We need to dismantle the idea of perfect motherhood

The gut-wrenching case of Lauren Dickason, the Timaru doctor who murdered her three young children, raises raises questions about our approach to maternal mental illness, writes Dr Eileen Joy.

According to a 2022 report on maternal mental health, 11,000 New Zealand women are estimated to suffer from postnatal depression and/or anxiety every year – an average of 75% of them not meeting the threshold for assistance from providers for the Maternal Mental Health service.

Thanks to the Perinatal and Maternal Mortality Review Committee, we also know that suicide is the leading cause of maternal death in Aotearoa and that this disproportionately affects wāhine Māori, who are 2.91 times more likely to die by suicide.

Maternal mental illness is a nasty beast.

In my experience, it came fast and hard, although the warning signs had been evident for months prior. I gave birth to my first child in 2005. I had been living in the UK for over three years, and my partner and I returned to Aotearoa when I was four and a half months pregnant. I was isolated in a tiny, cold flat in Mt Eden without a strong support network around me.

I spent the subsequent months ‘nesting’ in preparation for a birth that would change my life forever. Like many other new parents, my husband and I attended antenatal classes and gained new friends there. We learnt about how to birth a baby but almost nothing about how to be a parent, about the colossal shift that was about to happen in our lives. It should come as no surprise that I was referred to Maternal Mental Health not long after our son’s birth.

In that sense, I was lucky. I got respite care; I had a nurse come in and look after my son while I could take a few short hours as a break, to sleep and to recover. I got therapy. I was suffocating underneath the sheer weight and expectation of motherhood. I did not know who (or where) I was any more.

What I did know from my Plunket nurse was that my depression would harm my child. She urged me to read Sue Gerhardt’s book Why Love Matters which warns of the “danger” of not loving babies “enough”. She cautions that depressed mothers can condition children to “get used to a lack of positive feelings” that “a negative look can also trigger a biochemical response and that “anything that threatens [baby’s] regulation is very stressful because it puts survival at risk.”

A mum holding her baby. — A mother’s mental health matters because *she* matters. (Photo: File)

This focus on depressed mothers as mothers and the impact it has on their child is not unusual. Indeed, in my doctoral research, I found this idea prevalent in policy and practitioner accounts in child protection work; a mother’s mental health matters insofar as it affects her child, not apparently because she matters.

Statistics and evidence about the adverse impacts on infant wellbeing are regularly listed; that these children of depressed mothers will have emotional, cognitive and behavioural issues, that they’re more likely to grow up to have mental health issues themselves, be criminals, be on welfare, and go on to abuse their children.

And, lest we think this problematic framing only occurs in the context of child welfare, these same child-centric reasons were given primacy in that report I referenced earlier, in answer to the question “why maternal health matters”.

Mothers matter because they are people. No mother ever wants to cause lifelong trauma to their child, and telling any mother that she is damaging her child adds to the stress that she will never be good enough and that she is a bad mother. And, crucially, her only worth now is through being a mother.

We need politicians and policymakers to care about the mental wellbeing of birthing parents not just because of the impact on the child and whether that child will cost the state more money. We need to be cared about because we matter.

Many of us do not feel an instant bond with our babies. Many of us, like Lauren Dickason, have moments when we resent having our children, when we say things to our friends that we know are hyperbole, to vent and because we need to get them out somewhere safe.

Safety nets are essential. We are not meant to parent alone; we need space to be ourselves and learn how to be parents. We need healthy housing, liveable incomes, and a strong mental health system and we need to dismantle the idea of perfect motherhood.

That there’s such a thing as “perfect motherhood” is what keeps us disconnected and quiet.

For wāhine Māori, this fear is compounded with the knowledge that our child protection system disproportionately affects whānau Māori, that it is a colonising system that will judge them against Pākehā models of mothering and parenting, and potentially remove their children. It is the terror of wondering how our words, thoughts, and feelings could be used against us and who is safe to talk to.

No mother wants to be in the position Lauren Dickason is and was in. We can grieve those poor children and hold space for Lauren as a human being, for mothers as human beings.

We need come to a point where we can accept what happened was truly awful and admit that many of us have had similar thoughts. We need to start having courageous conversations with equally courageous listeners about how we can support mothers to find themselves as themselves without adding on the layers of idealised and unrealistic motherhood.