Mapping the web of stressors related to modern American motherhood
stressor web version 1... a work in progress but gotta start somewhere!
I have to admit, I love watching the way friends and colleagues react when I mention my goal of ‘mapping the stressors of modern American motherhood’. It usually accompanies an ‘oh, just a little thing?!’ comment, or something similar. Almost as if we have all accepted the inevitability and consequences of the stress along this journey to and through motherhood.
While, yes, some stressors are absolutely inevitable (e.g. colicky baby waking up every hour on the hour = sleep-related stressor), some are more nuanced (e.g. gender imbalance in the home = mental labor load stressors) and some represent societal failures to adequately support this stage of life (e.g. underfunded public child care system = caregiving-related stressors). Head back to this post for a quick overview on why I use the term ‘stressor’:
The map below is the starting point. It’s a reference to make the invisible, visible. It’s a guide for gathering evidence on how aspects, events, and exposures related to being a woman, a mother, a birthing person, and/or a caregiver in America are connected to our health via stress pathways. It’s the acknowledgement that most ‘stress management’ recommendations are strategies NOT solutions and we need to extend beyond individual responsibility and coping in order to have a real impact on health.
This map (ok, it’s more stressor web than map) is on a long, iterative journey to the final1. I’ve had brilliant minds weighing in for this draft but there is still a lot of work to do2.
Stressor web, version 2 (updated 8/28/2024)
If this makes your eyes glaze over and your brain hurt, that’s pretty normal.
This map is at its magic eye puzzle stage (👋🏽 fellow ‘90’s teens). I will be zooming in and zooming out in future posts. Consider this a reference point.
Version 1 is in the footnotes below. This version is an extension of the first version to include later life and older children.
This extended version captures where I am in life – the zone of elementary aged kids with one rapidly approaching tween-dom, in a body cruising towards perimenopause, and a family caregiving lift that will likely start to pummel me in the coming years. There is a special kind of “isolation” during this stage of life that I am interested in exploring (maybe this stressor node extends or maybe it lightens up and resurfaces later, as currently depicted… to be investigated!) I have a similar “double bubble” thing going on for identity conflict (this one also needs a deeper exploration).
Even though this version was updated, I still consider this as a starting point. Read on below for more guidance on how to read this thing at this early stage and how the concept will be expanded and applied in the road ahead (and hopefully become a whole lot prettier).
Key elements in the map:
Stressor nodes
Time
Connections between nodes
Color
OPPORTUNITY
Stressor nodes
Nodes = those oval shapes with titles. Yes, they are wonky and the color coding not perfect (more on that below) but, hey, gotta start somewhere.
The nodes of the web represent potential psychological stressors related to being a woman, a mother, and/or having a birthing body3. The specific nature of the psychological distinction means that stressors are detected and perceived by the brain first. These stressors do not cause direct physical harm or concern but have the potential for indirect physical health concerns by over-activating the stress system. Head back to this post for a refresh on this distinction:
The nodes are layered – far too layered for a diagram attempting simplicity. Future posts will peel back the layers of each node. When I shared an earlier version of this map with an amazing sociologist focused on mental labor load, she pointed out –”for ‘social narratives,’ what if you introduced a whole series of social narrative bubbles in a unique color, that appear at different points of the timeline? Like, ‘myth that mothers are less productive at work’, ‘Myth that breastfeeding is the only good mothering option’, ‘myth that breastfeeding is free’. To my sociologist friend – YES, all these things and more!
I fully acknowledge that there are still stressors missing and things that might need to be separated. For example, women’s pain (and the experience around it) was pointed out and I :
What did I miss?
Relationship with time
Another thing you may notice – the timebound(ish) nodes at the top half versus non-timebound nodes towards the bottom.
The timebound nodes most directly relate to the act of having and/or raising a child as a mother in America4. These might be longer for some, shorter for others, stronger for some, insignificant for others. I started by centering around pregnancy → birth → postpartum to capture the dramatic physiological shift that birthing parents experience. Across the reproductive lifespan, the cycling body experiences other dramatic shifts (e.g. menopause), and starting with a focus on the changes of the perinatal period allowed exploration into how the natural changes in the body make individuals more at risk for stress-related illness (here is my very academic take that I will break down in a future post).
I have started to expand up and through perimenopause/menopause and include stressors related to having tween/teens + additional family caregiving responsibilities, ageism in society and the workplace, health care access, etc.
The bottom half of the map is my attempt to capture the full scope of stressors that too many mothers in America – especially Black and Brown mothers and those in other marginalized communities – are exposed to more often than white, middle- to upper-class mothers. These same stressors often fall in the category of social determinants of health, for non-stress-related and stress-related reasons. I recognize that, from where I am situated in life and training, I have blindspots in these areas. To explore the layers of these nodes, I will be working closely with academics and leaders who are experts in this space (thank you to Dr. Brittany Chambers and Dr. Kobi Ajayi for critical insight conceptualizing at this stage) and I welcome any and all feedback along the way.
Starting with a broad map is not to say ‘you have it bad but so many more people have it worse’. This map is intended to be individual, personal, AND universal. If you could highlight the nodes that apply to your life (one goal is to make this map interactive) – you will likely not hit all of them… but you will hit a bunch. You are still swimming in stressors. You still deserve solutions and options and support. Expanding out emphasizes the intersectionality of the issues we are dealing with on a grander scale. Expanding out allows those of us who are not experiencing the daily, life-long stressors to see, yep, it is not shocking that a maternal health crisis exists that disproportionately affects Black and Brown women. It allows for highlighting and supporting the important work and valuable solutions in this space… and the urgency of them.
Connections
Another thing that makes this map a little dizzying are the lines going in every direction. I intended to have a beautiful web with clean and clear connections between nodes but as I added more, I realized… the nodes are pretty much ALL connected. For example, I spoke with a friend who had a history of miscarriages (a layer within the fertility journey node) to test a small area of her map connections specifically related to miscarriage – after an unsympathetic response to a late-term miscarriage, she feared discussing her pregnancies at work (workplace), she watched her friends get pregnant and have healthy babies while she struggled (isolation/loneliness) and she ultimately went the route of IVF (another layer within fertility journey) which affected her family finances (financial stability). When she did become pregnant, every sensation in her body woke her up in a panic (sleep stressors), and, as a high-risk patient (pregnancy complications) she constantly juggled additional doctor appointments and other responsibilities (mental load). The word ‘miscarriage’ alone affected her and how she felt about her body’s ability to carry to term (social narrative).
Another aspect of the connections between stressor nodes is to capture the relationship between the external stressor and the way the brain perceives and filters that input.
We feed external signals through more processing centers in our brain than nearly every other species.
The more connections or the stronger the connections or the more uncontrolled or unpredictable the stressor or connected stressors, the greater the health risk from an overall stress impact. BUT, when the load is lifted on connected stressors, when connections between stressors are weakened, when stressors occur with a perception of control or predictability, when stress buffers alleviate the gravity, the stress responses and the related health risk of the overall stress, can be reduced.
Solutions to limit, ameliorate, buffer maternal stressors exist within AND between stressor nodes.
Did I miss any connections? Chime in in the comments!
Colors
I started with three color categories that relate to the birthing body + parenting (black), general stressors women face but have a heavy relationship with birthing and parenting (purple), and stressors that speak more generally to the experience of those who identify as mothers and/or are just humans existing in America (grey). This last category includes stressors that may be experienced across the lifespan and generationally.
I updated this in the 8/28 version:
One slightly different category in blue – gender neutral stressors related to parenting and family caregiving. I am assuming they are gender neutral but If I find that these do, in fact, have a gender bias underlying the stress load, I will switch them back to purple (the stressors that disproportionately affect women and mothers). The black stressor nodes still reflect stressors related to living in a birthing body – the fertility journey through pregnancy (chosen or not) and birth experience. And the gray boxes are general stressors in life / modern society that connect to any and all of the above.
The positive side
The web and all the connections between nodes represent OPPORTUNITY. Opportunity for change. Opportunity for solutions. There are stressors we can ameliorate today and there are stressors we still need to start laying the groundwork for tomorrow. There are stressors we can weigh for ourselves and those around us at an individual level, and there are stressors that will require monumental social change.
Most importantly, if we visualize how everything is connected, we can start to see how certain solutions will have a widespread (and possibly, exponential) impact across multiple stressor nodes.
As noted in the Stress 101 post:
“we cannot ignore a body at risk for negative health outcomes or that real opportunities exist to prevent that body from tipping over the edge into an unhealthy state. Reevaluating and centering stress in a different way allows a more impactful view for risk analysis and preventive care. New opportunities for health solutions exist in the space separating external stressors and internal illness.”
First, we need to see every stressor. So, let’s start here.
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Here is the first version that was first included when I first published this piece:
YOU are also a brilliant mind and come to this with your own experience and expertise so please feel free to leave a comment on other aspects to should consider as this map adapts.
“Mother in America” is simplified copy for a category that can (and should) be more expansive. There are societal stressors related to the expectations/requirements of parenting and caregiving, as well as stressors related to the identity of ‘mother’ in a personal and cultural context. There are also stressors associated with and related to the physical act of birth running alongside the physiological changes associated with pregnancy, postpartum recovery, and lactation — acknowledging that not all birthing people are mothers or associate with the title ‘mother’.
So, yes, the term ‘mother’ is an imperfect catchall for both the societal and physiological sides of this coin and the project craves a more inclusive term. Please chime into this post to make recommendations as I learn and grow in this area.
see above!
Molly, this is such a (maybe somewhat?) obvious point that I’m sure has already occurred to you several times over. But it clicked in my head as I was reading through all of your work. We know that the number one killer of women is cardiovascular disease/heart disease. What is cited as a preventative measure? You guessed it - “just manage your stress!”
So maybe, stress is actually the #1 killer of women when we think about this in terms of your map and how all roads lead back to stress in some way. However, I also know you said in the "A quick(ish) lesson about stress" that stress doesn't exist as a clinical term/diagnosis (only in the subclinical space is it recognize). How do we reconcile with the idea that stress seems to be a primary contributor/risk factor to so many other diagnoses and health issues?
Hi Molly, amazing work. Unrelated fields, but see how SCOR represented connected data here with frequency and intensity depicted (see bottom left caption): https://dcm.ascm.org/. Click on big circles then little circles to see it change. As for the map itself, one thing is missing for me (in a heteronormative marriage) is the stress on top of it all of also having to maintain (work at) a marriage. At one point or another, a husband can be like having another toddler, and that is a cause of maternal load and an more stressor.