But what about the children?
But what about the children?
I have some thoughts on that question.
When I started socializing this grand experiment, I would often hear feedback along the lines of: “you should consider including child health outcomes too…”.
This suggestion is similar to the experience amongst maternal health researchers who focus on the maternal side of the equation. As
pointed out in her 2018 article on the maternal brain, common feedback for maternal mental health researchers, when they submit grant applications or manuscripts for studies that focus specifically on the maternal brain, often includes the question: “what about the offspring?”I find that problematic.
Now, I do love children. I love babies. I want all the babies in the world to be born healthy and live healthy lives. I want them to have healthy mothers and healthy caregivers. I also want the mothers and caregivers to be healthy because THEY ARE ALSO PEOPLE who deserve a healthy life. Full stop.
Here are my thoughts on why this project will not revolve around children’s health:
There are plenty of people already researching, writing about, and working on children’s health as it relates to maternal stress. Great, smart people. The childhood health space doesn’t need me.
I 1000% agree that considering the mother-infant dyad (especially during pregnancy and early postpartum) in health research is critically important. But, when the only research, writing, and work focuses on child outcomes, the message that parents (especially birthing parents) receive is “don’t stress… for the baby’s sake.” That message fully lays the blame and responsibility for stress management on the person sporting the baby oven – which, ironically, adds further stress! The Maternal Stress Project aims to distribute that responsibility to all levels of relationships, community, and society so for now I’m keeping the “don’t stress” language where it belongs: embedded as a layer in the social narrative stressor node.
Pregnancy is lovely. Motherhood is beautiful. We need mothers to survive and stay healthy for the sake of their children. I am starting to think that this view is what has stymied interest in general women’s health. Case in point: perimenopause+menopause. Perimenopause/menopause is another critical inflection point for women’s health in the reproductive lifespan. This point is even less researched and less supported medically and culturally. I have a theory on this — when it is just a woman’s body, a cycling body, that is changing, it does not register with the same level of importance as when there is a sweet, innocent baby to swoop in and rescue. Maybe if we continue pushing a reframe of the easy one, pregnancy, as an adult health issue, we will more readily acknowledge a child-agnostic stage, such as menopause, as an important health consideration as well. (Side note: the map should absolutely extend across the entire reproductive lifespan of the cycling body. Perimenopause/menopause + motherhood/caregiving deserves its own map entirely and I hope to jam on that sometime soon.)
Too much focus on the child can be dangerous for the mother. We live in a society where absolute prioritization of the baby/child during pregnancy, infancy, or childhood, is considered the best way to reduce risk without factoring in any degree of risk to the mother or birthing parent. An extreme example from our post-Dobbs world, we’re seeing this happen for cases of nonviable pregnancies where there is zero regard to the real risk of negative maternal physical or mental health outcomes related to birth or the trauma of carrying/delivering a stillborn. In other cases, prioritization of child health might lean solutions towards removal of the child from a mother’s care. For example, this study on maternal mental health, published less than ten years ago, investigated the value of child care for clinically depressed mothers. Now, I’m all about accessible child care as a way to improve maternal mental health BUT the conclusion of the study was not that. Instead, their study design and the resulting conclusion emphasized the importance of removing children from their depressed mother’s care, rather than the importance of helping mothers by treating/preventing depression.
Children grow up. If children’s health = human health, can we at least try to continue caring for the human after they’ve aged out of child status?
Sorry, kids. This one is not for you.
A little follow up
After I initially wrote this piece, I had a fantastic conversation with
(see the start of this conversation in the comments below with more to come in an upcoming post) about the circle that is child health affecting caregiver/parent health affecting child health. Both impact the other. It’s a circle. And the circle is important to consider.But it’s a lopsided circle. The child health → mother/caregiver health side of the circle has been historically deprioritized in research, healthcare, societal views, and everything in between. This deprioritization has created the lopsided circle. And while the mother/caregiver health → child health side of the circle is also not as complete as it needs to be (I appreciate you, Sehreen!), I, personally, want to contribute to beefing up the side focused on impacts on maternal/caregiver health, not impacts of maternal/caregiver health.
In 2019, Dr. Jodi Pawluski and I discussed elements of this in the context of maternal mental health. The paper titled: “Pregnancy, a final frontier in mental health research” for Archives of Women’s Mental Health examined it this way:
“There are many reasons why research on peripartum mental health lags behind other fields. At its most basic level, pregnancy and postpartum are hard to study. The body changes, physiological processes shift, hormones rise and fall to levels that do not naturally occur at any other time of life, model systems in the lab are imperfect models for human pregnancy.
Studying pregnancy also carries an added complication—the health and development of the fetus. And, unfortunately, we must consider that we live in a society that doesn’t prioritize women’s health.
Research and funding tends to focus on the infant when it comes to mother-infant dyad; a mother’s mental illness becomes a *risk factor* for the developing child, rather than a focal point.
This is a false choice, of course; a mother’s health should carry equal weight and equal importance to the health of the child.”
Equal weight. Equal importance.
I’m just trying to balance out the lopsided circle.
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The fact that you get that pushback is a reflection of how society really can't focus on the health of anyone that isn't a heteronormative man. There's really no reason to lump women's health and kids' health together; they each truly merit their own investigation and consideration. Yes, there can be a very strong dynamic between certain elements of the two (I often say that kids' health is also a maternal health issue, as I'm a medical needs mom whose mental + physical health was severely compromised) but the fact that we're all fighting for visibility and are being forced into an either/or or everyone together approach essentially reflects a MUCH bigger problem in healthcare equity and research.
Thx for this--I relate to this so much! I'm no researcher, but just as a female patient it's been bananas to me how much medical research on women is neglected, including reproductive research. Which, you you know, the species depends on!!