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How Motherhood Became A Diagnosis

What once was recovery and renewal is now coded as a psychiatric risk.

By Hannah Spier5 min read
Pexels/Alexander Mass

A century ago, the postpartum period was understood as recovery and renewal. Today, it’s treated as a psychiatric event. Rates of postpartum depression diagnoses have doubled in the last decade, and policy groups now call for universal mental-health screening of all pregnant and postpartum women. The once-modest claim that “one in seven women experience postpartum depression” has become a mantra—repeated in medical journals, wellness campaigns, and women’s magazines alike.

It looks like progress. Like a culture finally caring about mothers. But behind the language of awareness lies a worldview that quietly recasts motherhood itself as a risk factor. What should be a beautiful and strengthening journey of womanhood and a contribution to society in a way only women can, deserving of reverence and respect, has been rewritten as a vulnerability, a condition said to place women at risk for long-term psychological distress.

How Motherhood Became Dangerous

It’s the legacy of an ideology that spent half a century trying to separate motherhood from womanhood. Feminism told women that fulfillment could be found anywhere but in the home, and psychiatry, eager to confirm cultural trends, followed suit. Once motherhood was declared optional, the next step was to make it look dangerous. What better way to discourage it than to warn women that it might make them sick?

The clinical expansion followed. In 2016, the U.S. Preventive Services Task Force recommended universal depression screening for all adults, explicitly including pregnant and postpartum women. Three years later, it went further, urging preventive counseling for those “at risk.” The American College of Obstetricians and Gynecologists soon echoed the call, advising multiple screenings before and after birth. What began as a call to awareness became obligation: today, most obstetricians are required by insurers to screen. And where clinicians are trained to look for depression, they usually find it.

It’s a reminder that good intentions still need good evidence. And the foundation for this entire screening push is thinner than it seems. The famous “one in seven women experience postpartum depression” figure comes not from diagnostic interviews but from self-report questionnaires, tools that flag transient distress, not illness.

Behind the language of awareness lies a worldview that quietly recasts motherhood itself as a risk factor.

Still, this prevalence rate has been repeated so often that the word “postpartum” itself now sounds pathological. Over the past two decades, psychiatry’s growing surveillance has been matched by an explosion of academic and media attention. Between 2000 and 2020, research on postpartum depression multiplied severalfold. What began as a niche topic is now a global field of study. At the same time, news coverage ballooned. Stories of struggling mothers vastly outnumber those about fathers, whose mental health after birth is rarely discussed. If the same attention were given to men, the story would sound very different. We wouldn’t be told that babies make women sick. We’d be asking whether we’re doing parenthood wrong.

This imbalance, as well as the language used to describe it, shapes what mothers expect, what clinicians look for, and what women come to believe about themselves.

For example, a recent Danish study of hundreds of thousands of women describing a dramatic increase in the rate of postpartum depression concluded: “We need to examine more closely why they develop postpartum depression and what can be done to offer support during a vulnerable time.” As if vulnerability were an inherent state of motherhood.

What is built into mothers, in evolutionary terms, are the very traits psychiatry now calls symptoms. Vigilance, sensitivity, and heightened alertness evolved to protect infants from danger. What the Edinburgh Scale scores as anxiety may actually be attunement to the baby. But stripped of context and community, those ancient instincts turn inward, and what once served a child’s survival becomes a woman’s diagnosis.

From Support to Surveillance

Modern psychiatry loves a biomarker. Talk of hormonal shifts, serotonin levels, and neurobiological changes dominates the postpartum conversation, giving the impression that mental illness blooms spontaneously from a woman’s body. But the data tells a different story: in large cohort studies, nearly half of the women later diagnosed with postpartum depression already had a prior psychiatric history. In other words, the condition often isn’t caused by childbirth; it’s a continuation of a pre-existing syndrome, simply renamed.

Despite that, the diagnostic lens keeps tightening. The same feelings that once belonged to “baby blues”—sadness, fatigue, and loss of control—are now treated as symptoms of pathology when they persist beyond an arbitrary two-week cutoff. The distinction is subjective: it depends on who’s listening and what they’re trained to hear.

What was a human response to strain becomes evidence of disease.

A mother saying, “Some nights I just sit and cry because I feel like I’ll never catch up,” might sound to one listener like the normal exhaustion in the language of someone adapting to seismic change. But to a clinician attuned to risk, it can register as diagnostic: “depressed mood most of the day, nearly every day.” From that moment, the tone of care shifts. What was a human response to strain becomes evidence of disease.

It’s a striking demonstration of how careful we have to tread around psychiatric diagnoses. In more traditional societies, the same sentence would have triggered a different kind of intervention. A mother, sister, or neighbor might have said, “Let me take over while you go get some sleep, and we will prepare a nice meal for us.” Knowing that rest, reassurance, and company are often all it takes. Where clinical systems reach for labels, communities once reached for one another.

Beware of the Questionnaire

Then come the screenings. The ten-item questionnaires designed to detect suffering in every new mother. The questions are so vague they could apply to anyone awake at 3 a.m. with an infant: Have you been anxious or worried for no reason? Have you felt sad or unhappy? Have you felt everything is on top of you? Have you had trouble concentrating? Trouble sleeping? Answer a zealous clinician in the affirmative that it’s lasted longer than two weeks, and it fulfills the criteria for a serious disease. A sleepless mother circles “sometimes,” and suddenly she’s already halfway there.

There’s little mention, meanwhile, of the protective forces of motherhood psychiatry once took seriously: attachment and stability. Decades of research show that strong family bonds, consistent caregiving, and a sense of meaning in motherhood are powerful buffers against psychological distress.

Priming Women to Expect the Worst

Legacy women’s magazines play their part in this conditioning. They don’t just report on postpartum depression; they stage it. Their essays follow a familiar script: radiant pregnancy, abrupt collapse, redemptive self-care. A recent Vogue feature begins with a mother describing how friends warned her that she would “die without a night nurse.” After giving birth, she writes that sleeplessness made her feel as though she actually might.

The fear sells. The story climaxes with salvation at a luxury retreat: a 48-hour stay at a coastal resort that “rescued” her from despair for $1,500 a night. Their advertising leans on the same vocabulary psychiatry made famous: risk, prevention, and self-care. But this isn’t support. What mothers need isn’t a spa to recover from motherhood; it’s a community that still believes in it.

Feminism taught women that motherhood would erase them and oppose their identity. Psychiatry simply offers the scientific seal to fear their biology.

The diagnostic frontier keeps widening. What was once a short-term mood disturbance has now become a chronic identity. Researchers increasingly list “long-term depression” among the risk factors for postpartum illness, and legacy women’s magazines have begun asking, “Why aren’t we talking about long-term postpartum?” The suggestion is clear: motherhood doesn’t just unsettle you; it changes you permanently. For the worse.

The language has shifted from temporary adaptation to lasting harm. The idea that motherhood could make women stronger has been replaced by the assumption that it leaves them scarred.

Feminism taught women that motherhood would erase them and oppose their identity. Psychiatry simply offers the scientific seal to fear their biology. What should be a season of integration and pride is presented as a crisis in need of intervention. This is how cultural messaging primes women, long before pregnancy begins, to meet motherhood with trepidation.

The Psychological Background

There’s also a psychology to this that we rarely acknowledge. Pregnancy, in modern culture, still carries a certain prestige. A pregnant woman is treated with tenderness; she belongs to a collective story, noticed and cared for. But the moment she gives birth, the attention dissolves. She moves from the center of concern to the periphery. Her friends, still childless with careers still in motion, quietly move on. While she has to grapple with belonging to a group she was taught to resent.

What’s described as postpartum depression may often be the pain of exile: the sudden loss of status, attention, and belonging.

What’s described as postpartum depression may often be the pain of exile: the sudden loss of status, attention, and belonging. It’s a failure of transition.

What Mothers Really Need

We inflated the numbers and then created the suffering to match them. We taught women to expect collapse, then left them alone long enough to prove us right. Meanwhile, the real causes—eroded community, absent family structures, a culture that keeps new mothers home alone and then asks them repeatedly how sad they’re feeling—go untouched.

The public concern around postpartum depression—the screenings, hashtags, and wellness campaigns—looks like compassion but follows the same logic that has long defined feminist “care.” When feminism “worries” about mothers, it can’t celebrate them; it can only pathologize them. They medicalize female experience instead of dignifying it, which makes women feel like fragile objects in need of supervision rather than empowered and dignified, capable of adaptation.

And postpartum depression fits perfectly within that framework: it confirms the idea that womanhood is dangerous without institutional oversight, justifying endless monitoring from the same systems that created the anxiety: academia, psychology, and public health. It’s a worldview in which women are perpetually at risk: from men, from society, from biology, and now, from their own babies.