and guarantee immediate access to best practice specialist help if they become unwell.”

Can you imagine if we had that?

Can we all also see now why the focus is on the individual and how much they’re hurting their whole family instead of on the system itself? If we keep moving the conversation to mums and how they’re damaging their babies and their partners, we don’t have to get to the real shit.

The report says what so many in the system don’t want to talk about:

“At the societal level, the stressors that drive perinatal distress are structural and systemic, and tend to be the same things that drive wider forms of disadvantage. These include: poverty, racism, gender disadvantage, food insecurity, gender-based violence, poor housing, limited education, and weak social networks”.

These aren’t soundbites.

They involve all of us working together. They involve an actual government response, they involve accountability from DHBs and the Ministry of Health.

It shouldn’t be a surprise that the way to help our most isolated and vulnerable mums is to come together and all carry the burden that they are so often forced to carry alone.

I was interviewed about this report and I was asked: What would you say to a mum who was suffering?

I would of course tell her she is loved and I would try to help her. But I said I wanted to turn that question around:

Everyone has messages for The Mum. I want to give a message to everyone else: the friend of The Mum, the colleague of The Mum, the neighbour, the brother, the cousin, the grandmother, the parent of The Mum… God, the health professional who keeps talking over her!

You need to show up and fight for her life.

The way you speak about her matters. The way you speak about other mothers around her matters. Telling any mum who is sick that she’s harming her baby by being sick will not help her. It’s cruel.

She is fighting. She is tired. She is doing her best.

Are you fighting for her?

Are you doing your best for her?

Are you going to fight for systemic change for all?

Today, will you walk with the mum who is struggling?

Today, as a health professional, will you consider how your words will impact mothers?

Today, will you look at the way you talk about mental illness and ask yourself: How does this feel to someone who is trying to stay alive?

Will you make this fight your fight too?

What will you do?

 

Where to get help

Need to talk? Free call or text 1737 any time for support from a trained counsellor.

Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)

Samaritans – 0800 726 666

Shine (domestic violence) – 0508 744 633

Women’s Refuge – 0800 733 843 (0800 REFUGE)

Le Va – suicide prevention and support for Pasifika communities

Yellow Brick Road – mental wellbeing advice and information hub

Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)

Depression and Anxiety Helpline – 0800 111 757 or free text 4202

Image: Tina Tiller
Image: Tina Tiller

SocietyMay 3, 2022

More and more people are giving up flying to save the environment

Image: Tina Tiller
Image: Tina Tiller

As borders reopen, a growing number of people are questioning if their pre-pandemic travel habits are still sustainable. Kerry Sunderland speaks to three New Zealanders who’ve committed to avoid flying whenever possible.

My Canberra-based uncle and aunt recently sent word that they are heading to New Zealand for a holiday later this year and are keen to visit me during their stay in Nelson. They are 92 and 88, respectively. It’s amazing they’re still travelling at their age.

My initial response was to hope that I’ve got some of their “intrepid elderly travel” genes, but then I remembered: if I keep flying as if there’s no tomorrow, the planet probably won’t be habitable by the time I’m their age.

Aviation is a relatively small industry, but pre-pandemic it accounted for four to nine per cent of the total climate change impact of human activity, according to the Vancouver-based David Suzuki Foundation. This resulted in a disproportionately large – but often invisible – impact on the climate system. 

These days, according to FlightAware, there are somewhere between 7,782 and 8,755 commercial planes in the air at any given time. While this is 10% to 20% fewer aircraft than pre-Covid days, the aviation industry is inching closer to “business as usual”.

When Air New Zealand welcomed more than 4,000 customers on April 13, the day border restrictions between Australia and New Zealand were removed, it declared it was “the day New Zealand has been waiting for”. But this wasn’t true for everyone. 

I’m not the only one who realised, pre-Covid, that cheap fares were literally costing us the earth. There are a growing number of New Zealanders who continue to question the inclination to jump on a plane just because we can.

Ange Palmer is co-producer of the 2013 documentary 2 Degrees, which examines the abysmal failure of the UN climate negotiation process in Copenhagen in 2009 and follows a courageous community campaign for a solar thermal power plant in South Australia. In essence, it’s a documentary that assures us that we all have a part to play in finding a solution to climate change. Attending the New Zealand premiere first got me thinking about my own carbon footprint and the impact my many overseas and domestic flights was having on the planet.

In one of the bonus features on the DVD, Palmer implores viewers to reconsider our need to travel by air and pledges not to fly whenever possible. 

Like Palmer, Dunedin-based writer Emma Neale also avoids flying whenever she can. Since moving back to New Zealand 20 years ago, after a stint living in the United Kingdom, Neale has only undertaken two overseas journeys, both to Australia. While she has occasionally flown domestically for work, she tries to avoid it whenever she can, often politely declining to travel or asking to participate online instead of in person. 

Dunedin-based writer Emma Neale (Photo: Caroline Davies via RNZ)

When invited to take part in the 2019 Nelson Arts Festival, Neale agreed to do so only if she could travel overland. She described the journey, which involved three separate bus rides and took roughly 13.5 hours each way, as a “mega marathon” spread over two days of travel – six hours from Dunedin to Christchurch, then about 7.5 hours to Nelson.

For someone with a fertile imagination, bus travel can have its benefits. “There were some fabulous aspects of travelling this way: so many sights and sounds en route – I collected lots of comic scenes and poetic imagery,” says Neale.

Only a quarter of the way into her outbound trip, she started to see things: a concrete truck was an elephant; fir trees were tribes of witches, then an elegant corps de ballet; the gorse and lupin were masses of scrambled eggs. “At one point, trying to hold on to what the bus driver was saying was like trying to follow the doctor’s voice while going under anaesthetic.”

Marlborough-based Bill McEwan has also made a commitment to avoid flying. Reading Bill McKibben’s The End of Nature 20 years ago first alerted him to “the grave crisis we are facing”. Then Palmer’s doco, along with her commitment not to fly at all domestically, inspired McEwan, then 70, to camp out in the band rotunda in central Blenheim with his then 33-year-old son. They both fasted for a week to call attention to their civil action. It wasn’t a protest, he says, but a “karanga”; a call for his local community to start having conversations about their impact on the environment. It gave birth to the Climate Karanga Marlborough movement.

Marlborough climate change campaigner Bill McEwan. (Photo: Chloe Ranford/LDR via RNZ)

McEwan was the first person to introduce me to the concept of “love miles”, a term first coined by British writer George Monbiot to describe the distance one must travel to visit friends and partners and relatives. 

He says he has embarked on only two journeys by air in the past seven years – one to meet his daughter’s partner in Queenstown and one across the Cook Strait to visit his dying aunt.

He used to hitchhike, but says at 77 he’s now getting too old for that. He still frequently takes the ferry and finds other ways to get around, but it involves a lot of inconvenience. Like Neale, McEwan bemoans the lack of intercity public transport in the South Island.

Like Palmer, Neale and McEwan, I also made a promise to myself many years ago not to fly unless it was “essential travel”. But after moving to New Zealand at the end of 2012, I found myself flying home to Australia about twice a year to visit family and friends and for work; I wasn’t very successful at keeping my promise. Flights kept getting cheaper, which made it easier, but the feeling of disquiet grew inside me – until the pandemic arrived.

When Covid-19 first grounded planes around the world, I welcomed the “Great Pause”. The earth seemed to let out a deep breath. I rejoiced.

The beginning of the first lockdown also signalled the end of my many trans-Tasman trips every year, and the occasional holiday in Asia and the Pacific. Since I’d already been feeling guilty about the impact my travel was having on the environment, I was relieved the choice had been taken away from me. 

So too was Neale: “I felt this weird relief. It took the moral decision out of my hands.”

Yet now that borders have re-opened, I feel conflicted all over again. Can I justify making a trip back to Australia this year if it qualifies as legitimate love miles?

Silhouette of person standing watching passenger jet take off into sunset
(Photo: TravelCouples via Getty)

Neale says she also allocates herself a small allowance of love miles, but suggests: “If you do go, go for longer.”

McEwan still believes there is still such a thing as “valid flying”, which includes diplomacy, essential business and love miles: “It’s important to keep kinship alive.”

I also recently caught up with Palmer, who now lives completely off the grid up the Baton Valley, where she hosts educational retreats and grows her own vegetables. Her only daughter and grandson live in Melbourne. I ask her what her take is now on travelling by air.

Palmer says she recently checked the impact of her domestic travel on a carbon calculator. “I have for many years chosen not to fly domestically, but if you compare the carbon emissions from driving on my own from the top of the South Island to Auckland, it’s about the same. If I share the car with somebody, it’s a different story.”

On her last trip to visit her father, Palmer carpooled with her sister as they drove north and then, to get home, caught the bus from Napier to Wellington, the ferry over the Cook Strait, and then drove home alone from Picton. “Normally I would hitch, in both islands, but it hasn’t been so easy in the time of Covid.”

Palmer still feels conflicted about flying, even when she’s clocking up love miles. “But am I prepared to never see my daughter and grandson again? That’s the love mile paradox.”

Air New Zealand recently announced a “roadmap” to reach net zero emissions by 2050, which includes phasing in the use of sustainable aviation fuel, introducing zero emissions aircraft (including hydrogen-powered planes), replacing its fleet and “improvements in operational efficiencies”.

The David Suzuki Foundation warns that if we don’t make radical changes, a quarter of all emissions could be from flying by 2050. 

McEwan isn’t convinced technology will be the solution. He believes Air New Zealand’s plan doesn’t get to the heart of the problem. 

“Biofuels and technology like they’re suggesting are primed to support the status quo, which will be fatal for the planet,” McEwan says. “Energy descent is what’s required. We all need to use less energy, very quickly. We need to tackle ‘affluenza’, reduce overconsumption, and change the status quo. I don’t want to appear to be a luddite, but I care about the consequences. We need to be doing only about a tenth of the flying we’re currently doing.”

For me, my saving grace might be that my husband has a fear of flying that could keep me (mostly) grounded anyway. But I’m not sure I have the stamina for our third roundtrip this year from Motueka to Invercargill for his mother’s 80th birthday in July. I might just have to fly.