That time a study about access to parental leave inadvertently showed us that how we define mental health is capitalist as hell, and also wrong

Let me start by saying I support the ever-loving fuck out of paid parental leave. Imma say it again: I’m an old school commie feminist, and I support the ever-loving fuck out of paid parental leave.  Not because it improves outcomes for kids (as claimed by highly questionable science; more about that later). Not because it promotes breastfeeding, and white feminism says that breastfeeding is a valuable commodity, and not because some segregationist said it enhances the bond between babies and mothers (and its always mothers, always gendered), like mothers who work three jobs to make ends meet could love their children any more than they do in a world where economic justice is so far out of reach.  I support the ever-loving fuck out of paid parental leave because we are more than units of production, whether that production is material goods, emotional labor or our offspring, and because I believe that all people have the right to make autonomous decisions.  I support the ever-loving fuck out of paid parental leave because I believe in justice.  And paid parental leave is a question of reproductive justice, economic justice, racial justice, disability justice, all the justice, and so I support the ever-loving fuck out of it.

So some fancy-ass researchers did a study in which they compared what defined as the the mental health of women in Europe who had had different amounts of paid parental leave. (And again, it’s always women, and we’ll talk gender in just a bit, but shout out to the dads, and to the parents of all genders and to the older siblings and the one safe adults doing the mundane and exhausting and so much else work of keeping kids safe in a capitalist world that views them first as commodities and secondly as ripening investments in a broken system.)  This study looked at what they defined as “older women” (over 50, with an average age of 65, and a large standard deviation, which means that there was a big age range) who were included in an already existing database of people the researchers claim represent the population of Europe as a whole.  People in their 50s and beyond usually haven’t given birth recently (and therefore taken a parental leave), but people who were surveyed as part of the database lived in countries with maternity care policies that had changed over time, and so researchers thought that this would be a good way to look at the long-term impacts of maternity leave policies.

This bring us to the first problem with this study: The researchers only looked women in this database who gave birth when they were between 16 and 25, and the youngest person in the database was 50.  That means that at least 25 years, and likely many more had gone by in between the time maternity leave policy was most relevant in a person’s life and the time she was asked to report on her current level of depression. A lot can happen in 25 years.  Some of it might be related to maternity leave policies, in that a country that supports parents taking leaves might support families in other ways as well, but most of it will be entirely unrelated, unless we view paid parental leave as way of determining a society’s commitment to equity, and to undoing racism, but it’s pretty clear that the authors don’t.  I’m saying this because I read the study’s methods section carefully, and I take issue with how the researchers set up the study, and defined many of their variables.

The authors used what’s called a difference in difference design, which means they first grouped women by whether they were working or not when they gave birth to their first child, then looked at differences among women in each group. In other words, they found a group of women who had been employed and compared those women to each other.  They also compared women who had not worked to other women in the group of not-employed people.  Their rationale for only including people who had their first kid when they were 16-25 was that younger women were less likely to pick jobs based on whether they offer paid parental leave or not, which as far as I can tell is based on nothing but assumption.  This is some classic white feminism framing, that where we work-and thus our access to the resources needed for health and well-being-is purely a product of individual choice, and that feminism’s end game should be more women (prolly white) leading the capitalist machine and joining the 1%, when really it’s about burning the system to the ground and dancing our way through its ashes to a system that values everyone’s humanity, but I digress.  Though in my world, feminism has always been about not what choices people make, but what choices are available, and to whom, and the overall context in which we make choices.

Who is working when they are 16? Not the children of the 1%, that’s for sure.  Probably people who are just scraping by as young parents, especially in all the places where paid parental leave pays at half one’s usual salary and is thus unaffordable because their landlord hasn’t taken maternity leave, and neither has the electric bill.  And here we are back at access to the resources needed for well-being, but also at the social forces that determine who has access to these resources.  The authors don’t mention racism or white supremacy here, and it appears to be off their radar, but school funding and police violence and unemployment and health care isn’t colorblind; our whole entire world is really fucking far from colorblind, to paraphrase the brilliant Eve Louise Ewing. There’s some variation across Europe,  I’m sure, but there’s a lot of overlap between young parents who can’t afford to take even paid parental leave and the young parents most marginalized by racism, classism, ableism, segregation, hiring discrimination, generational trauma, patronizing treatment in health care settings, lack of police follow through on sexual violence against us, structural violence in general, and cultural genocide.  Which, you know, are things that could also just a little potentially maybe so fucking much be correlated with depression later in life, or at any point, really.  And with whether one can get appropriate support or treatment for their depression, or any other mental health concern they experience, and whether their doctor will believe them and go to bat to help them access the care they need.

And I haven’t even really gotten to my point, which is about how the authors defined mental health impacts later in life.  This was really just depression in the last 12 months, as measured by a standardized survey, the Euro-Depression scale,  which asks people if they had experienced 12 supposed symptoms of depression in the last year, including tearfulness, pessimism, death wishes, guilt, decreased enjoyment, or changes to sleep or appetite. A person is considered depressed if they have 3 or more of the 12 symptoms. See any cultural bias here? Any perpetuating of colonial ideas about stiff upper lips? Any de-contextualizing or dismissals of very real experiences? I’m just gonna put out there that if I were a second generation immigrant in Britain, I might be enjoying my life less after the Brexit vote made clear that my family and I are unwanted targets, and if I were a French Muslim of North African descent, I might be experiencing pessimism, sleepless nights and tearfulness about all the racist rhetoric, fear-mongering and hatred directed against me and my community.  Let me be clear here: depression (or any other mental health concern) can be biological, and it can be social, and it can be an interaction between the biological and the social.  We have had mental illness and neurodiversity for as long as human beings have roamed the earth, and it has always been complex, quite a lot more complex than whether people who had maternity leave 25 years ago had 3 or more culturally mediated symptoms within the last 12 months.

In science, its considered good practice to have what’s called a mechanism of action, or a way to get from point A, in this case parental leave, to Point B, depression later in life. The standards for being able to prove your mechanism of action are generally pretty low, but this study hits a new and very misogynistic low point.  So here’s their reasoning:  “Maternity leave policies may also have indirect effects on mother’s mental health. A period of leave shortly after birth may improve mother–child relationships and reduce the risk of later disorders in children (Brockington, 2004), which may in turn improve maternal well-being in older age.”  That’s right, when mothers (and its always mothers) stay home, they may have better relationships with their kids, to the point that their kids will have less likelihood of having later, unspecified but definitely scary sounding disorders later in life.  Later in life like when the mothers are older than 50, and just sitting around waiting to be depressed by their grown children’s unspecified but definitely scary sounding “disorders”. Women over 50 aren’t depressed because of their own biology or brains, or because of cultural genocide, rising fascism and anti-Muslim violence, referendum votes that clearly inform us that we are unwanted in the country we were born in, police violence, racism and the stress it entails, or any number of other actually occurring, actually documented things, no.  Women over 50 are depressed because over 25 years ago, they didn’t properly bond with their infants (as they worked their asses off to provide for said infants, coming home late at night to watch said infants sleep, then rising 4 hours later to pack a school lunch before rushing off to another job to pay for the food inside the lunchbox); and now said infants have grown up to have “disorders.”

This is a giant claim, and a gendered one.  It’s misogynistic, and ableist, and classist. And it’s not backed up: if you follow the chain to the article the authors cited to support their claim, you find a very generalized and medicalized overview of how to treat maternal postpartum mental health issues.  There’s nothing about kids, save for a note that people experiencing postpartum psychosis might have difficulty bonding with their infants.  Few studies of outcomes for kids are cited, and there’s certainly nothing to suggest the dreaded “disorders” in grown children that supposedly cause women in their later years so much suffering.  It’s an ableist, pathologizing view of mothers (and it is always mothers) and the trauma they experience within the medical and psychiatric care systems.  It has a paternalistic tone and treatment suggestions that ignore the actual person experiencing the mental health issue and assumes anyone with a medical degree knows more than she does within 10 minutes of meeting her, but that’s psychiatry, not proof of the authors’ flimsy as fuck mechanism of action.

The authors continue, though: “Women with a prior episode of depression are more likely to experience divorce and marital difficulties, and to have a spouse with psychiatric disorders (Hammen, 2003).” To which I say, a. no shit, sherlock.  When I was married to a domestic abuser, my life was full of isolation, late night strategizing as my abuser slept, and episodes of depression, and I thank all the heavens above that I was more likely to experience divorce, cuz my other option was a body bag, and had my life had less of the patriarchy that leads to depression, i also might not have married it, but that world is far away; and b. this information about depression is related to parental leave how, exactly? Is it that if we have maternity leave, we will be better wives who react less depressed-ly to the conditions and oppressions that manage our lives?  Hammen, the single reference cited to support this claim, has remained silent on this confusing issue.  And to make it more complicated, there was no way in fuck I could have sought treatment or support for my patriarchy-induced depression when I was with my abuser, because he would have hurt me if he found out, but also because the mental health care model that was accessible to me didn’t acknowledge the patriarchy at the root, and saw me, and my staying with him, as the problem.  Now, several untreated head injuries later, with impacts on my mental health that feel mostly biological, I wonder if the mental health care system would see the interaction between my biology and my world, but I dont want to risk it.

And here’s what I wanted to get to when I started writing this, mental health as a collective, communal concept that is tied directly to our collective access to justice as much as it is to our individual biology. In other words, our mental well-being is inherently tied to our environment, and the context we live in, which in turn is determined by the pervasiveness of oppression, and our personal exposure to it.  So I’m just not sure how researchers can define depression by whether or not we experience pessimism in a world where optimism is a commodity available to the very few who wield too much of the power.  And I don’t think we can look at differences in depression rates when only some of us can afford or are offered treatment. Our sleep changes in capitalist economies when our worth and how much we love our kids is viewed as directly proportional to how much time we can earn with them, and the system is already slanted against us. And here comes science focused on protecting our aging mothers from our dreaded, unspecified disorders, but not on making sure we all have the same opportunities to raise our children in the  way  we see fit, in an environment free from fear and poverty. So you’ll excuse my side eye, and my pledge to donate a dollar to SisterSong Women of Color Reproductive Justice Collective every time I hear this ridiculous study described as cutting edge, meaningful, smart, strong or any other adjective that would be more properly ascribed to the parents who love their children so fiercely that they go to work to put food in their mouths and have bonded with their kids so strongly that they resist economic injustice.

But here’s how the authors set it up, as quoted in a Harvard news pieceWe hypothesized that the lack of paid maternity leave might have long term or “scarring” effect as people get older. While the analytic approach we used is complex, the bottom line is not—women with several months of maternity benefits with full wages were 16.2% less likely to be depressed than women without paid maternity leave…..A period of leave shortly after birth may improve mother-child relationships, which may in turn improve maternal well-being in older age. Women with prior episodes of depression are more likely to experience divorce and marital difficulties.

I don’t think their conclusions are as straightforward as they do.  Scarring effects, huh? May improve mother-child relationships, you say? The authors don’t offer any evidence for these improved relationships, just like they don’t offer any real evidence for their claim that children whose mothers are home with them have fewer disorders and better maternal-child relationships.

So here’s a new idea: could we argue for paid parental leave because  we are more than units of production, whether that production is material goods, emotional labor or our offspring, and because all people have the right to make autonomous decisions in supportive, equitable contexts? Could we explicitly link our collective mental health to our collective access to justice, and our collective affirmation of neurodivergent and mentally ill people and their worth and truth?   Could we define positive outcomes as heightened justice, increased equity, real and true intersectional feminist systems that support our collective well-being and refuses to shame individuals? Could we acknowledge a world past capitalism, and begin to define our mental health in terms of our inter-dependence and our diverse spectrum of neurologies, instead of our production, material, emotional and offspring?  We’d have to talk about parental leave, not maternity leave, and not mother-blaming, and we’d have to maintain our focus on collective justice, and collective health, and death to the capitalist machine. And we could dance in the ashes, starting with this dumpster fire of a study.

So bottom line, we are in this together and we are the resistance, whether or not research can handle it, and we gotta keep justice on our horizons.

In love and solidarity,

Nechama

 

 

 

 

 

And this is where I start to throw down with the white feminist “count breastmilk and maternal-child bonding as part of the gross national product so we can prove that maternity leave is important after all” crowd.

As a former midwife, sure, breastfeeding is great, if its your thing.  But the vision of younger moms as lacking autonomy and needing

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