Perils of Divorced Pauline

The Names Have Been Changed, But the Story Is True


April 05
World-class gnarly divorce survivor. Custody Battle blogger with a sense of humor. Mom. Wife. Cat-Lover. Visit me at or on Twitter @divorcedpauline.


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APRIL 30, 2012 9:32AM

Does Being Rich Protect Women from Post-Partum Depression?

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I was rich when I gave birth to both my children. Twice I arrived home from the hospital, infant in tow, welcomed by baby nurses and doulas and full-time nannies.

In case you were not the mommy dilettante that I was, you may not know what some of these people do, exactly.

Baby nurses live with families 24/7, up to three months -- or more -- after the baby is born. They wake up at night with a crying infant and handle the feeding. They bring him to the mother during the day for her to breastfeed. They change the diapers and wash the baby's clothes.

Doulas take care of the mother, preparing her meals, massaging her feet, and providing emotional support when post-birth hormones take hairpin turns.

When I had trouble breastfeeding my son, I hired a lactation consultant who made a home visit. A maid cleaned the house. During the day, I strolled blissfully through the neighborhood, my baby nestled inside a sling. When I got home, I'd breastfeed him, rock him in the rocking chair, then hand him to the baby nurse...or the doula...or the nanny (frankly, I can't remember what on earth the nanny had to do at that point) and crawl back into bed.

I had married into a rich family, so my in-laws were able to pay for these services, which in hindsight seem laughably over-the-top. I mean, I was not Beyonce, for the Lord's sake. What was I doing, other than being pampered?

It turns out that I was "Doing the Month," without even knowing it. Doing the Month is a custom started in Asia 2600 years ago that is still practiced by some traditional Asian women. Asian cultures recognize that the first month following the birth of a baby is a critical period during which a mother needs to regain physical and psychological stamina.

In the first 40 days post-partum, a new mother's relatives cater to her so she avoids stress. She rests in bed as much as possible. Her relatives bring her meals designed for a lactating mother. They keep the baby in another room, taking the infant to her when it's time to breastfeed. This process of mothering of the mother supports her so she can get back on her feet, both physically and psychologically.

UCLA OB-GYN Michael Lu believes that this kind of support network "has a lot of impact on [the mother's] long-term mental health." So much, in fact, that he credits "doing the month" with warding off post-partum depression.

I did not have post-partum depression (PPD) after the births of my children. I felt immensely fortunate and slightly embarrassed to have enough staff in my house to fill a separate wing.

However, I do remember struggling to right myself against a feeling of being unmoored. A feeling that originated, I believe, from my experience as an adoptee.

Although my birthmother is in my life and visited shortly after both children were born, she hadn't raised me and wasn't able to pass on the stories of my babyhood and childhood, the stories that give new mothers an existential context for embarking on their own child-raising  journey.

My adoptive mother was the one with the stories, but she had died two years before my first child was born. I do not have many close extended family members, and none near by, so there were no grandmothers or aunts to rally around and regale me with family anecdotes or bequeath me with the bassinet that had been in the family for generations.

I remember rocking my son in the the rocking chair when it hit me: I would not be raising him in the religion in which I had been raised. I had caved into pressure and converted when I married my first husband, and now I realized, really realized, the loss of part of my heritage.

Religion had never seemed important but suddenly it was. And then I started thinking of all the other things I'd lost, or couldn't legitimately claim: my birthfamily, my adoptive family, a sense of belonging.

Without standing on a secure base of my own, I panicked: what would I have to give to my child?

If I had not had a squadron of surrogate female relatives to make me feel special and cared for, I think I would have had plunged into post-partum depression.

And I would not have had that squadron of surrogate relatives without money.

I don't mean to generalize and say that PPD never strikes rich mothers. I remember being stunned when Brooke Shields went public with her struggles with PPD. We are close in age and I'd felt vaguely connected to her via friends of friends, growing up. I also was once in a store when she came in to use the bathroom and I was impressed by how utterly gracious and unassuming she was. My sense of Brooke was that she was perpetually upbeat and sunny, her mood thermometer fixed at 75 degrees.

Which is remarkable considering that she comes from a long line of childhood trauma. Her grandmother Theresa was orphaned at age ten and became the surrogate mother for her many siblings, one of whom died at thirteen. From Brooke's account, her grandmother grew up to be a sad and bitter woman who transferred her grief onto Brooke's mother Teri, who ran away from home to escape abuse.

From the moment Brooke was born, Teri displaced her own trauma and dashed dreams on to her daughter, and determined to make her a star...which, as we know, is exactly what happened.

Teri also became a florid alcoholic and apparently such a troubled individual that Brooke cut off contact with her for awhile.

Given Brooke Shield's psychological heritage, it is a good bet that whacked-out hormones were not the only cause of her PPD. Becoming a mother brings the intrapsychic chickens home to roost, along with the baby.

Being affluent may not stave off PPD, although it can buy help that women need. Besides sleep deprivation, past trauma and/or social isolation seem like the greatest triggers of post-partum depression. Remember the horrific case of Andrea Yates, whose post-partum psychosis led her to drown her five children? It's worth noting that her husband Rusty purposely left her alone with the children in a sadistic plan to bolster her mothering skills.

So, does being rich protect women from post-partum depression? Certainly being able to afford staff who care for your infant and fix you food and enable you to rest helps. But the thing that most staves off PPD, I believe, is being rich in family: psychologically healthy relatives, or friends, who surround you with the awareness that families are safe, relationships endure, and your touchstones are there for you when you need them.







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Well reasoned story. I do think that being rich may help, in that one can afford that raft of staff you describe, plus any and all necessary and desired medical care. Not having to worry about how to pay for housing, food, utilities, etc., probably helps too. But still, money cannot disinfect every disorder.
Totally agree, Mary. I think being rich in a support network of friends and family is ultimately more helpful.
I can relate to this, Pauline, because of my familiarity with the Asian (in my case Turkish) tradition of being attended carefully for the first 40 days after giving birth. We call it "lohusalik" period. I had my mother who saw me through both, but I still think that PPD is a state of the hormones and the mind. It can still happen even when a new mom is distracted with all kinds of luxuries. I was more worried about having exposed to my innocent, beautiful baby to a world of chaos and disorder with issues of pollution and wars, from the snuggly comfort and protection of my womb.
I didn't have post-partum depression after the birth of my only child, but I did suffer a severe bout many years later. I wasn't rich, either; just the working wife in a well-paid family. Based on my experience with depression that has been diagnosed as biochemical, I doubt there is any connection between household staff and the illness. I could have been the Queen of England and still been laid low by sadness and despair.

I do think wealth helps mitigate the effects of depression in that people have access to more resources. But you're right that ultimately it won't conquer depression -- Christina Onassis is testament to that.
Thanks for your insights, Pauline. I think we have a lot of doublespeak in our country. On the one hand, there are policy makers and managers and CEOs who would like children to be seen and not heard, never making their little selves known in the workplace. If you're going to have a kid, fine, just don't let make a mess out of your productivity or your job. Kids are seen by the work world as a sort of expensive, all-consuming hobby.

Then there is the pro-life crowd--we will bend over backwards to protect your uterus from yourself, and give life status to a zygote, but by golly when you have the little nipper, you're on your own. You have bootstraps, don't you? Pull yourself up already! And get your lazy welfare butt back to McDonald's and go to the dignity of work.

For those who can afford it, like the life you used to have, and for those with an extensive community of support, moms get what they need.

Everyone else is on her own to figure it out.

I love these dispatches that you write from your former life--it really makes me think about the world that the likes of the Romneys live in, and how different it is from mine.
"Becoming a mother brings the intrapsychic chickens home to roost, along with the baby." You may a great point here about the effects of family and community on mental health in general as well as in a mother's postpartum phase. If we each were nurtured by a team of loving, caring experts throughout all of life's trials and crises, wouldn't the world be an easier place?
My guess is that there's more of a chemical base to it. Certainly outside help and support would make everything easier, including the diagnosis of actual depression or psychosis, since you would be able to exclude factors such as loss of sleep that are often blamed.
I love your term rich in family. Recently a date told me that I seemed to be wealthy in people (family, friends, people who care about me). I thought that was such a lovely observation.
I don't think it's known precisely what either PPD or other kinds of depression really are or are caused by but I'm sure stress relief has to help - if not as prevention as protection from the effects of the disease. In other words, as at all other times, post-partum, rich women are better cared for. That can't hurt.

And, if it matters, I know someone honest who used to see Brooke Shields at certain parties pretty regularly and it seems as if she may have inherited the family disease her mother suffered from. She still gives every impression of being, as you say, a gracious and unassuming woman and I hope she's conquered it.
Another great post, Pauline! I like the concept of "doing the month". There is a tradition in many African cultures that the early evening hours (when babies are often crying for no apparent reason) is "grandparents' time". I know women who had the baby nurses, the doulas, the night nannies, the whole shebang. I also know women who had money as well as severe PPD. So I think you are right on that really it is the support network that helps, regardless.
Money never hurts, but it can't really fix anything. A good support system in the form of caring and understanding family and friends are invaluable.
I have seen many poor and middle class people who do and do not suffer post-partum depression. Some of each experience (PPD and not) have histories of family trauma and some don't. Some have lots of support and some don't. I think support is helpful but most of PPD is biochemical.
Money certainly helps make things easier but it's equally as important, in fact more important in my opinion, to have a loving and supportive network of family and friends. Interesting article.
I had minor PPD with all four of my children and no support from family, friends or others protected me or my children from coping with it. Eating well and exercising and meditating helped. An occasional outing without children helped me get through some of the tough times when there was an overwhelming emotional overload, it helped me realize depression doesn't discriminate.
As a childbirth educator, La Leche League leader, and mother of 4, I fervently believe in the necessity of doing the month. And tragically few American women are given the option, even though about 33 percent of them are recovering from C sections. Their mothers often live far away and are still working. Many don't have any paid maternity leave. We support our new mothers worse than almost every country in the world.

I was so lucky that my mom spent two weeks with us after each of my four daughters was born. It made all the difference.
I found this post absolutely fascinating. At first, I sighed enviously over all the help you had with your children - especially someone to feed the baby at night. I was reminded that I'd heard about Asian cultures treating the mother this way, when I read your words. And I found myself worrying, because I have access to neither thing. But then, your conclusion just seemed so reasonable to me. It put things into perspective. From what I've seen with friends of all economic levels who've had or not had post-partum depression, your theory seems to be right. I hope it is. Thank you.
What a contrast from the "having it all" theory. I knew a woman whose plan for labor was to drive herself to the hospital from her office. (Luckily, she worked near the hospital.) Baby? It wasn't going to slow her down. In this modern world, we can conquer tedious obstacles like basic human biology.
What a contrast from the "having it all" theory. I knew a woman whose plan for labor was to drive herself to the hospital from her office. (Luckily, she worked near the hospital.) Baby? It wasn't going to slow her down. In this modern world, we can conquer tedious obstacles like basic human biology.
I don't know that being rich "protects" women from post-partum depression any more than having money and access to the care it can buy protects a woman from any other mental illness. I had PPD after my first child was born although it wasn't called that - I don't think it was even recognized then as a condition. It was scary and demoralizing. I certainly wasn't wealthy but I wasn't destitute either. I do remember wishing there was a drug that would help me feel the way I was supposed to feel - fortunately now there are lots of them. An anti-depressant would have done what no amount of outside help could have.
Many of you have mentioned that underlying predispositions to depression/mood disorders trigger PPD -- and that is absolutely true. I realize not mentioning that in this piece was a rather odd oversight on my part, so thanks to all who pointed it out.
"Doing The Month" great is this! I was kicked out of the hospital after 24hrs because that is all my insurance would pay and the hospital staff actually told me I could leave early without my baby and come back and get her 5 hours later, uh no. How nice it would have been to have a family that supported "Doing The Month" I was job hunting 3 weeks after my child was born, no time for PPD, so yes, I think being wealthy would have helped me, but then again it may have given me too much time to think about how the heck I was going to raise this little one. Good post! Rated.