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  • Writer's pictureDr. Marianne O'Byrne

Perinatal Difficulties - The Stigma Persists


A few years ago, I was scheduled to give a talk in a small community based play centre on breaking the silence about perinatal difficulties, that is talking about depression and anxiety during the transition to motherhood. Despite my excitement and enthusiasm, no one came. My Cognitive-Behavioural Therapy brain immediately come up with possible alternative explanations to my immediate thoughts of “It’s something about me” and “This topic is not interesting/important”... Maybe it's because “It’s one of the first sunny days outside and mommies prefer to be walking around then cooped up talking about emotions”, “It’s a new establishment and they yet to have the community to support these kind of events”, “No one could identify with the subject matter”, etc… Even though these arguments made sense, I couldn't help but wonder if the lack of attendance was because it is difficult to attend a session on perinatal difficulties and admit to struggling… perhaps, just maybe, this has to do with the persisting STIGMA.  


This talk also coincided with a conversation with my mom about a deeply saddening event near Montreal of the passing of a 12-day old boy and his mother to suicide.  My mom commented “It’s so sad to know that no one noticed any difficulties”. Given the circumstances under which new mothers live, I, regrettably, am not surprised that this has gone unnoticed. Here’s why:


Pregnancy is a time when feelings of elation intertwine with confusion and anxiety concerning the redefining of the women’s sense of themselves and their responsibilities. Pregnant women often develop a maternal identity and bond with their unborn child soon after conception, which continues to deepen as the pregnancy progresses. Often the first parenting task takes the form of learning the “rights” and “wrongs” of pregnancy, for instance, how to eat and care for their unborn baby in the “right” way. As they approach the birth, the ambiguity about the unknown components of labor and mothering can result in a mixture of emotions about their maternal identity.


Upon the arrival of the baby, the initial stages of parenting are often enjoyable, and a source of fulfilment and pride with the satisfaction arising from “caring for their children and having them around because they loved them so much” (Phoenix et al., 1991, p. 239). Adjusting to the process of becoming a parent and to the routine needs of infant care can vary substantially depending upon individual circumstances, resources, availability of emotional support, the quality of the partner relationship, the interaction with the routine of infant care, their self-esteem, and belief in their competence. Becoming a mother evolves over time as mutual adjustment, mastery of new skills and learning occurs for parents and as parental attachment to the infant is established.


Often the dilemma faced in the postpartum period is the recognition of the normative expectation of a mother as being “attuned to other’s needs” and exhibiting selflessness, which often places a strain on mother’s ability to care for themselves and be attuned to her own level of fatigue, emotional difficulties, and need for relaxation. Tension arises because of the dichotomy between real life and the “perfect mother” who devotes all of her time, energy, and resources to the upbringing of her children. Moreover, mothers can exhibit a tendency to question their parenting skills (e.g., ability to care for their child, to love their baby) and to compare their perceived abilities with those of other mothers or to the high standards associated with the cultural ideal of a “serene and calm mother and baby”. Without the social validation and approval for their maternal efforts, some mothers may experience a diminished sense of “moral worth” as they strive to be an “exceptional mother” with an “exceptional child”. The cultural ideal of a good mother can be exacerbated when women try to integrate the maternal ideals with how they perceive their own performance as a mom. As such, women may often feel pressure to excel at all roles and facets of their identity (e.g., being a mother, partner, employee, income earner).


Given these normative and personal expectations of a “good mother”, I understand why it would be difficult to come to a talk about perinatal difficulties admitting that you may be struggling or to display “weakness”. That is why I am so focused on helping mothers normalize their feelings, needs and struggles during this difficult transition period. Doing so within the culturally defined ideals of being a mother is not easy, and part of reducing the stigma is to talk about it. I will continue to talk about it in hopes that new and seasoned mothers can gain some self-awareness about what they are experiencing and be able to understand when they need to seek help. Seeking help is a display of strength!!! My hope is to also strengthen other’s ability to identify early risk factors during pregnancy and in new moms in order to reduce the likelihood of rare but fatal outcomes.


If you want to host an event to learn more about prenatal and postpartum depression and anxiety, please contact me. If you have any questions about how you are currently feeling, I am available to talk

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