Medication can’t solve the systemic issues crushing mothers.
Last week the Food and Drug Administration approved the first pill to treat postpartum depression, zuranolone. I applaud the potential this could have for women and birthing people across the country, the lives it will save. But it won’t cure the conditions that make American motherhood so difficult and dangerous in the first place. And I wish the same “fast tracking” and investment was put into other common-sense interventions that would save mothers’ mental and physical health.
Meet the expert
Dawn Huckelbridge is the founding director of Paid Leave for All.
I believe depression is a very real, clinical condition. I believe that a drop in hormones in a woman’s body after childbirth can contribute. What I don’t believe is that our country acknowledges its complicity. How much easier it is to diagnose a disorder and prescribe a pill than to think critically about the ways we treat new mothers and families and then develop real cultural and policy changes to address that.
Since I gave birth years ago, people have asked me if I thought I had postpartum depression. Maybe, of course, I often reply. But wouldn’t you?
My baby wasn’t sleeping, my body wasn’t healed, but I’d gone back to work. I left every morning carrying breast pump parts, pain, and guilt. I endured repeated rounds of mastitis infections that often put me on the floor shaking. I couldn’t stop losing weight. I was sleep deprived to a point that has been defined as torture. I felt like my identity had been taken from me. I felt my value dropping every day at work. I felt isolated, abandoned, and trapped. I didn’t know how to afford child care. I didn’t know how to take care of my body. I had to go down rabbit holes on the internet or quietly ask friends to answer questions about my recovery that medical professionals never did. I felt more and more invisible in this country. And still, I was lucky—I had insurance to cover the obscenely high bills, I had some paid leave to heal and bond with my son, I had family to care for him when I had to go back to work.
But what about the one in four women in the United States who have gone back to work within two weeks of giving birth? The three in four without any paid family leave from their job? The women who are still bleeding, who have been told not to lift weight after a C-section, the ones who can’t yet legally get their babies into a child care center? The lowest-wage workers trying to afford the average child care cost of $10,000 (in some places much more)? What about the women, particularly Black women, who face preventable physical injury in birth and, increasingly, death in the days after giving birth? Postpartum women should have access to a number of supports, including medication. But the American postpartum experience is uniquely harmful; it will require more than a pill.
Much of the rest of the world does things differently. China practices “zuo yuezi” or “sitting the month,” a period of rest for new mothers. Denmark offers in-home midwife services. Bulgaria offers 410 days of maternity leave. France offers free pelvic floor therapy. Paid leave and child care programs are taken for granted in other countries, where motherhood is not a stigma. America falls behind by nearly all measures.
We are one of the only countries in the world that does not guarantee any form of paid leave for its people—a policy proven to reduce postpartum depression in mothers. Studies in Nordic countries with some of the most generous paid parental leave policies have found that mothers are less likely to need anti-anxiety medication when fathers are present after childbirth.
There’s more. As a country we invest less in child care than most OECD nations. Only 6 percent of block grants for “maternal and child health” actually go to caring for mothers. We have the highest maternal mortality rate among wealthy countries, a rate that has more than doubled in the past 20 years.
The truth is, in this country we give a good deal of lip service to motherhood and family values, but we do not value mothers’ lives or labor. I look forward to the day that we make robust and comprehensive investments in maternal health and wellness beyond highly lucrative drugs. I look forward to the day, I hope very soon, that we “fast track” action on federal paid leave and care policies to support mothers and whole families. Those investments would yield systemic change and lasting returns for mothers, and for all of us.