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Before we were mothers, people would tell us--rather smugly, we thought--that everything was going to change once our babies came. It seemed overly dramatic and a little presumptuous. What? we'd ask. What's going to change so shockingly and irrevocably? Oh, you'll see, they'd say, like irritating psychics, full of knowledge but stingy with the details. Months later at our baby shower, when we found ourselves excited to receive the Diaper Genie--a contraption that, as one of our (childless) friends pointed out, makes sausage links out of dirty diapers--we had to concede a little. Things do change. Here we set out to unearth the effects of motherhood. What does it do to your body, your mind, your finances, your relationships? Is motherhood good for you? Bad for you? Or, like life in general, unpredictable measures of both?
Not long ago, we found ourselves asking, in an Andy Rooney-style locution, "Why is it that before we had children, we could afford an exotic vacation, but now that we could really use one, we can't pay for it?" Oh, we know why. We've read the articles on how much it costs to raise a kid these days. We've read them, knowing we shouldn't, in the way we know we shouldn't calculate how much the mortgage will ultimately cost us. Unlike the mortgage, though, the actual costs of raising a child are difficult to calculate. For one thing, the money we spend on our children varies greatly from mother to mother. And what's more, since caregiving is rife with the stuff that Mastercard's ad agency remind us is "priceless" (e.g., an hour of sleep, a child's first knock-knock joke), pinning down the economics of motherhood--accounts payable and receivable--is a tricky thing. Undeniably, it does take some cash money. For any given mother, you might sum up her financial health in the words of Pink Floyd: Money, get away. The first step toward motherhood is often a step away from birth control. Voila! Cash savings! But an average, uncomplicated pregnancy--including prenatal care, a vaginal, physician-attended birth, and hospital care for the mother and newborn--can cost $4000 or more. (Higher-risk pregnancies and c-sections will run more; midwife-attended home births will run less.) Fertility treatments can cost less than one hundred dollars a month for ovary-stimulating pills to a few thousand dollars for in vitro fertilization (provided the woman is young and the sperm frisky) to nearly fifty thousand dollars for an egg donor and gestational surrogate. The non-biological route also varies in expenses. According to the National Adoption Information Clearinghouse, a resource run by the federal Administration for Children and Families, adoptive parents' cash output runs the gamut from nil to tens of thousands of dollars. Adopting a special-needs child from a public agency can cost nothing. Private and independent domestic adoptions range, on average, from four thousand to thirty thousand dollars. Overseas adoptions can range from seven thousand to twenty-five thousand dollars, although that number doesn't include some expenses like travel and lodging. Mercifully, after the kid's home and the checks are written, the rest tends to come in dribs and drabs, a pack of diapers here, a behind-the-wheel lesson there. The Center for Nutrition Policy and Promotion, an arm of the U.S. Department of Agriculture, puts out a comprehensive report that's supposed to help states set child support rates and foster parent payments. "Expenditures on Children by Families" breaks down how much families spend on their kids. (2002 is the most recent year for which data was available). How much dough you're shelling out for the kids depends on a variety of factors including the age of your child, how many kids you have, whether you're parenting solo or partnered, the household income, and where you live. The report makes apples-to-apples comparisons by figuring how much a family with two children (which is the average family size these days) spends. The spending patterns are pretty much the same across the board. That is, everyone spends more on food than on clothes, more on older children than on babies. Families with only one child tend to spend twenty-four percent more on their single child; families with three or more children spend twenty-three percent less on each child. (A recent Newsweek article posited that women are having smaller families precisely just so they can spend more on each kid.) Not surprisingly, single parents--who have, on average, a lower household income (even including child support payments) than two-parent families in the same income bracket--spend a greater proportion of their income on their kids. Likewise, poorer parents spend a greater proportion of their income than more affluent parents. What is surprising, though, is the difference in the dollar figures. Two-parent families making less than $39,700 will spend $127,080 on each kid by the time that kid reaches eighteen (in 2002 dollars). Families making between $39,700 and $66,900 will spend $173,880. Families making over $66,900 will spend $254,400. Which means that the rich spend over a hundred grand more on their children than poor parents do. That's twice as much money. It speaks to just how varied the economic realities of American mothers' lives are. The average affluent couple can spend just 13 percent of their income by blowing $13,750 on their toddler. The average poor couple spends just $6,620--but it's a quarter of their annual income. Across the board, though, the biggest expense for parents is housing, which eats an estimated 33 to 37 percent of the money we spend on our kids. However, the CNPP points out that they're probably underestimating the figure since mortgage principal payments aren't included (they're filed under "savings"). The middle class is especially affected, according to The Two-Income Trap: Why Middle-Class Mothers and Fathers Are Going Broke, by Elizabeth Warren and Amelia Warren Tyagi (Basic Books, 2003). We stretch the household income to mortgage more expensive homes--not because we're pretentious or greedy, but because we want our children in good school districts. Mothers, they conclude, are thirty-five percent more likely to lose their homes than folks without children. And, for those of us who aspire to foot the college tuition, there is more unpleasant news. For the 2002-2003 school year, the average cost of tuition and fees at a public university was $4,000; at a private university, it was $18,000. (And these costs don't even include the dorm room, the ramen noodles, the latest edition of The Riverside Shakespeare.) According to the College Board, tuition and fees rose 38 percent in the past ten years, even after adjusting for inflation. Whew. We can imagine a not-too-distant past when things might have been different. A Little House on the Prairie scenario, when you could put hateful little Nellie Oleson to work tending the store, and everyone--in braids and dresses, suspenders and unfortunate, home-barbered haircuts--was involved in building the homestead. Weren't kids considered a financial asset at some point? When did it become the way it is now? We posed this question to Nancy Folbre, a MacArthur fellow, author of The Invisible Heart: Economics and Family Values (The New Press, 2001) and an economics professor at the University of Massachusetts at Amherst. No one really knows the answer, she says. "Children in some cultures or environments, maybe they were an asset. What we do know is that children used to defray their costs more than they do today." Almost undoubtedly for the better, though, children's labor is no longer essential for most American families to make the rent. While children, especially in lower-income families, do often contribute unpaid labor by babysitting younger siblings and performing other essential household tasks, as a culture, we don't condone it. Children are supposed to be recipients--of money, care, education--these days. Which brings us to a question that the proverbial (or actual) market-obsessed brother-in-law might ask: If children are so damn expensive, why do we have them? "Children are intrinsically worthwhile," Folbre says. "They're part of who we are and who we want to be. But it's important to understand their economic impact on parents and on society as a whole." Folbre explains that children can be analogous to pets. Why, for example, would we have Cleo, an aging beagle mix who racks up vet bills and food costs, has pretty much trashed our nice recliner, and once scarfed down a whole plate of cocktail shrimp set on a low shelf in the refrigerator? Well, love and companionship and the pleasure of hearing her doggie nails on the floor as she follows us into the kitchen. Quality of life stuff. It's the same deal with children, Folbre says--up to a certain point. Parents' investment in children (unlike our investment in Cleo) benefits not only those parents but society at large. Children grow up to be the next generation of workers. Their wages will pay the Social Security checks that our generation--those who were in the workforce, anyway--will collect in old age. What's more, today's chubby-cheeked darlings on the playground will become tomorrow's adults who take care of the sick and elderly, run the government, collect the trash, hold the hands of hospice patients, fix our cars, cure our diseases, harvest our food, create our cultural masterpieces, and generally keep the economy trucking along. Our country relies heavily on caregiving, Folbre says, along with the two other big economic institutions, the market and the state. "You can't organize an economy that is based only on markets. All market economies rely on a combination of public and family provision of care," she points out. But here's the problem, as Folbre and others see it: Caregiving is taken for granted. While society as a whole reaps the benefits of generations of kids' being ushered into a productive adulthood, their mothers pay the price. "[Mothers and other caregivers] take a big financial risk," Folbre says. "As with most risks, not everyone is equally affected." A lot of us are, though--especially those of us who raise the kids full-time. As Ann Crittenden laid out in The Price of Motherhood: Why the Most Important Job in the World is Still the Least Valued (Henry Holt, 2001), the work that mothers do in child-rearing is unpaid, is unfair, and exacts a price on women. "Mother-hood is the single largest risk factor for poverty in old age," she writes, which is maybe the most startling fact to come from her book. Forty percent of mothers who divorce don't even have to wait until old age--they fall into poverty right away. What's more, by eliminating or reducing our paid work hours, she says, mothers lose out on Social Security and other retirement income. Crittenden and others maintain that what we need is a cultural shift to value the unpaid work of caregiving and to consider family issues in making corporate and public policy decisions. Sharon Hays, a sociologist and professor at the University of Virginia, wrote The Cultural Contradictions of Motherhood (Yale University Press, 1996) and Flat Broke with Children: Women in the Age of Welfare Reform (Oxford University Press, 2003). Like Crittenden, she would like to see a "public conversation" surrounding family issues. (Just imagine if these issues got the same attention that, say, car safety does.) In other first-world countries, caregiving is not the do-it-yourself situation it is here--or as Hays puts it, "all these individual mothers in their individual homes holding up half of the world." She shows how the other half lives: "In Norway, for instance, support for the family is at the center of state policy." Hays would like to see the issues important to families in the U.S.--especially those with dual earners and single parents--reflected in our state and corporate policies. "We have to understand [care and obligation] as equally important as making money." In the U.S., the sorts of measures that would help families, especially mothers, aren't even on the table. These include universal daycare, Social Security credits for unpaid caregivers, divorce laws that divide assets among all family members, proportional pay and benefits for part-time workers, etc. For now, the financial risks of motherhood remain. There is one calculable financial benefit to raising children, though. Most of us won't see it until years from now--when we're older and gray(er) and have long ago converted our children's toy-strewn bedrooms into the sunrooms where we take our afternoon tea and read novels uninterrupted. "Children are a pretty valuable insurance policy," Nancy Folbre says. "Very seldom do adult children take their parents in their homes, but they do a lot of management work that's very valuable to the elderly." She also points to a study showing that senior citizens with children are less likely to wind up in a nursing home on Medicaid. We think of what we've been doing with our children lately--listening to their halting, labored reading ("Worm . . . Is . . . Stuck!")--and are floored to realize that this kid right here will one day have to make sense of our insurance forms, our memoirs, our will.
Physical Health During a routine pregnancy check-up, we once tried to make conversation by asking our OB/GYN how forensic examiners can tell whether a woman has ever given birth. We were remembering all the shows we'd seen where the medical examiner comes out of the autopsy room, snapping off his gloves as he files his report: "Female Caucasian, early twenties, never had kids . . . " We expected our doctor to talk about the size and shape of the postpartum womb or something about the cervix. Instead, he said (a little boastfully), "I can tell whether a woman has ever had a baby just by looking at her in a bikini." It's all in the belly button: Before babies, it's vertical, like a keyhole. After even just one child--and no matter how much weight she's lost or Pilates she's done--it's gone horizontal, more like a droopy eyelid. Oh brother. There's no denying that bearing children brands us. We wear the badge of motherhood on our bodies, usually with pride. But sometimes it seems that the news about what motherhood does to your health is just another form of Chinese water torture. Drip, drip, drip: tiny drops of worrisome information beating on our brains. The physical changes that we experience mostly fall into two categories: those related to childbearing and those related to child-rearing. If you've been pregnant--or have even spent an afternoon with a woman who is in her eighth month and ready--you probably know about the childbearing-related changes. Those pregnancy hormones have a lot to answer for. They cause everything from a heightened sense of smell to a thicker head of hair. Hormones also cause the connective muscles to relax, allowing the bones in your pelvis, for instance, to move apart. A good thing, seeing as the last thing you want when you're driving a watermelon through a hosepipe is a bunch of bones blocking the path. But the result may be that you end up with a different shape post-pregnancy (wider hips, bigger feet) than the one you started with. Having your body expand and contract like a hot-air balloon can do a number on you, too: stretch marks, less taut breasts, a bladder that thinks it's a sieve. On the whole, those are usually the minor issues. Indeed, according to the Centers for Disease Control, the chance that you will actually die from pregnancy-related causes is small. Of the four million women who give birth each year, only between seven hundred and eleven hundred will die of pregnancy-related causes. But 31 percent of women who give birth in the U.S. today do suffer some form of "maternal morbidity," what the CDC describes as "a condition that has an adverse impact on a woman's physical health during childbirth, beyond what would be expected in a normal delivery." That rate climbs to 43 percent of mothers if you count (as the CDC does) the major surgery involved in a cesarean section as an instance of morbidity. These statistics mean that every time you have a baby, you're nearly as likely as not to have some kind of obstetric complication. The most common problems the CDC found were third- and fourth-degree lacerations, cervical lacerations and pelvic trauma, preeclampsia and eclampsia, gestational diabetes, genito-urinary infection, postpartum hemorrhage, and amnionitis (inflammation of amniotic sac). The most common pre-existing condition that becomes aggravated by pregnancy is high blood pressure. But let's say you get through the hurdles of childbearing relatively unscathed. What are the health hazards after the baby's born? What's the forecast for, oh, let's say, the next twenty years? Once again, the answer rests atop a stack of other factors that all contribute to the quality of an individual's life, like economic stability, personal temperament, genetic make-up, and general susceptibility to major illness--not to mention proximity to (and reliability of) a mate, relatives, and friends. It's not as though anyone can give a simple answer to this, on an individual basis, at least. But like foreign correspondents phoning in reports of unrest in a far-off land, information is coming in dribs and drabs, as researchers around the world post news of their studies on various ailments and their correlation with childbearing. The media generally delivers the story to their audience either with a wry "Watch out for this" or a bemused "Huh. Interesting!" Rarely is it pulled together into a coherent picture. Late last year, we heard of a study concerning childbearing and heart disease conducted by researchers at the University of Bristol in England. With each child after the first two, a woman's risk of heart disease increased by thirty percent. Fathers, on the other hand, had only a twelve percent greater risk with each additional child. In addition, obesity and diabetes were more common in larger families. The chief scientist in the study, Debbie Lawlor, noted that there was a correlation between larger families and both poverty and what she called "a less favorable lifestyle." "However, different results for fathers and mothers suggest that multiple pregnancies also have a specific adverse metabolic effect on women," Lawlor added. These suspected effects may lead to heart and blood sugar problems. What motherhood takes from us with one hand, however, it may give back with the other. Evidence is piling up that having children reduces your risk for such diseases as ovarian cancer. According to Andrew Berchuck, a cancer specialist and professor of gynecologic oncology at Duke University Medical Center, a woman who has three children has half the risk of ovarian cancer as one who has never been pregnant. (Then again, women who have used birth control pills for at least five years have the same reduction in risk, Berchuck says. The hormone progestin, found both in the placenta and in the Pill, is believed to protect the ovaries against cancer.) Other studies conclude that women who breastfeed have a lower incidence of breast cancer than women who don't. The American Journal of Epidemiology published a study in 1997 showing that pre-menopausal women who had breastfed for at least twenty months had a fifty percent lower risk of breast cancer, compared to women who had had at least one baby and did not breastfeed as long. Another study in the same journal, in 1999, found that the beneficial effects of breastfeeding may last throughout a woman's life. Women who breastfed for even as little as two weeks had a reduced risk of breast cancer up to fifty years later. Once again, it may be a hormone thing. Higher levels of estrogen and progesterone (which fluctuate with our menstrual cycles) are linked to increased risk of breast cancer. After a baby is born, breastfeeding delays the resumption of ovulation in the mother, which in turn reduces her overall exposure to these hormones. Still, these studies are focused on the physical changes wrought by childbearing. (Very few of us can jumpstart our breasts into milk production without having been pregnant recently.) Is there anything to say about the health effects of mothering? Actually, there is. Taking care of children (and grandchildren) seems to contribute to heart disease, too, according to a study of more than fifty thousand women published in the November 2003 American Journal of Public Health. Mothers caring for their children more than twenty hours per week, and grandmothers caring for grandchildren for as little as nine hours a week, were one and a half times more likely to have heart disease than women who don't provide care for children at all. What's more, a new, small field of study is focusing on mothers on a day-to-day basis, particularly on the effect of mothering on a woman's general health and well-being. For the time being, these researchers are concerned not with major illnesses like cancer or postpartum depression, but with all the minor ailments that can add up to a life lived at a lower level of happiness and satisfaction than it could be. They're concerned about mothers who can't or don't take good care of themselves, don't eat well, don't sleep enough, don't get out enough, who spiral down, sometimes slowly, sometimes alarmingly fast, into a state of low energy, depression, marital dissatisfaction, guilt and disappointment, unhappiness with themselves and with their lives. These factors all add up to a condition that the authors of a recent book have dubbed Maternal Depletion Syndrome (MDS), a serious bio-psycho-social condition that they say affects the well-being of many women who bear and/or raise children. The book that outlines MDS, Mother Nurture: A Modern Mom's Guide to a Healthy Body, Mind, and Intimate Relationships (Penguin, 2002), was written by psychologist Rick Hanson, nutritionist Jan Hanson, and OB/GYN Ricki Pollycove, the former chief of gynecology at California Pacific Medical Center. Together they're on a mission to bring MDS to greater public awareness. In a Powerpoint presentation that Hanson and Pollycove often present to med school classes, they list "common presenting problems of women"--in other words, ailments that bring women in their childbearing and child-rearing years into their doctors' offices. These range from depression to low libido to auto-immune conditions, excess weight, fatigue, and gallbladder or kidney problems. The single common factor that increases the risk of each one of these conditions is motherhood, the authors point out. The insidious thing about it, says Hanson, is that motherhood isn't usually considered a factor in any one of these conditions. Or if it is, it's written off as "just part of the job." Take fatigue, for instance, or stress. How many times have you heard people say that it's all part of having kids? Maternal depletion is the number one unacknowledged health care problem in the U.S., Hanson says. We should take this condition seriously not only for the sake of the individual women themselves, but also for the impact on our country and the economy when so many women are "running on empty." Children are neglected, marriages get into trouble, jobs suffer--"all of which, one way or the other, costs our economy billions," Hanson says. But research that correlates motherhood with particular health complaints is spotty. "There are virtually no longitudinal studies that match mothers with non-mothers over, say, a three to five year period to assess their risk for certain conditions," Hanson says. He and his co-authors spent months doing a thorough review of the medical literature, in the end compiling eighty pages of references. ("I'm the guy in your seventh grade class with three pages of footnotes on his book report," he says.) All of it adds up to a big gaping hole in our knowledge of how being a mother affects us on a day-to-day level. The authors are both adamant and anti-alarmist. They don't want to sensationalize their findings, but they firmly believe it's both pervasive and invisible. It's been so easily ignored up to now, Pollycove says, partly because our culture doesn't like to hear mothers complain. And women who are ground down are less able to muster the energy to make a big issue of their health. Hanson also points to a psycho-social reason we've overlooked MDS to date: At some level, he believes, we're aware that our own mothers may not have always had an easy or wholly enjoyable time raising us. That makes us feel guilty, which makes us more inclined to stick our heads in the sand when faced with evidence that many women are suffering through their child-rearing lives today. "And you can't underestimate the economic motive either," he says. "We don't like to acknowledge that we are always exploiting the unpaid labor of mothers." MDS happens, they say, when three common factors collide: the high physical and mental demands of bearing and raising children; the low resources many mothers have on hand when they have kids (ranging from poor-quality food to insufficient help from a partner); and "personal vulnerabilities," such as having children at an older age, a prior health problem, a temperament that's unsuited to the chaos of living with young children, or a bout of postpartum depression. By their calculations, one-third of all mothers will sail through the birth and caregiving years relatively easily. They're likely to have the deck stacked in their favor: a loving, helpful partner, good overall health, youth, enough money, and "plain old good luck," Hanson says. One-third are likely to find it more challenging, suffering some depletion, fatigue, depression, or difficulty with their relationships--but they're able to rise out of it by the time their youngest child is in kindergarten. The remaining one-third of mothers are at risk for significant depletion. "They have a really difficult time, especially in the early years, with more serious health problems and deeper depletion that has longer lasting consequences," Hanson says. "Their depletion may last into their children's teenage years, and then collide with the challenges of the transition to menopause." Those mothers often suffer for years without pinpointing the problem. "It typically takes one to two years for a woman who has underlying risk factors to drain their deepest resources," Hanson says. "They'll have a lot of subclinical problems: they're run down, they're having weird periods, they've got no patience, they have insomnia, or a loss of libido. They see their doctor for the typical six-minute appointment, and they may get one of those thing looked at. "But if one more stressor is added to her life--a spouse's job loss, a difficult child, even less sleep than normal--she starts circling the drain of depression and depletion." Many women are able to begin building up their resources (sleep, time apart from their baby, healthier eating habits) at about the time their child starts coming out of the toddler years. But if she hasn't fully "restocked" before the next baby comes along, the cumulative stress could drain her more quickly and more deeply. Some of the underlying issues of MDS can be easily addressed, they say. There are simple medical tests that can pinpoint a thyroid problem (which is often a culprit in fatigue), for instance, or a nutritional overhaul. There are relaxation techniques for dealing with day-to-day stress and communication strategies to help an MDS mother talk more effectively with a spouse or partner. But the first thing that has to happen, they say, is that the mother herself has to acknowledge that her health matters. "I've been trying for twenty-seven years to sell women on the idea of taking care of themselves," Pollycove says wryly. "It's a hard sell. Women will buy ten books on pregnancy and the newborn stage. But after that, it's like they drop off the planet." "We're not knocking the wonderful parts of motherhood. We're just trying to point out that if we can gain some recognition for the idea of Maternal Depletion Syndrome, more research can be done," Hanson adds. "Maybe we could find a way to flag those women who are higher risk earlier in their child-rearing careers which would not only help them, but help the children under their care, and even the economy. "Motherhood is not a clinical condition," he says. "On the other hand, it's a very serious undertaking that doesn't stop when mom and baby go home from the hospital."
Mental Health The research on motherhood and mental health is, if possible, even more primitive than that on motherhood and physical health. Take, for example, the most publicized mental-health bogeyman for mothers: postpartum depression. The Diagnostic and Statistical Manual, the bible of the mental health profession, doesn't list postpartum depression as a separate category of illness; it's listed under general depression. The psych textbooks these days acknowledge a subcategory of depression "with postpartum onset" and divide the sufferers into one of three groups depending on the severity of their symptoms. According to Dr. Kimberly A. Yonkers, associate professor of psychiatry at Yale University School of Medicine, somewhere around seventy to eighty percent of all women experience "baby blues" after giving birth. We remember this cute-sounding but not-so-pleasant period ourselves, during which just thinking about how hard it would be to get up from the nursing chair to fix a sandwich would make us burst into tears. Baby blues usually start within a day or two of giving birth. You're irritable, tearful, anxious--sometimes all three. Whether caused by sudden drops in hormone levels, the shock of sleep deprivation, the jolt to the status quo in your relationship, or some other factor, the salient thing is the brevity of its duration: within a few weeks, your mood levels out. Of course, if the way your mood levels out is that you're feeling crappy most of the time, you may be one of the ten to fifteen percent of women who suffer from postpartum depression. This is the baby blues cranked up a notch or two and stuck in a tape loop. You're sadder or more irritated, and for a longer period of time. Most PPD resolves itself within a few months, but ten to twenty percent of women have longer episodes and may require treatment with drugs, therapy, and/or hospitalization. At the extreme end of the scale, affecting one to two women for every one thousand deliveries, is postpartum psychosis. As with any kind of psychosis, PPP sufferers hear and see things that aren't there. They're delusional, they're not sleeping, and they may be agitated and angry. They cannot function normally, and they're at risk of hurting themselves or their children. This is Andrea Yates territory, a medical emergency requiring immediate intervention by family and medical professionals. It has been hard for researchers to find the exact connection between having babies and becoming depressed. The obvious fall guy, once again, would appear to be fluctuating hormones. Diana L. Dell is an OB/GYN at Duke Medical Center in Durham, North Carolina, a reproductive psychiatrist, and co-author of Do I Want to Be a Mom? A Woman's Guide to the Decision of a Lifetime (McGraw-Hill, 2003). Treating psychiatric disorders related to childbearing and reproduction, she has dealt with scores of women with postpartum depression. "The rates of depression for women are twice as high as that for men--but only in the reproductive years," Dell says. "Women are vulnerable to depression during adolescence (as is everyone) and during peri-menopause. But postpartum is the most biologically vulnerable period presumably because of all the changes in hormones going on." On the other hand, in a 1998 review of past studies on perinatal mood disorders, psychiatrist Teri Pearlstein and her colleagues found that "the association between postpartum depression and hormonal and biologic factors have yielded few consistent findings. No association has been found between postpartum depression and postpartum estrogen or progesterone levels or the hormones' rate of fall." So maybe hormones aren't the culprit. Or maybe they are just part of a stew of other factors, like suddenly feeling (and actually being) isolated from your friends and separated from your normal routines or the social and financial perks of your job. A 1995 study in the American Journal of Obstetrics and Gynecology compared the rate of major depresssion in women who have recently given birth to the rate of depression in women of the same age who haven't given birth. In both groups, the rates of depression were the same, hovering around ten to fifteen percent. In other words, at any time in her childbearing years, one in every ten women may be suffering from major depression, whether or not she has children. Is there something unique about postpartum depression? Dell believes that based on the women she's seen, there is. "It's more of a mixture of anxiety and depression rather than just depression." Everyone agrees, though, that more research needs to be done. From another, more encouraging, quarter comes the news that having and raising children changes your brain in good ways. For the last five years, Craig Kinsley, a neuroscientist at the University of Richmond, has been publishing the results of his studies on rats that show that mother rats are calmer, braver, and less stressed out than rats without pups. Mother rats are also smarter (in this case, as measured by how well they locate food in a maze). Kinsley and his colleague Kelly Lambert of Randolph-Macon College created parallel stress tests for mother and non-mother rats (using bright lights and open spaces), ran them through mazes, restrained them, and finally, examined their brains. The brains of mother rats showed permanent changes in such areas as the amygdala, which regulates fear. Other recent studies show that oxytocin--a hormone present in high quantities in nursing mothers--increases the spatial intelligence of rats. Virgin rats given oxytocin ran mazes more easily than rats without it; nursing mother rats whose oxytocin was inhibited were worse at it. Granted, these are rats. But the leap to human mothers isn't such a large one, Kinsley says. "We share most of our genes with rats. The way the rat and the human brain are put together differs only in size and complexity. The same basic areas are there. It's like a globe of the earth compared to the earth itself. The basic plan is the same." The hormonal profiles are similar, as are behavioral changes that accompany hormonal fluctuation. Again with the hormones. Says Kinsley, "Studies show that hormones affect the structure of neurons in the brain." Catherine Woolley at Northwestern University has done studies showing that neurons in the hippocampus are sensitive to hormones like estrogen and progesterone; hormones encourage neurons to make new points of attachment, allowing the brain to grow new connections. These create cognitive changes that facilitate care for offspring, like an increased ability to find food and locate nest sites, maximizing the likelihood of a mother's genetic survival. Looked at from an evolutionary standpoint, as Kinsley does, these changes make perfect sense. If it's your goal to pass on your genes, it pays to be brave, to be fiercely protective, and to be good at finding food under adverse circumstances. Extrapolating once again to human mothers, Kinsley is careful to say that, for human mothers, "smarter" may not translate into a new facility with quadratic equations or a sudden ability to remember people's names. It may relate more closely to abilities that enable mothers to rear offspring to adulthood successfully. We've all heard the stories that demonstrate this--mothers throwing themselves in front of their children in war zones, taking over the family finances when Dad walks out, figuring out how to get Billy into that already over-subscribed preschool. Forget the clinical issues for a moment. What about the end game, the overall life satisfaction quotient? Will you be happier for having had children? There's no evidence that children are a buffer against the emotional depredations of old age. A recent study published in November 2002 in the Journal of Marriage and the Family conducted by Tanya Koropeckyj-Cox, a sociologist at the University of Florida, surveyed 3,800 men and women between the ages of 50 and 84. She concluded that there is "no significant differences in loneliness and depression between parents and childless adults." But, truly, there are no solid answers regarding happiness. As Diana Dell points out, "every mother's experience is so different." Every so often, we'll run across a reference to a famous Ann Landers' poll. In November, 1975, Landers asked her readers whether they would still choose to have children if they could live their lives over. "Were the rewards enough to make up for the grief?" Landers asked. Ten thousand readers responded. Seventy percent of them replied in the negative: No, the rewards weren't greater than the grief. No, given a second chance, they wouldn't have kids. Seventy percent! Doesn't that tell us something? Actually, what it tells us is how not to conduct a survey. (As a matter of fact, Landers's poll is widely used in high school and college statistics courses as Exhibit A in the case against "voluntary response" surveys. They're rarely representative or accurate.) After Landers's results made headlines around the country, a firm of professional pollsters conducted their own--random, national, statistically respectable--survey. The results: Ninety-one percent of parents said they would have children again.
Relationships About a decade ago we used to watch this call-in show on MTV about sex. Almost each week, someone would phone in for advice regarding a menage a trois, explaining the situation as if it were titillatingly unfamiliar territory for the show. And without fail Dr. Drew, the show's therapist, would strongly advise against participating in a threesome. Once you bring another person into a relationship, the doctor would explain (again), things just aren't ever the same. Strip away the amateur porn overtones, substitute "floppy-headed newborn" for "hot co-worker at the strip club" and we'd have to agree with Dr. Drew's statement. After we become mothers, any given relationship may be better or worse, but it's not ever the same. Take, for example, how we interact with our own mothers. It's probably overblown and all too Freudian to say that, for most of us, motherhood dredges up a concern that we're turning into our mothers. But caring for little ones often brings up the issue of how we ourselves were cared for. One study published in a 2002 issue of the academic journal Family Process found that both our relationships with our mothers and our memories of how they raised us affect our relationships with our own children. Although the sample was small--forty-nine families--psychologists Molly D. Kretchmar and Deborah B. Jacobvitz found that mothers with happy memories of childhood and good relationships with their own mothers generally were "sensitive" to their own babies' needs. In other words, the way we parent is, in some ways, transmitted from generation to generation. What's more, they say, the transition to motherhood might encourage women either to renew the closeness they had with their own mothers--or to distance themselves if the relationship wasn't a good one. Friendships might meet a similar fate. "In the early years, motherhood can really decimate most of your relationships," says Julie Shields, author of How to Avoid The Mommy Trap: A Roadmap to Sharing Parenting and Making It Work (Capital Books, 2002). "If you're lucky, you have friends going through the same thing at the same time or friends who have been through it and know what it's like." As the kids get older, she adds, it's different: motherhood may actually facilitate deep bonds with pals. A community of friends is important for those of us raising children, some research suggests. Isolation is generally not so healthy. Friends are helpful not only for emotional support when, say, the toddler goes on a two-hour screaming jag because you wouldn't let her pull the potted plants out by their roots, but also for practical support. You need people who will actually come over and distract the kid. But this isn't the way motherhood works, not in our culture anyway. Historically and cross-culturally, sociologist Sharon Hays explains, the norm wasn't at all for mothers to raise their children in individual family units. "Actually, the work of childrearing was shared among a much larger group of women and female children," she says. (Daycare isn't quite analogous since it's a "commercial enterprise".) As she explained in The Cultural Contradictions of Motherhood, the cultural ideal now is for every mother to get in the trenches and mother alone and intensively, as if training for a triathalon. (This ideal of intensive mothering is also the subject of Susan Douglas and Meredith Michaels's new book The Mommy Myth: The Idealization of Mother-hood and How It Has Undermined Women, reviewed in this issue.) "One of the things that concerns me is that the rules of childrearing have become more intensive, more impossible to manage," Hays says. She laughs. "Then you add to the whole thing that you're supposed to be going to work!" Ah, work. As Julie Shields sees it, the whole work/parenthood thing can be an enormous stressor on marriage, one of the relationships most affected by motherhood. Moving from couplehood to family, she says, adds a degree of power to the relationship that wasn't there before. Who's going to do more paid work? Who's going to do the unpaid work? "[Having a child] can be a big source of unexpected unhappiness in the first couple of years, and then the couple will have to deal with that," Shields says. Shields identifies three sorts of gender ideologies for parents. Unless both partners are content with the traditional arrangement--mother does the domestic and childrearing work, father brings home the bacon--there's likely to be some conflict. Couples that want to split all duties fifty-fifty are also in decent shape, but Shields says, "It can be hard to find workplaces to accommodate that." The couples that Shields calls "transitional"--and that's most of us, she believes--lie somewhere between traditional and egalitarian, and it's often messy trying to figure out who does what and who's entitled to what. "[New parents] probably didn't expect this would become an issue," Shields says. "Even if they aren't arguing about the global issues in the way their lives are set up, they argue about the details. And lack of sleep makes everything that much worse. Arguments escalate and everything seems very immediate." Worse is that women, once they become mothers, are at their weakest in terms of bargaining power in a relationship, she finds. In other words, let's say you're seething because you notice that your partner never unloads the dishwasher, leaves the newspaper strewn all over the kitchen table, and acts like he can't hear the wailing from the bassinet. What are you going to do at this point--leave him? "In an ideal world, people would talk about [the division of labor] when they're dating," she says. "It's important if you want to share parenting." If we remember dating correctly, the whole issue of sharing the tab was dicey enough, but we see Shields's point. Couples can come to a mutually satisfactory arrangement years after the baby is born, she adds. But it will take a lot of talk and work and compromise, and more often than not, flexibility in each partner's workplace--which may be the Achilles heel to Shields's solution to the shared parenting conundrum. Is this really an issue in most marriages? we wondered. Sure, a decrease in nooky seems to be a universal effect of parenthood (married or single), but does having a child cause this much strife across the board? Do other couples really think in terms of who can leave whom? Or is it just the churning feeling of loss--of time, of connection--like when Liz Phair sings, What happened? When did you let go of me? I miss you so badly. It seems to us that each marriage is a locked box and those of us outside of it can never see what's really going on. John Gottman, emeritus professor of psychology at the University of Washington and director of the Relationship Research Institution, which studies the effect of parenthood on marriage, claims that his research shows that 67 percent of couples experience "a significant drop in marital contentment after their first child is born." New parent couples also have eight times the number of arguments as non-parents. "This is partly because parents are tired and don't have a lot of time for themselves," he says. A study published in the August 2003 issue of the Journal of Marriage and the Family also offered a peek inside the way other people's marriages are. It showed that, overall, the married-with-kids set report ten percent less marital satisfaction than childless couples. The researchers, who analyzed data from 148 other studies from as far back as the 1950s, also found that richer couples are more negatively affected by children. Affluent couples experience a 22 percent drop in marital satisfaction, middle-class couples 7 percent. Couples who became parents in the last decade experienced a bigger drop in marital satisfaction with parenthood--twice that of couples in the '60s and '70s. Mothers of infants reported the lowest rate of marital satisfaction than anyone else in the study. Only thirty-eight percent of them reported high marital satisfaction; sixty-two percent of childless women reported the same. (The researchers propose that this is because women usually have the primary responsibility for the kids.) The more children a mother has, they found, the less likely it is that she'll rate her marriage satisfying. The number of kids didn't seem to make a difference for men's ratings. When the study was released last summer, Jean Twenge, one of its authors, emphasized to reporters that the message was not Avoid Having Kids. Rather, she said, it's that couples should know that life with children is a big change. And Twenge pointed out that the study didn't measure overall satisfaction--the parent-child relationship can be a big source of happiness, too. Which is true. It sounds obvious, but the best thing we've gotten out of motherhood is, hands down, our kids. When it's good, there's nothing like the mother-child relationship. There's nothing like the sweet animal way our newborns rooted for our bodies, nothing like the gale-force hugs we get when we pick them up from preschool, nothing like finding a note written in a five-year-old's handwriting, XOXOXO. In these early years with our children, it's the closest we'll ever get to being someone's beloved deity. Sociologist Sharon Hays says that we're not alone in feeling this way, based on her interviews with mothers. "The way mothers will often express it," she says, "is 'I get so much love from this experience'." She points out that for poor women, whose marital prospects aren't as bright as more affluent women's, the mother-child relationship becomes an even more important source of love in their lives. "This kind of relationship, this is one that you can't tear apart," she says. "That becomes really crucial." Other studies have come to similar conclusions. One released in 1999 showed that divorced mothers often depend on their daughters for support--and that that's a mutually beneficial thing. Psychology Today reported that these mother-child relationships were based "in friendship, not hierarchy" and can actually open up the children so that they talk to their mothers more. But even if you're raising a child who's going through an I-hate-you stage and lately when he says "I love you," it means mostly "Buy me this overpriced toy," there are other benefits to being a mother. "It is mothering that teaches you about care and obligation," Hays says. "[These lessons] are not just important on an individual level--they're important to make a society, to build community. In a competitive society like this one, without that, we'd be in serious trouble." Just as we need caregiving to keep the country's economy chugging along, we need it culturally as well. Hays says, "A fact of the 'me' society--a competitive, narcissistic, dog-eat-dog world--is that life would be, as Hobbes put it, 'nasty, brutish, and short,' if there weren't some kind of counter-balance. Mothering becomes all the more crucial. "I say this not out of sentimentality towards motherhood. Part of what I argue is that the reason people are still holding on tight to mothering is because it's one of the last bastions of community where we find care and obligation to others," she says. "The number of places in one's life where one can find care and obligation has shrunk historically and cross-culturally. It makes it all the more important that you hang onto mothering." Hays adds, "Ultimately this is a problem because mothering needs to be something that's not gendered." It's no accident, she says, that the backlash against feminism has happened as our country has become more and more driven by individual achievement. If every American mother focused solely on her career and outsourced all the mothering stuff, the loss to our culture would be devastating. It's an idea taken to the extreme--the culture isn't, of course, in any real danger. Because, for many of us, the surprising and seemingly irrational pull toward motherhood is undeniable. We can remember when we wanted to get pregnant so badly that every baby we passed made our uterus ache. It's something more than just biology, we think now. Hays talks about how motherhood actually saved some of the women she's interviewed; it transformed them from women who might have engaged in prostitution or petty thievery into moral leaders for their children. Motherhood, in many ways, grounds you.
Graphs and statistics and studies aside, there is a spiritual dimension to motherhood. Being a parent provides one of life's best opportunities for expanding your soul. We're not saying that popping out kids automatically makes you a better person. Far from it. Joseph Stalin was a parent; so is Saddam Hussein. Mother Teresa didn't have children of her own, nor did Florence Nightingale. But we're guessing Joe and Saddam didn't spend much time in the sandbox or the sickroom, and we do know that Mother Teresa and Florence Nightingale were intimately involved in the care of other people. There's something life-changing about spending a lot of time concerned with the welfare of others--and it's not just that your paycheck suffers (a sad truth about caregiving of all stripes). You become a different person in a way you might not get the chance to do otherwise--and maybe a better person. It's an opportunity to deepen your hold on life, on the future and on the past. For the most part, we can't remember what it was like when we were very young. Playing with our children, measuring their growth, caring for their bodies--all of it is a reflection, either true or distorted, of what it was like for us when we were little. And all that effort we put into kids, all that late-night, no-sleep, bone-tired, up-to-the-neck-in-dirty-laundry effort, makes us deeply invested in their future. And so it makes us invested in the future of the world. Still, this soul-expansion doesn't pay the rent, keep us healthy, keep us sane, make our relationships any easier. And these are not inconsequential things. Given all the hits a mother is liable to take, is motherhood worth it? To be honest, it's a rhetorical question. Because you can't ever tell what version of motherhood you'll get. We all want to be the mother who reaps the rewards and isn't much affected by the risks. But despite our best hopes and efforts, we could all easily be the woman who slips into depression, whose marriage falls apart under the weight of this life, who cannot raise a whole family up out of poverty on her own, whose fatigue is just overwhelming. Just as we can't know what kind of people our babies will grow up to be, we can't know what cards motherhood will deal us. On the other hand, we also can't know what version of childlessness we would have gotten either. In the end, we do what mothers have always done: try to fix what's broken, live our lives, and hope for the best.
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