Mothers Under Pressure

In an unusual confluence of transformative historical events, 1984 saw both the debut of the Apple Macintosh, with its monumental impact on personal computing, and the publication of What to Expect When You’re Expecting, the pregnancy guide that would go on to sell more than 22 million copies—the book a fire breath of terror conveying all the potential catastrophes of a poorly managed womb. Technology would eventually alter both the psychology and the practice of American parenthood, allowing us to surveil our children, their caregivers, one another. Over the next several decades it would drive new fears, obsessions, judgments, and exercises in self-recrimination.

Much of what disturbs and transfixes us about technology and parenting today were phenomena still far in the distance during the early 1980s, when the study of child development kicked into an unusually vigorous period distinguished by a growing body of work on infant perception. Around the world, video recorders and computers were making possible easier and more refined means of monitoring how babies respond to stimuli, resulting in an increasingly sophisticated sense of what they know and when. It became possible to find a child, four days into his life, in a steel bassinet beside a simulated nipple hooked up to a computer—the machine chronicling the movements of his mouth as the baby might suck, or not, in response to a random series of utterances coming from a loudspeaker. Researchers were determining what sounds were recognizable to someone so tiny. Between 1978 and 1983 the number of studies on infant cognition tripled.

Technology was offering more than mechanical utility; it was providing a new paradigm and language for the considerations of the nursery. “The baby is a friendly computer!” Jerome Kagan remarked in 1983 as he was leading the field of developmental psychology at Harvard. Building on the work of attachment theorists, researchers were bringing a deeper focus to the exchanges between mother and child, examining subtle shifts in maternal expression and their effects on a baby’s disposition and adaptability. What if, after a long, beleaguering commute at the end of the day, the face a mother brought home to her baby registered only a worn-out vacancy? Was this a problem? Indeed it was. Psychiatrists had begun talking about “interactivity” and the “two-way circuit” between parent and child as increasingly important aspects of how infants and toddlers processed their surroundings. Mothers, especially, had to mood up.

New standards for connection and new ways to measure infant capacity inevitably meant new opportunities for parents to feel inadequate. The baby, analogized as software, demanded something novel—the parent no longer occupied merely in the role of watchful caretaker but charged also with the work of vigilant programming. The market intervened quickly to exploit a mounting collective insecurity. With an expansion financed by venture capital, Gymboree, an outfit specializing in educational play spaces, for example, grew to 125 franchises by 1984. The company was conceived and headquartered in—where else?—Silicon Valley, with promotional material proclaiming that “learning to read begins at birth.”

If the modern child needed to tackle Hello, Mrs. Piggle-Wiggle before she left the maternity ward, she had better arrive in the world in fighting shape. What to Expect When You’re Expecting set the mother-to-be on the proper course to ensure her baby’s fitness of body and mind. Under the book’s tutelage, pregnancy became its own occupation and tyranny.

Maniacal attention was to be paid to every nutrient consumed, every chemical possibly encountered, every unpleasant feeling experienced physically or emotionally. Early editions of the book sternly discouraged refined sugar, anything fried, white flour. Dark breads were not free of suspicion either, because there was always the chance that they had achieved their brown coloration from dubious additives—who knew what sort of disloyalists lurked in the production plants at Pepperidge Farm?

It does not take a particularly conspiratorial mind to find, in the years of the incipient tech revolution, the roots of nearly every overwrought habit in modern American parenting—the template for a pattern that has gone unbroken. The technocracy now needed recruits and a growing market for what it produced. Was the country up to it?

Washington itself had become apprehensive. In 1983 the Reagan administration released A Nation at Risk, an agitated report on the state of American education, full of dire proclamations about declining SAT scores, unchallenging curricula, and the “rising tide of mediocrity” that threatened the country’s stature in a global economy driven by information technology. School, in the view of the authors, had become too soft—beholden to solving “personal, social, and political problems” at the expense of providing facts, science, rigor.

Auguring the era of high-stakes testing, the report had the effect of returning childhood to the service of the GDP. The previously dominant ideals of John Dewey—focused on the intrinsic value of learning and the enrichment of the “whole child,” emotionally, socially, academically—had given way to a creeping neurosis. Seven months later, that neurosis was coddled even more thoroughly with the introduction of the US News and World Report Best Colleges Ranking. Of an authority entirely self-devised, it forever reshaped American bourgeois adolescence as a strategic initiative.¹

It was during the early 1980s that many forces coalesced to set the modern era of maternal anxiety in motion. Just as women entered the workforce in unprecedented numbers, the laissez-faire parenting style that had defined the previous three decades—a style in which the various responsibilities of child-rearing were shared with television, the frozen-food aisle, Jane Jacobs’s “eyes on the street,” and the random neighbor in 3F—came in for stampeding indictment. Now mothers were always to be “on,” engaged in relationships with their children that were at once kinesthetic, tirelessly management oriented, and unrelenting in their emotional solicitations.

Across demographics, American mothers have absorbed the cultural pressures to beat the odds, whether that involves navigating charter school admissions in West Baltimore or shepherding the diligent but ordinary son of Winnetka toward Yale. In place of universal childcare or federally subsidized paid leave—both of which were included in President Biden’s stalled Build Back Better agenda—mothers are left scrambling to find formula amid a pandemic shortage spurred on by inflation and issues with supply chains. What they can relish instead is the output of a multi-billion-dollar industry in parenting advice. The United States may not equal Sweden in what it offers new parents—which amounts to little more than hostility—but it is surpassed by no foreign power in its ability to manufacture the illusion of control over the single human endeavor in which we have the least. Amazon currently offers 60,000 titles in its parenting category, which caters to increasingly niche agendas.² License to Parent, for example, comes to us from two former spies who promise a “distinctive approach to raising confident, security-conscious, resilient children” with “practical takeaways rooted in CIA tradecraft.”

Emily Oster cannot tell you how to incubate a career in covert ops, but for several years now she has presided over what those drawn to her TED Talk energy earnestly call “the parenting space.” Oster’s rise is a phenomenon as much as it feels like an inevitability. Three decades of neoliberalism, with its abiding faith in the logic of the market, its addiction to credentialed innovation over dronish experience, was bound to produce someone like this reigning over the fraught world of childminding—someone who is not a pediatrician or a psychologist or a person especially philosophical in orientation, but rather, in Oster’s case, a Harvard-trained economist, the daughter of two Yale economists, who herself teaches economics at Brown. (My husband also teaches at Brown, in the English department, and I have enjoyed talking to Oster on a few occasions in Providence.)

Oster’s galvanizing idea is that the outsized stresses of modern parenting are best relieved with the help of statistical inquiry and business-school paradigms for making this choice over that—the spreadsheet as sedative. Her work stands at quite a distance from that of her predecessors. Dr. Benjamin Spock arrived, most famously, in 1946, with the Common Sense Book of Baby and Child Care amid a mood of postwar euphoria; the book went on to become one of the best-selling of all time, counseling women to trust themselves. We find ourselves, however, long past the fashion for instinct. “Economists’ core decision-making principles are applicable everywhere. Everywhere. And that includes the womb,” Oster wrote in her first book, Expecting Better, welcomed by women as a necessary counteroffensive against all the restrictions that the culture of childbearing had imposed on them.

When Oster was pregnant with the first of her two children, she had questions her doctors could not answer definitively. This bothered her. Could she drink wine? One or two glasses a week were “probably fine,” her doctor tells her. But as she puts it: “‘Probably fine’ is not a number.” Immersing herself in the research, sorting through hundreds of papers to parse the figures and identify all the falsehoods, Oster determines that a drink a day in the second and third trimester is OK (and one every now and then in the first, fine as well) because she found “no credible evidence” that consumption at that level had “any impact” on a baby’s cognitive development. Even if that were unequivocally the case, any woman faces an increased risk of certain cancers and other illnesses if she is drinking daily.

Susan Hemingway, the director of Washington State’s Fetal Alcohol Syndrome Diagnostic and Prevention Network, was among those who disagreed with Oster’s position when the book arrived in 2013. At her clinic over the past twenty years, she wrote, one out of every fourteen children diagnosed with fetal alcohol syndrome had a reported exposure of just one drink a day. In her view, then—the view of someone who had been conducting laboratory and public-health research on fetal alcohol syndrome since 1981 and who created the world’s largest database on the condition—it was best for pregnant women to heed the advice the surgeon general’s office has given for decades and abstain.

“As an economist, Dr. Oster concludes a drink a day during pregnancy is safe,” Hemingway wrote. “As a pediatric epidemiologist, I conclude a drink a day is not safe. So which of us is correct?” Oster argues that an insistence on total avoidance is “ridiculous” in part because so many things carry risk. “Tylenol overdose can lead to liver failure,’’ she writes, and yet it is “routinely suggested to and taken by pregnant women.” Leaving aside that Tylenol is not addictive, Oster’s position ignores the distinction between needing relief from physical pain and wanting a gin and tonic to make dinner with the legal team more tolerable.

In 2019, Hemingway’s research on siblings revealed that fraternal twins exposed to the same level of alcohol in utero could have very different outcomes because of variations in genetic vulnerability. Given that you could not know how the baby you were carrying might react, she determined again, there really was not a safe way to drink while pregnant. Regardless, a new conventional wisdom had evolved outside the medical establishment.

Oster’s popularity is rooted to a great extent in how reliably her conclusions, derived from all that cool, methodical number crunching, manage to align with what her cosmopolitan readership would like to hear. Early in the pandemic, she became the country’s most vocal proponent of in-person learning, an ultimately important message appreciated by parents like me who had had enough of virtual meetings interrupted by tiny fists banging on the door demanding grilled cheese. It was not a message that spoke to parents who were out in the world experiencing the devastation of Covid’s first phase. These parents, though, are not Oster’s constituents.

Decades earlier, Spock—who in 1972 ran a fringe presidential campaign on a platform of capped income, free medical care, and closing corporate tax loopholes—sought an ecumenical reach. Oster has essentially confined hers to the psychographics of Audi drivers. In a country where the top 10 percent of earners own nearly 70 percent of all wealth, what marketer would have possibly advised her otherwise? The movement around child-rearing that emerged in the 1980s and endured so robustly is defined above all by its insularity, a march led by and for the knowledge class.

A century earlier, the last time that the business of childhood had come up for radical reevaluation, it was Progressive reformers who were at the vanguard—single, educated women from wealthy families driven beyond any sense of social myopia to improve the lives of tens of thousands of children immiserated by the realities of industrialization. It was this spirit that Spock and proponents of the Great Society carried with them. But as a matter of social conceit and political priority these principles soon lost their currency. By the 1980s the fate of poor children was no longer central to the tenets of a dominant Republican Party that was vastly different from Teddy Roosevelt’s. Under Ronald Reagan, the balance of federal childcare funding shifted, with the amount of money going toward benefits for middle- and high-income families doubling, and the amount spent on low-income families drastically reduced.

With a practiced relatability that never quite convinces, Oster leaves us with a twist on the Socratic notion that an unexamined life isn’t worth living—the impression that the unquantifiable isn’t necessarily worth considering. Moving to stay with you through various phases of your child’s growth, Oster has come forward most recently with The Family Firm: A Data-Driven Guide to Better Decision Making in the Early School Years. Here the contradictions between her call for more laid-back parenting and her complicity with some of the most insidious habits of the achievement class emerge in higher relief. In the book she tells us that as her children got older, she realized that what she taught students about running companies could be used to better organize her family life. That the revelation surfaces as she is scheduling a meeting with her eight-year-old to discuss the upcoming school year, a conversation for which she has used Google Calendar and prepared draft documents, suggests she had been getting her kitchen-counter McKinsey on long before.

The book has Oster advocating for a procedure she calls “The Four Fs,” which, she believes, will help parents resolve difficult conundrums (the Fs would have you “frame the question,” “fact-find,” make a “final decision,” and “follow up”). Among the questions she imagines you might submit to the approach, we come upon Should I send just one of my kids to private school?—the modern-day Sophie’s Choice.

Oster can present herself as a spirit guide to “relaxed’’ parenting because she is not prescriptive, because her tone is genial and free of explicit judgment—she is the one inviting you to pour the Côtes du Rhône, after all. Dealing with screen time, she won’t tell you that video games are a pox. That would be ideological, uptight, and off-brand. Rather, much like someone who, laying out a snack buffet, positions the broccoli florets next to the fudge and simply leaves things to you and your Apple Watch, she asks readers to think about the attendant “opportunity cost.” What else could your child be doing instead of playing Roblox? If the child is an eleven-year-old boy in the middle of a pandemic I can promise you that the “what else’’ isn’t going to be sitting down with As You Like It. In effect, you should always be maximizing, always be closing. Oster presents as a beta-blocker and lands like a hit of speed.

Seventeen years ago Judith Warner’s book Perfect Madness: Motherhood in the Age of Anxiety became a touchstone looking at the cult of perfectionism that compelled middle-class women toward a style of parenting that demanded both professionalization and a prairie-home attention to domesticity if their children were to succeed in an increasingly competitive world. Warner had lived in France, where parenting was not a Darwinian affair, where she observed mothers enjoying themselves and avoiding the drama of school choice because the school down the road was more than adequate. Noting that presidential polling in 1996 and 2000 revealed that what American women really wanted was more “time”—an ease to family life best enabled by the kind of entitlements the French government provided—she advocated for a “politics of quality of life.” We had already made this commitment to one subset of parents, she argued, subsidizing luxury spending through the Bush tax cuts that disproportionately benefited the rich.

In the years since, the vast majority of American women have certainly not found themselves on the receiving end of the politics she envisioned. A much-publicized study in the Journal of Marriage and Family, in 2016, revealed that mothers in much of the Western world (though not France) were averaging nearly twice as much time on childcare when compared to their counterparts in 1965, even though many more of them were now working. Currently, only ten states and the District of Columbia have enacted paid family-leave programs. In 2021 North Dakota actually went in the other direction, passing legislation prohibiting cities and counties from implementing these ordinances on their own.

Dependably, though, Big Tech has stepped in where political will has failed, “disrupting’’ motherhood with its efficiencies. Two decades ago, Harvey Karp, then a popular Los Angeles pediatrician, became a kind of guru with his book The Happiest Baby on the Block, which drew on non-Western traditions and the wisdom of the ancients to teach modern parents how to soothe their infants to sleep. Mechanizing those habits was bound to prove more lucrative. In recent years Karp has raised tens of millions of dollars in venture capital to back what has become the cornerstone of his empire—an app-assisted robotic bassinet allowing a parent to track, as one online reviewer put it, “emerging trends” in a newborn’s sleep patterns. The SNOO, as it is known, will run you about $1,600. But in keeping with the fictions that support Silicon Valley’s trickle-down understanding of equity, it is available for rent at $160 a month, or as Karp put it in an interview with Forbes, a cost amounting to a daily “Starbucks cappuccino,” money “poor tired parents are already spending.”

Over the course of the twenty-first century so far we have normalized maternal anxiety as a malaise of the privileged and a marketing opportunity—the price of doing business in a rigged meritocracy. The notion behind Sarah Menkedick’s book Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America is that it has become something far worse, a pervasive psychological affliction, underreported and too little studied, alienating women from their best selves and their children.

An essayist and once-adventurous traveler, Menkedick emerges from giving birth to her daughter terrified of everything. Living in places far from Amtrak’s Northeast Corridor, the women who populate her book suffer under a similar spell—the kind unlikely to be broken by the warm Turkish towel of data sets. Early on, we meet someone who worries that she’ll sleepwalk, enter her daughter’s room, and harm her unknowingly. To prevent this, she wears ankle weights; when this feels insufficient she tethers herself to her husband in bed.

To a rational mind, this might seem crazy and over the line. But where, precisely, is the line? We valorize obsession when it comes to the stewardship of young children, muddling the ability to distinguish between sick and well, Menkedick argues, between protective fear and its oppressive stunt double. For a long time after my son was born, twelve years ago, the horror movie playing in my head all too frequently had me tripping on something—a magazine lying in the stairwell, as I was holding him—causing him to take lethal flight from my arms. It didn’t matter that our subscriptions were all received digitally, that I kept the floors relatively free of paraphernalia. No probability expert could have steered me from my certainties. Oster and many others would tell you that anxiety is a problem when it interferes with your ability to “enjoy” your baby, but a mother under the influence is not measuring her perseverations against the possibility of pleasure—she is Joshua charged with leading the Israelites safely across the river to Canaan.

“Anxiety begins like an abusive relationship, with a twisted agenda masquerading as excessive concern,” Menkedick writes. It is also a state of mind buoyed by a kind of grandiosity—the idea that you alone are aware of all the various scenarios that could lead to CT scans and the most horrific news and remain the only one equipped to prevent them.

A decade ago, feelings like this were little discussed, and by Menkedick’s telling not much has changed, Substack be damned. Depression continues to command our focus in the area of postpartum mood disorders. From the vantage point of society, the depressed mother is a problem—inert, flattened by her apathy, her indifference endangering. By contrast the anxious mother operates in overdrive—evangelically cautious, safeguarding, detoxifying, buying things. The difference in social utility would seem to go a long way toward explaining why maternal depression has been at the center of so much research while postpartum anxiety has attracted less interest. And yet nearly every psychologist Menkedick speaks with sees the latter in patients far more than the former. One of the few studies on the subject, a 2013 paper that appeared in the journal Pediatrics, found that anxiety was three times as common as depression among those observed.

Too often, if women don’t meet the criteria for depression, they are considered fine. Too often anxiety is regarded merely as evidence of an underlying sadness rather than the illness itself, which complicates treatment—assuming that a new mother has the wherewithal to seek it out, and assuming that she can find good care when she does, which generally is a lot easier in Cambridge or Santa Monica than it is in, say, rural Ohio. The subjects of Menkedick’s book in many cases come up short. One woman, left with a doctor who fixates on an imagined potential for suicide when the patient is struggling with intrusive thoughts that have nothing to do with self-harm, is asked if she has ever heard of Brooke Shields. (Shields has spoken openly about wanting to kill herself after her children were born.)

Developed more than thirty years ago, the most widely used screening tool, the Edinburgh Postnatal Depression Scale, presents ten statements, each accompanied by a selection of responses signaling levels of agreement or disagreement. Only three of the ten address anxiety, and they are framed reductively: “I have been anxious or worried for no good reason.” A new mother—or for that matter a mother five or fifteen years at it—is anxious for the very good reason that she has been entrusted to keep a vulnerable human being alive.

If she was prone to dread before, she might wonder why she elected to introduce so much more of it into her life. Any expression of regret, however, is distinctly forbidden. It is safer to say, in liberal company, that you avidly support the death penalty than it is to suggest that your decision to have children was terribly misguided. Imagine the isolation of a woman in a post Roe v. Wade world who has to bring up a child she feels sure she cannot properly care for in the first place.

Draining anxiety is often the price a mother subconsciously exacts on herself for the sin of her ambivalence. If she is over forty, bending toward the hypochondriacal, she will fixate on her body—the possible lump, the odd emission, the intermittent pain. Would it have mattered if she died when there was no one around to depend on her? Now, in a contract devoid of any expiration or loophole, she demands another fifty years. If she is poor, she bears the fear of falling under the patrolling eye of the child-welfare establishment—a sink stacked with dirty dishes in Park Slope is another tedious item on a to-do list; in parts of the South Bronx it can easily turn into an entry in a case file. If a woman has felt disempowered her whole life, she might struggle to understand the power her words hold in a new kingdom of her own creation. The maternal mind, a woman will discover, is a potter’s wheel in endless rotation, on which the delicate vessel containing her worry only keeps getting taller.

Covid, of course, made everything worse—introducing new fears, further exposing the fault lines in a precarious childcare system. Provided with the chance to be around our children all the time, we had only paradox to give them—emotional absence embodied in near-constant physical presence. Women drank—especially women with young children.³ Children retreated to online worlds; parents, defeated by exhaustion, generally felt helpless.

Into this strange, discomfiting moment landed an entertainment that, speaking to the hunger for reprieve from so much stifling domesticity, found particular resonance. In The Lost Daughter, the film adaptation of Elena Ferrante’s novel, a middle-aged academic named Leda goes on holiday and becomes fixated with a young mother who is depleted by caring for her toddler. The two form a bond steeped in deceptions, but during a moment of candor Leda confesses that when her own daughters were young she left them for three years. The woman asks her what that was like and Leda tells her that “it felt amazing,” a disclosure whose subversion is blunted by the tearful, penitent spirit in which it is conveyed.

Audiences found the film liberating, revolutionary, even as it holds back on any clear acquittal of Leda’s transgression. Whether she gets away with it—or whether the gods deliver devastating retribution many years later, on top of the emotional unraveling to which they have already subjected her—is left to a purposefully ambiguous ending that asks the viewer to draw her own conclusion. We may have reached a point where we feel free to affirm that mother-love is, as Rachel Cusk put it more than twenty years ago, a “conflict” with “no possibility of resolution,” but we are hardly in the business of granting mercy.

In his 1949 paper “Hate in the Counter-Transference,” the British psychoanalyst D. W. Winnicott took it as an article of faith that a mother “hates her infant from the word go.” He cited nineteen reasons why this would be the case, among them that the baby is “ruthless” and “treats her as scum,” that she must tend to him constantly while betraying none of her anxiety, and that “if she fails him at the start” he’ll embark on a lifelong pursuit of revenge. What amazed Winnicott is that any mother could endure all this—“her ability to be hurt so much…and to hate so much”—without enacting her own retaliations, choosing instead to wait for “rewards that may or may not come.”

At its cruelest the culture of contemporary child-rearing brings guilt without solution; at its most deceptive it channels capitalism’s dubious promise that “rewards” come to those who do the work; at its most venal it gives us the filial relationship not as a sacred bond but a value proposition—the child is not “father of the Man,” in Wordsworth’s famous declaration, but the son of Mountain View. At its most alienating it leaves all but the very fortunate behind; at its most mistaken it sidelines the impact of volcanic emotion—rage, ecstasy, grief, longing—forever at the center of the parenting project, imagining that these feelings are easily subjugated to reason, goal-setting, the prospect of healthy choices made under the tent of evidence. Oster doesn’t speak to the woman on the verge; but she has plenty to offer anyone who can deny the precipice.

Guiding a child through the world demands above all a still embrace of uncertainty, a recognition of your psychological cracks, the will and energy to shore up what is reparable. How to proceed? “Your life was ours, which is with you,” the poet John Fuller wrote in a meditation on parenthood. “Go on your journey. We go too.”