Are public health campaigns to blame for postpartum anxiety?

Whether it was the fact that I had an easy, uncomplicated pregnancy or that it's just my nature to be relatively laid-back, I enjoyed a worry-free nine months carrying my (now nine-year-old) son, Isaac. Admittedly, I avoided reading too many pregnancy books and never watched any birth stories on TV, which kept me delightfully oblivious to anything that could go wrong during my pregnancy, labour and delivery.

That all changed the second my water broke, before labour started: My amniotic fluid was green and filled with meconium. I was induced and eventually wound up having an unplanned C-section 40 exhausting hours later.

The morning after my son was born, on Christmas Eve, a cheery nurse wearing a Santa hat came into my room, removed my catheter and told me to get up and go for a walk. "It will help with that first bowel movement," she told me with a wink. As I gingerly walked through the maternity ward, one hand clutching the plastic bassinet, one hand protecting my incision, a circa-1980s poster on the wall caught my eye. It featured a beautiful naked woman sitting on a mossy log in the middle of a lush green forest, with a baby latched onto her breast. The headline read: "The most natural food."

Two thoughts immediately crossed my mind: First, it was a totally unrealistic photo because she'd be covered in mosquitoes; and second, breastfeeding is the least natural thing I've ever experienced. In the first few hours following my son's birth, I failed to get him to latch and nurse without tears and pain.

Breastfeeding continued to be a struggle even after we went home with our baby, so I finally opted to pump and bottle feed—and a public health nurse actually shamed me for this choice. "Don't you know that breast is best?" she asked. Needless to say, I didn't tell her about the stash of formula I had hidden in my pantry. It wouldn't be fair to blame my postpartum anxiety solely on that poster and the nurse, but it sure played a role in feeling I'd let my son down. Ironically, recent research shows that public health campaigns do play a role in how anxious new moms feel.

The study, out of Australia's Monash University School of Public Health and Preventive Medicine, was published recently in the Women’s Studies International Forum. As lead researcher Heather Rowe explains, "While a degree of anxiety is inevitable at this time in a woman's life, the complexity of modern pregnancy and the postpartum period appears to have a downside, delivering over-simplified public health advice as well as professional and social scrutiny."

Over the course of the study, researchers met with 20 mothers and their babies to talk about the sources of their anxiety, and they discovered four common themes behind perinatal anxiety: managing maternal image, single-message health campaigns, maternal instinct and evidence-based decision making. At the conclusion of the study, researchers determined that health and social messages can cause distress, confusion and stigma that undermines a new mom's confidence.

"Public health campaigns with a strict single message such as 'breast is best' can make women feel pressured, and can lead them to feel guilty and ashamed if they make an informed choice not to breastfeed," Rowe says. "Similarly the 'Safe Sleep Space' campaign to prevent SIDS can cause parents to over-estimate the likelihood of SIDS and lead them to be excessively watchful and worried."

Last year, British Columbia's Fraser Health came under fire for asking new moms to sign a breastfeeding contract. It was quickly pulled from hospitals after public outcry, but it proved that pressure to breastfeed is real. And if you remember Milwaukee Public Health's controversial SIDS awareness campaign, the message about the dangers of co-sleeping are equally over-exaggerated.

So what is an anxious new mom supposed to do when she's surrounded by pressure to be nurturing and natural? As someone who suffered from postpartum anxiety, believe me, telling us to relax will not work. Rowe suggests doctors and other health professionals play a key role in helping ease anxiety by busting the myth that mothering is instinctive. Instead of thinking about what motherhood should be like, know that taking care of your baby requires learning new skills that may not come easily. Ask your friends, family and doctor for help, and know that this motherhood thing will get easier. I promise.

Follow along as Jennifer Pinarski shares her experiences about giving up her big city job and lifestyle to live in rural Ontario with her husband, while staying home to raise their two young children. Read more Run-at-home mom posts or follow her @JenPinarski.

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