Facing Risks, Finding Resilience: A Review of Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America

May 23, 2023

A couple of years before becoming a mother, I saw the classic movie Terms of Endearment. Before the opening credits, the film portrayed Aurora, played by Shirley MacLaine, as a worried mom who checked on her baby every five minutes in the middle of the night and expected the worst. In the baby’s bedroom, she stared at the crib of her infant daughter and imagined crib death: “Rudyard, she’s not breathing,” she gasped to her husband in the next room. Then she shook her daughter awake from her quiet, peaceful sleep. And as the baby cried, Aurora claimed, “That’s better.”

Moviegoers everywhere laughed, though sudden infant death syndrome is one of the top fears of new moms, as Sarah Menkedick says in her searing book, Ordinary Insanity. Scientists do not understand the cause of SIDS or know how to help prevent it besides putting infants to sleep on their backs. Extensive media coverage stokes the fear of SIDS, leading to a perfect storm of dread that obscures the facts. “The actual percentage of babies who die of SIDS in the United States is .0000625,” as Menkedick points out. “Not 1 percent, not 2 percent: .0000625 percent. Yet for many women, avoiding SIDS becomes the single most important focus of their early days with their babies.”

These moms are not total outliers, as the data shows. Over 40 million Americans struggle with anxiety, but it’s especially common in pregnancy and the immediate period after birth. Ninety-five percent of new mothers are haunted by obsessive compulsive thoughts, according to one study Menkedick cites. Another estimates that 17 percent of mothers live with clinical levels of anxiety that disrupts their every waking moment. Yet doctors and researchers make few efforts to ease their plight, so fear remains a silent crisis among American moms.

Their reluctance to speak out reflects deeply rooted stereotypes about “female hysteria, overreaction and noisome presence,” as Menkedick points out. “Mothers should be invisible, should be in control and self-sufficient, and at the same time should patiently and studiously absorb a nonstop stream of medical and cultural haranguing about dangers, expectations, needs and shoulds. They should just be able to handle it, just be natural.” And living up to the current ideal of single-minded, self-sacrificing motherhood, Menkedick grimly concludes, has created “a degree of anxiety and guilt in mothers that is unparalleled in history.”

Hence the frantic women whose stories Menkedick relates as she fills the silent crisis with their voices. One told Menkedick that she’s “terrified of everything.” Another wore ankle weights to stop herself from sleepwalking and perhaps hurting her baby. One was manipulated by her obstetrician into voluntarily admitting herself for psychiatric evaluation and wound up placed on a 72-hour hold at a hospital ward geared toward people detoxing from drugs. Then there was the sleep-deprived young mom whose anxiety was so high, she leapt out of bed one afternoon when she heard noises coming from the kitchen because she imagined someone was putting her baby in the microwave oven. None of these moms received proper help until they either found it themselves or hit dangerous levels of stress.

Neither did Menkedick after the birth of her daughter, Elena, while her family was living in a nineteenth-century cabin. “For me, it began with mouse poop,” she recalls. It was innocuous but she feared it could kill her baby and went on a cleaning frenzy. And that was the start of a widening circle of fear. “I was afraid of the mouse droppings, glyphosate in Quaker Oats, the toxins given off by my new mattress, fracking chemicals in the air, fracking chemicals in the water, preservatives in granola, synthetic fabrics.” Her whole life felt like a “held breath,” and Menkedick came to realize she needed help because anxious mothers become obsessive risk managers who make anxious children.

The many mothers like this reflect the influence of our current “risk society,” as Menkedick explains. Though we are “the healthiest, wealthiest and longest-lived people in history,” we also have access to a wealth of information that leads us to fret about a wide range of threats in daily life: the plastics in our toys, toothbrushes and T-shirts; the cars that emit carcinogens and might someday smother our planet; asthma-inducing carpet mites and the cholesterol in fast food. Nearly everyone has some fears, but emotion plays a crucial role in how we evaluate risk and studies have shown that people are wildly inaccurate in judging the actual dangers they face.

Take child abductions for example, Menkedick points out. The vast majority of them are the result of children running away from home or being taken by family members, and most of the children return in less than a day. The actual number of children who are kidnapped by a stranger is 90 per year in the United States, which puts the risk for the average child at .000015 percent. But dramatic media coverage of these rare instances ignites strong fears that blur the line between uncertainty and danger.

Mothers are most prone to these skewed perceptions, Menkedick points out, because their brains rewire in pregnancy to make them natural protectors. Then society stokes their natural instincts, Menkedick goes on to say. “Stories about the fragility and infinite potential of children are so prominent in our culture, mothers’ judgments about risk are bound to be off the charts” as they focus on what they fear most. “In a risk society both safer than ever and tormented by the possibility of a rare catastrophe, mothers are bound to drown in risk.” So, mothers contend with self-imposed restrictions that stop them from living rich, full lives and limit their children’s lives, too.

Prevailing concepts of the zero-risk child and the good mother who keeps her child completely safe are the culmination of outdated social mores and medical myths, psychiatric beliefs and superstition, Menkedick explains in sweeping breadth. She tells us how the ancient world viewed motherhood as a source of power and how the Renaissance saw the Virgin Mary as a model for the humble matron at home. She explores the impact of psychoanalysis and its ideas about female hysteria, prejudices against midwives and attacks on them as witches. She shows the influence of the fight for women’s rights and ‘50s ideals of the perfect household, the passage of the Social Security Act and the beginnings of welfare. In addition, she pays close attention to the legacy of slavery and how systemic racism leaves its mark on Black women, who are now far more likely than white women to die of pregnancy-related causes and develop post-partum depression, whatever their economic status.

The stresses of motherhood also make an especially strong impact on Black moms because the “strong Black woman syndrome” makes them reluctant to seek help. “I think that Black women are forced to be strong,” as one woman told Menkedick. “It’s not choice,” so the mom didn’t even dream of seeking help until her daughter began having anxiety attacks around age three or four. “It was through her journey that I began looking at my own reactions and behavior,” the mom said, looking back at her progress from depression to mental health.

She went to a mental health conference to learn more about her daughter’s issues and one of the presenters taught her something that stuck with her for decades, as she recalled. “If you have high blood pressure or gestational diabetes, you go to the doctor. It’s very matter of fact. But when it comes to your mental health, Oh, now they’re going to think I’m crazy.” Still, “there’s nothing wrong with seeing a therapist,” and the mom finally did. The experience led her to earn a certificate as a doula who guides women through pregnancy counsels them post-partum and listens to their stories of struggle.

Menkedick’s personal story had a happy ending after she was diagnosed with O.C.D. and received the therapy that she needed. In the process, she not only conquered her crippling fears but also learned the importance of not sacrificing her identity for the sake of her child. “The moments when Elena is happy playing dress-up while I cook or write in my journal,” she reveals, “or when she sits on the bed with my husband and me and play-acts reading her book while we read ours are my favorite experiences of family life.” To establish this kind of intimacy, a mother “needs to reclaim herself, to find space in which to breathe and grow,” as Menkedick now knows. A mother’s affirmation of her own needs and desires is essential to having an authentic relationship with her child.

And this message made me think back to my own experiences as both a new mother and a young child. When I was a little girl, my mother, Winnie, found me on the floor holding a little spider. My mother was terrified of spiders and wanted to scream but remained silent, as she recalled. She held herself back because she didn’t want her child to be afraid of spiders, she explained to me when I was an adult. By then, I was also a mom, and I wasn’t the least bit afraid of spiders. But I was facing my own fears for the safety of my son. Sometimes, I, too, felt like going off the rails as I fretted about my active, adventurous little boy. And when I did, I found resilience by recalling some wise words that my mother said: “The best thing you can give a child is a calm, fulfilled and happy mom”—like Winnie has always been. She has been with me through trials and triumphs. She’s always supported me while preserving her own sense of self. And there are few terms of endearment that can express just how I feel about her.


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