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Understanding Your Moods When You're Expecting - The Conspiracy of Silence
by Lucy J. Puryear, MD

Recently, I received a phone call from my friend Janice, who was pregnant. Janice had suffered two miscarriages in the first trimester, and all of her friends were concerned about her ability to carry this baby to term. When I called her back, the first thing I asked was, "Are you okay?"

"I'm terrible," she said. I held my breath. Her voice made me think she had lost the baby. When she complained about her bad morning sickness, I was relieved.

An award-winning journalist, Janice had put off getting pregnant until she finished a major investigative series for a local newspaper. At first she couldn't conceive, and then she miscarried. This time Janice seemed to be holding on to the pregnancy. But she was also struggling with the hormonal symptoms common in early pregnancy. She couldn't think straight, she was so tired she couldn't get out of bed when her alarm went off, and she had terrible morning sickness. Her emotions were changing from moment to moment, and she had come to the conclusion that her career was over.

I did my best to comfort her. I told her that the hormones that protect the fetus also can produce many of the symptoms she was experiencing. She understood that intellectually, but my generalizations didn't touch her where she lived. She told me that friends who didn't have children couldn't empathize with her; they couldn't imagine it being that bad. They thought that she shouldn't complain. After all, this pregnancy was working, unlike her earlier attempts, and they'd been present for her tearful losses so many times. She imagined that they were thinking, "You shouldn't be complaining. You tried so hard to have this baby. You should be grateful. I can't believe you're being so selfish." She felt extraordinarily guilty for wanting a baby so badly and now being so miserable.

Nobody had said to her, "Janice, you're not a bad person; it's not your fault. Yes, you feel miserable. Sometimes I felt miserable, too. But you will feel better."

Then she told me that her writer friends had warned her that she would never again write the way she had before getting pregnant. Her mind would be permanently changed by motherhood; she'd have "mommy brain," and she'd better prepare for life without the great career she had begun. Even if she was able to think intelligently again, she would be so consumed by diapers, baby food, and Barney that there wouldn't be time to express what she thought.

"What?" I yelled into the phone.

"Well," she said, "isn't that true?"

By now I was angry. I reminded her of the prize-winning writers who had children, the full-time volunteers who had children, the women heads of state who had children. Janice was in a weakened condition, and she was vulnerable to old wives' tales. We talked for about an hour, and then she asked me why nobody else had talked to her the way I did.

Why do so many mothers keep the whole story of pregnancy from their daughters? Why do so few women help each other by admitting their fears, worries, and ambivalence during pregnancy? Why isn't there a body of honest lore and comfort for women embarking on motherhood to draw on? There's certainly a difference between telling the truth and scaring a new mother. There's no need to overdramatize how difficult life is when you have children. But there's also no need to pretend that it's easier than it really is. That approach only sets women up to feel like failures when things don't go as smoothly as they appear to for everyone else. In response, women struggle to keep their mouths shut, not wanting to admit that they are the only ones who don't have a clue about this pregnancy and parenthood thing.

I think this conspiracy of silence has many causes. The first is amnesia -- biology's way of keeping the species going. If every mother remembered in detail all the woes and pains of pregnancy and delivery, Homo sapiens would have died out long ago. But amnesia isn't enough to explain the silence. Perhaps people don't want to scare pregnant women or make them hyperalert to all the possible downsides of pregnancy and motherhood. Or maybe they don't want to admit that being a mother is a very hard job.

One of the biggest reasons for the silence, I think, is that there is a cultural taboo against mothers having mixed feelings. Pregnant women are icons in our society: strangers touch their bellies, people on elevators give them advice on breastfeeding and diapers, and their every public action is scrutinized. Icons don't throw up all day or feel overwhelmed about the future. Mothers are sacred; they will always love us, and they will always think we're wonderful. If we allowed mothers to be real people with real feelings -- if we admitted that mothers sometimes don't enjoy being pregnant or don't feel like taking care of their children -- we'd also have to admit that sometimes our own mothers might not have been all that happy with us, every minute of the day.

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I was reading People magazine recently and saw many beautiful movie stars beaming at the camera, showing off their big bellies or looking just wonderful as they held their newborns. It made me feel bad for all the pregnant women and new mothers who had the time to leaf through this magazine. I wanted to call out to them and say, "Don't imagine that's what you're supposed to strive for. They are ten deep in help! The makeup and hair people spent hours on them! They are crying just like you, and their episiotomies hurt them, too. They just aren't telling. And the reason they're back in their tiny jeans six weeks after delivery is that their personal trainers went to the hospital with them."

I discussed all this with Janice, who admitted the secret name she and her husband had given the fetus: TDC (That Damned Critter). I let out a whoop of laughter, and I could hear in her voice such a sense of relief that she had told me everything and I still wanted to be her friend. She was beginning to realize that her feelings were part and parcel of being pregnant, and she felt a lot better about her future -- as a writer and as a mother.

The above is an excerpt from the book Understanding Your Moods When You're Expecting by Lucy J. Puryear, M.D.
Published by Houghton Mifflin; June 2008;$24.00US/$32.95CAN; 978-0-618-34107-8
Copyright 2008 Lucy J. Puryear, M.D.

About the Author:
Lucy Puryear, author of Understanding Your Moods When You're Expecting, is a practicing psychiatrist specializing in women's reproductive mental health. She has been director of the Baylor Psychiatry Clinic, Baylor College of Medicine, and was an expert witness for the defense in the trial of Andrea Yates. She is the mother of four and lives in Houston, Texas. For more information, please visit: www.LucyPuryear.com.

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