Social context, depression and the transition to motherhood

Cultural assumptions about motherhood create an artificial dichotomy between the normal, happy, mother and the pathological experience of post-partum depression. However, the evidence suggests that it is more reasonable to see post-partum depression as one end of a continuum of normal adjustments to motherhood. While some postpartum psychiatric conditions do seem to be hormonally mediated, non-psychotic post-partum depression is not qualitatively different from other forms of depression, and is best explained by inadequate social support, high workloads, and unrealistic expectations about motherhood This paper reviews the evidence on post-partum depression and on the normal experiences of new mothers, showing that new motherhood is a major life-event which poses extensive adjustment problems for most women. Cultural expectations that family caring is naturally women's work, and that it is easy and stress free, mean that many mothers suffer a combination of work overload and guilt. A change in social expectations, greater involvement by fathers, and more flexible work practices to allow parents to care for their children would contribute greatly to the alleviation of distress in the post-partum and early motherhood years.