• Afaf Alfawal, with her son Zach, sought treatment for postnatal depression. (Supplied)
The growing conversation around postnatal depression still neglects the ways in which experiences of early motherhood are shaped by factors such as culture and race.
Neha Kale

29 Oct 2018 - 6:00 AM  UPDATED 29 Oct 2018 - 9:09 AM

Afaf Alfawal always wanted to have a baby. But the bubbly 26-year-old, who comes from a large Lebanese-Muslim family and suffered anxiety as a teenager didn’t expect the apathy she felt towards her newborn son.

“Zach was three months old and I woke up one night and couldn’t pick him up — I felt this unexplainable dread and fear,” she recalls. “I started having panic attacks and intrusive thoughts of something bad happening to myself or to my baby. In Arabic, there’s a word for ‘I’m not myself’ but there’s no word to describe depression. In Middle Eastern culture, having a child is supposed to be this healthy, amazing thing. There was this idea that it was selfish for me to feel how I was feeling. I didn’t tell anyone for months.”

Alfawal consulted a checklist provided by Perinatal Anxiety and Depression Australia (PANDA), an organisation that supports Australian mothers and fathers who suffer from post-natal depression and anxiety. She recognised the symptoms and confided in an aunt who provided solace. She sought the help of a psychologist who prescribed her medication that was compatible with breastfeeding. Once she started to get better, she realised that she was far from alone.

In Australia, one in seven women and one in 10 men suffer from post-natal depression and anxiety according to statistics from PANDA. These figures are more alarming given that in 2013 the Federal Government cut the National Perinatal Depression Initiative (NPDI), a screening and counselling program that aimed to treat the illness during its early stages.

The ways in which women experience and respond to post-natal depression is also complicated by political and cultural factors such as race and ethnicity. March 2017 research from Western Sydney University and the St John of God Health Care and School of Psychiatry found that 20 percent of women from migrant backgrounds experience symptoms of post-natal depression and this is one and a half to twice as likely when compared with non-migrant women. And January 2016 research from the University of Buffalo found that nearly 38 percent of low-income mothers from African-American and Latina backgrounds experience mental health issues, with nearly 60 percent lacking access to support.

I struggled to explain my [post-natal depression] to my parents, aunts and uncles because they’d all had eight, 10, 13 children and somehow managed to do it without a mental health condition

Verona* didn’t predict the turmoil that would mark her first months in Australia. The former civil engineer, 51, was three months pregnant when she immigrated from Chile. She was thrilled at the possibility of life in a new country. Then, she found herself wracked with panicked thoughts in the months following her son’s birth.

“There were social factors such as the isolation of moving to a new country, but I had an unexpected problem during labour and wasn’t able to walk properly,” she says, flinching slightly as she recalls that period of her life.  “I was dealing with the stress of looking after a child in that condition and didn’t have any support. I started to develop irrational fears that my kids could get sick and that nobody would be around to look after them. I was trying to navigate a new world I didn’t understand and didn’t quite know what was normal and what wasn’t.”

The growing conversation about maternal ambivalence — buoyed by books such as Sheila Heti’s Motherhood and Jacqueline Rose’s Mothers — is shedding light on the ways in which the ideals of motherhood can deviate from reality. But by perceiving the experiences of being a mother exclusively through the lens of white womanhood, it also risks erasing the challenges women of colour face.

Antoinette Lattouf concurs with these struggles. But Lattouf adds that the Arabic community’s experience with physical trauma has seen less awareness around less visible kinds of trauma like post-natal depression. She says that her own experience of illness was exacerbated because she lacked a blueprint for being a Lebanese mother and a professional woman at the same time.

“I struggled to explain my [post-natal depression] to my parents, aunts and uncles because they’d all had eight, 10, 13 children and somehow managed to do it without a mental health condition,” says Lattouf, who’s now an ambassador for the Gidget Foundation, an organisation that raises awareness around the illness and a senior journalist at Network Ten. “When I didn’t have that bond with my child, I was dreaming of being back at work because that was an environment in which I felt I thrived. But that wasn’t something that I thought I could share with members of my community because so many of them have chosen to have children and stay at home full-time.”

Jessica Friedmann is drawn to the word ‘matrescence’, a term, conceived by the anthropologist Dana Rafael to describe the “period of psychic and physical change in which a woman becomes a mother.” But Friedman, who’s the author of Things That Helped, a collection of essays that meditates on her own experience of post-natal depression, says that it’s important to remember that motherhood is a political category — one that’s defined not just by biology but by race, sexuality and disability as well as the sociocultural systems that shape our world.

“In Australia, we have a really difficult time speaking about any health crisis that is caused by psychosocial factors,” she explains. “We want it swept under the rug — whether by sentimentalising motherhood or by not providing sufficient services for new mothers in psychiatric crisis. But post-natal depression is a public health crisis, and it’s only by treating it as such that we’ll make any progress.”   

*interviewee declined to provide her last name

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