I used to think it was newborns that were vulnerable. I would see them in shops and cafes, strapped to their mothers, and feel a pang at their soft fontanelle, their little noses and toes. Before I had a child, it seemed to me that it was babies who were precious, and parents who were fierce. But in the last five years, my thinking has turned upside down.
When I see a mother and child now, my first thought is not for the baby. Babies, after all, swallow coins and buttons and are generally fine; they survive earthquakes, mudslides, floods. What I do, now, when I see a new mother and her child, is inspect the mother minutely, for signs that she may no longer be coping.
An estimated one in seven women experiences postnatal mental illness, but you wouldn't know this from the way we talk about early motherhood. Until I experienced it myself, I had no idea how common--and terrifying--the experience could be. One of the leading causes of maternal death is suicide, but the deadliness of become a parent is rarely acknowledged, hidden beneath jokes that are not really jokes about sleepless nights, exploding nappies, and exhausting cluster feeds.
Perhaps this is because it is so distressing it is hard to talk about. Perhaps, as with many things, it is because postnatal mental illness disproportionately affects women.
Separate from the 'baby blues', a period of feeling down as hormones crash and readjust, postnatal mental illness is a complete upheaval in health and personality. Sufferers often stop sleeping altogether, separate from the wakefulness of their babies. Changes in appetite are common, as are lapses in memory, a sense of isolation, a plummeting mood and feelings of worthlessness; as the condition worsens, panic attacks are common, and thoughts of suicide can become persistent. When these thoughts take hold, they are hard to resist. It takes an intense therapeutic focus, and often medication, to guide a woman in the grips of this illness back into the light.
Though postnatal mental illness has affected women throughout history, its causes are still not entirely known. The Mayo Clinic splits its discussion of causes into 'physical' and 'emotional' categories, but social and cultural factors can also play a role. A gender non-binary or trans person giving birth might feel isolated from the idea of 'motherhood', for example; I use the term 'mother' here only because the research is gendered as such. The new migrant might mourn cultural practices and support systems lost; an artist may feel suddenly dislocated from the creative practices that have given her life meaning.
Each experience is different, but what we have in common as new parents experiencing mental illness, some for the first time, is a feeling of vulnerability. Though postnatal mental illness is extremely common--imagine if every woman who gave birth on a Monday experienced it, and that is the frequency that we are talking about--there is still, in talking about it, a sense of risk and shame. Shame that we are not fit to be mothers; fear that our babies will be taken away from us; sadness at dashed hopes and buried dreams, and above all, sorrow and guilt.
The stigma of mental illness is still so prevalent that admitting to it at a time when we 'ought' to be our most joyous seems like a grotesque perversion of social norms. But postnatal mental illness is as common as breast cancer, and twice as common as diabetes. Instead of keeping our silence about it, we need to take it up as a major feminist issue, and make sure that women's vulnerability in this period is acknowledged and healed. Because parenting a newborn can be impossibly frustrating and hard. But there is no reason, none at all, that it should ever need to be deadly.