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Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America
Fear among new mothers is a growing but largely unrecognized crisis. In the months before and after birth, countless women suffer from overwhelming feelings of fear, grief, or obsession that do not fall neatly within the outmoded category of "postpartum depression." These women are left isolated and captive, fending for themselves with scarce resources for their care and precious little time or support as they attempt to distinguish normal worry from debilitating anxiety. This crippling state of madness, though sometimes temporary, is commonly left untreated, and, perhaps even more dangerously, treated as a taboo in our culture.
Drawing on extensive research, countless interviews, and the raw particulars of her own experience with anxiety, writer and mother Sarah Menkedick gives us a comprehensive examination of the biology, psychology, history, and societal conditions surrounding the crushing and life-limiting fear that is becoming the norm for so many. Woven into the stories of women's lives, Menkedick examines factors like the changing structure of the maternal brain, the ethically problematic ways risk is construed during pregnancy, and the marginalization of motherhood as an identity, asking how motherhood came to be an experience so dominated by anxiety and how mothers might reclaim it.
Drawing on extensive research, countless interviews, and the raw particulars of her own experience with anxiety, writer and mother Sarah Menkedick gives us a comprehensive examination of the biology, psychology, history, and societal conditions surrounding the crushing and life-limiting fear that is becoming the norm for so many. Woven into the stories of women's lives, Menkedick examines factors like the changing structure of the maternal brain, the ethically problematic ways risk is construed during pregnancy, and the marginalization of motherhood as an identity, asking how motherhood came to be an experience so dominated by anxiety and how mothers might reclaim it.
432 pages, Hardcover
First published April 7, 2020
73 people are currently reading
2893 people want to read
About the author
Sarah Menkedick
8 books44 followersSarah Menkedick's second book, Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America, was released on April 7th from Pantheon. It explores the scientific, psychological, historical, and spiritual roots of a silent epidemic of anxiety among American mothers. Sarah’s debut essay collection, Homing Instincts: Early Motherhood on a Midwestern Farm (Pantheon, 2017), was longlisted for the PEN/Diamonstein-Spielvogel Award for the Art of the Essay.
Sarah's writing has been featured in Harper's, The New York Times, The Washington Post, The Los Angeles Times, The Kenyon Review, Oxford American, The Guardian, The Paris Review Daily, Aeon, Guernica, Buzzfeed, and elsewhere. She writes a column for Longreads on the craft of nonfiction. Her essay "Homing Instincts" was selected as notable in The Best American Essays 2014, her essay "Living on the Hyphen" was selected as notable in The Best American Essays 2015, and her essay “The Making of a Mexican American Dream” was selected as notable in The Best American Essays 2017. She was a 2015-2016 Fulbright fellow in Oaxaca, Mexico. She is a 2019 Creative Nonfiction Writing Fellow.
Sarah holds a B.A. in History of Science from the University of Wisconsin-Madison and an M.F.A. in nonfiction from the University of Pittsburgh, where she taught nonfiction writing. She speaks fluent French and Spanish.
Sarah's writing has been featured in Harper's, The New York Times, The Washington Post, The Los Angeles Times, The Kenyon Review, Oxford American, The Guardian, The Paris Review Daily, Aeon, Guernica, Buzzfeed, and elsewhere. She writes a column for Longreads on the craft of nonfiction. Her essay "Homing Instincts" was selected as notable in The Best American Essays 2014, her essay "Living on the Hyphen" was selected as notable in The Best American Essays 2015, and her essay “The Making of a Mexican American Dream” was selected as notable in The Best American Essays 2017. She was a 2015-2016 Fulbright fellow in Oaxaca, Mexico. She is a 2019 Creative Nonfiction Writing Fellow.
Sarah holds a B.A. in History of Science from the University of Wisconsin-Madison and an M.F.A. in nonfiction from the University of Pittsburgh, where she taught nonfiction writing. She speaks fluent French and Spanish.
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Displaying 1 - 30 of 66 reviews
March 11, 2020
This amazing book did more than anything I've ever read on motherhood to explain why I've often felt so overwhelmed from day one as a mother--despite the facts that 1) I always wanted to be a mother and 2) love my now-13-year-old twins. It also explained why so many other mothers of my generation act in what seem like crazily overprotective and/or irrational ways.
The roots of these things are complex. We all know, for example, that maternal hormones make profound changes to a mother's body and brain. But did you know that many of those changes are permanent? And that if those changes are combined with a tendency toward anxiety, depression and/or OCD and the woman in question has no access to help or isn't believed when she says she needs it, mothers can find themselves with crippling mental health issues long after the ill-defined postpartum period ends?
But biology is only one area that contributes to the epidemic of anxiety the author describes here. Also at play: psychology, history, and culture, especially the patriarchal legacy of using motherhood as a pawn to keep women in their place. The ideal mother, in this world view, is instantly fulfilled and in love with her baby. If she mourns her old life and self or doesn't feel happy and serene all the time, she's deemed inadequate or selfish at best and crazy at worst. Even other women judge her. The result for those of us who fall short of that ideal (and I'd wager that's most of us) is some level of fear.
"Fear--the debilitating and constant and I-know-it's-crazy-but-can't-stop kind of fear, fear that walls off the world and imprisons the self in a frantic scramble for control, fear that can never be satiated and that mimics care and love and intelligence so precisely it's impossible to recognize as an imposter--is the last major taboo of American motherhood," the author writes. "Fear has become the way American mothers police, educate, and define themselves. It is the ritual with which they commemorate their transition to motherhood. It is tightly baked into the historical strata beneath their everyday lives. It is built into their very brains. But they don't talk about it."
The research here is impeccable. It is also bolstered with personal stories, the author's own and those of others, including those of mothers of color, who bear an especially heavy load given the cultural and institutional forces stacked against them. Some of these stories are terrifying: one brand-new mother was institutionalized after circling the wrong answer about her mental state on a questionnaire; another’s obstetrician suggested she end her pregnancy on learning she was a single mom. There's also a lot of interesting history, including a section on midwives in general and in African-American culture in particular, and how their subordination to the medicalization of childbirth did women few favors.
How do we deal with this? "The norm in childbirth used to include death," Menkedick writes. "That norm was met with interventions, protocols, development, time, energy. We must establish norms of treatment and research and support and intervention to counter the current norm of fear."
My own postpartum issues mostly resolved when I finally started to get enough sleep after my husband and I hired a night nanny to come in twice a week and handle the twins so we could truly rest. But we were lucky we had the money to pay for that out-of-pocket and that we really only needed her for about three months. Not every family has that luxury. If we truly value mothers and motherhood, that kind of help, along with counseling, doulas, and groups of mothers who can support one another, should be the norm--and it should be part of the medical protocol and insured services available to new mothers.
I recommend this book to anyone who has ever judged an anxious mom or been one herself. That's probably....everybody reading this.
The roots of these things are complex. We all know, for example, that maternal hormones make profound changes to a mother's body and brain. But did you know that many of those changes are permanent? And that if those changes are combined with a tendency toward anxiety, depression and/or OCD and the woman in question has no access to help or isn't believed when she says she needs it, mothers can find themselves with crippling mental health issues long after the ill-defined postpartum period ends?
But biology is only one area that contributes to the epidemic of anxiety the author describes here. Also at play: psychology, history, and culture, especially the patriarchal legacy of using motherhood as a pawn to keep women in their place. The ideal mother, in this world view, is instantly fulfilled and in love with her baby. If she mourns her old life and self or doesn't feel happy and serene all the time, she's deemed inadequate or selfish at best and crazy at worst. Even other women judge her. The result for those of us who fall short of that ideal (and I'd wager that's most of us) is some level of fear.
"Fear--the debilitating and constant and I-know-it's-crazy-but-can't-stop kind of fear, fear that walls off the world and imprisons the self in a frantic scramble for control, fear that can never be satiated and that mimics care and love and intelligence so precisely it's impossible to recognize as an imposter--is the last major taboo of American motherhood," the author writes. "Fear has become the way American mothers police, educate, and define themselves. It is the ritual with which they commemorate their transition to motherhood. It is tightly baked into the historical strata beneath their everyday lives. It is built into their very brains. But they don't talk about it."
The research here is impeccable. It is also bolstered with personal stories, the author's own and those of others, including those of mothers of color, who bear an especially heavy load given the cultural and institutional forces stacked against them. Some of these stories are terrifying: one brand-new mother was institutionalized after circling the wrong answer about her mental state on a questionnaire; another’s obstetrician suggested she end her pregnancy on learning she was a single mom. There's also a lot of interesting history, including a section on midwives in general and in African-American culture in particular, and how their subordination to the medicalization of childbirth did women few favors.
How do we deal with this? "The norm in childbirth used to include death," Menkedick writes. "That norm was met with interventions, protocols, development, time, energy. We must establish norms of treatment and research and support and intervention to counter the current norm of fear."
My own postpartum issues mostly resolved when I finally started to get enough sleep after my husband and I hired a night nanny to come in twice a week and handle the twins so we could truly rest. But we were lucky we had the money to pay for that out-of-pocket and that we really only needed her for about three months. Not every family has that luxury. If we truly value mothers and motherhood, that kind of help, along with counseling, doulas, and groups of mothers who can support one another, should be the norm--and it should be part of the medical protocol and insured services available to new mothers.
I recommend this book to anyone who has ever judged an anxious mom or been one herself. That's probably....everybody reading this.
July 21, 2020
This was fascinating but a bit uneven. There are parts that are just basic post-partum issues, which I found to be fairly well-covered areas. The parts that were most fascinating is when she tries to analyze motherhood anxiety as a way of dealing with a changing world. I think this area is under-explored and I'd like more research here. I mean with the vaccine wars, covid, homeschooling, environmental threats, etc that the way we mother has become a political phenomenon.
July 7, 2020
I've had the opportunity to read an early version of this incredible book---it is groundbreaking. The author is looking at something people are only just becoming aware of—the full range of perinatal mood and anxiety disorders, and the dangerous misunderstanding of the ubiquitous “PPD” diagnosis. The author interviews women who were misdiagnosed, horribly mistreated, and hospitalized erroneously. The book is riveting and powerfully written—I would follow Sarah Menkedick's voice anywhere! I think she has done something very important not just for women but for parents—she is exploring the colossal change the human body and brain undergo during pregnancy and birth and the wide, wide range of crazy-seeming thoughts and behaviors new mothers experience that are actually completely normal. Even if proper treatment is needed, these thoughts and behaviors present no risk to the infant. I came away from the book shocked by my own misconceptions, ingrained stigma, and assumptions. This is book that will help to break apart old ways of thinking about perinatal emotional distress. It is a book that is desperately needed right now--by mental health practitioners, medical professionals, and new mothers and fathers.
June 2, 2021
I have come to despise describing books as "important" and "necessary." This book probably falls into those categories, but as much as I would love everyone to take a deep dive into the construct of motherhood in America that you get from this book, I recognize that not everyone finds the experience of motherhood as fascinating as I do. So I will skip imploring everyone I know to read this and instead say that reading this was paradigm-shifting for me.
This book is a combination of historical research and memoir of Menkedick's own motherhood experience. The scope of the book is vast, but reading Menkedick's beautiful prose and her depth of insight is a therapeutic, even cathartic, experience. Even though she covers the experiences of many mothers over years and years, I felt like I could identify with so much of what she wrote. For example, of mothers who have taken the brave step forward to mention the *possibility* of depression and/or anxiety to their medical providers at that oh-so-inadequate six week postnatal visit (yes, you can have sex! Get back in your lane where you belong!), I wonder how many would not identify with the experience Menkedick describes:
"We chatted a bit and then I offered, as if mentioning a curious weather pattern, that I'd been having some anxiety. She didn't lift her eyes from the computer screen. 'Uh-huh,' she said. 'We can connect you with a social worker.' [Menkedick mentions she is moving out of state.] She immediately ceased her search. 'Oh, then I can't help you. You should find someone, though. You know, anxious mothers make anxious children.' She gave me a curt smile and a handful of printouts with my height and weight, then left. I didn't talk about my anxiety with anyone else for another year and a half."
Even though my worldview is different from the author's and I did not always agree with her conclusions (I often found myself thinking, "Lady, the answer to this is Jesus!"), there were a lot of great takeaways for me as I understand my own motherhood experience. To be honest, I really wanted to do a better job with this review to do this book justice and I had great visions of writing a beautiful essay that communicated how strongly I interacted with this book and that was worthy of Menkedick's writing skill. But alas, I do not have the same writing skill and I finished this book a few months ago but haven't been able to sit down and write that glorious essay, so this is the end of my review. (Sorry, Sarah.)
This book is a combination of historical research and memoir of Menkedick's own motherhood experience. The scope of the book is vast, but reading Menkedick's beautiful prose and her depth of insight is a therapeutic, even cathartic, experience. Even though she covers the experiences of many mothers over years and years, I felt like I could identify with so much of what she wrote. For example, of mothers who have taken the brave step forward to mention the *possibility* of depression and/or anxiety to their medical providers at that oh-so-inadequate six week postnatal visit (yes, you can have sex! Get back in your lane where you belong!), I wonder how many would not identify with the experience Menkedick describes:
"We chatted a bit and then I offered, as if mentioning a curious weather pattern, that I'd been having some anxiety. She didn't lift her eyes from the computer screen. 'Uh-huh,' she said. 'We can connect you with a social worker.' [Menkedick mentions she is moving out of state.] She immediately ceased her search. 'Oh, then I can't help you. You should find someone, though. You know, anxious mothers make anxious children.' She gave me a curt smile and a handful of printouts with my height and weight, then left. I didn't talk about my anxiety with anyone else for another year and a half."
Even though my worldview is different from the author's and I did not always agree with her conclusions (I often found myself thinking, "Lady, the answer to this is Jesus!"), there were a lot of great takeaways for me as I understand my own motherhood experience. To be honest, I really wanted to do a better job with this review to do this book justice and I had great visions of writing a beautiful essay that communicated how strongly I interacted with this book and that was worthy of Menkedick's writing skill. But alas, I do not have the same writing skill and I finished this book a few months ago but haven't been able to sit down and write that glorious essay, so this is the end of my review. (Sorry, Sarah.)
April 26, 2020
Within the first two chapters, I couldn’t stop exclaiming out loud how desperately necessary this book is. Reading this book has been so thoroughly illuminating to my own experience giving birth twice in the United States within the past six years and so many times, I felt like a weight being lifted off me as the details validated so many of my experiences. The writer puts all the research and facts out there in an objective manner, through clear and descriptive writing which only makes the information so much more powerful. She is brilliantly able to weave hundreds of years of history into the present day times so precisely pointing out how we got to the place we are now and it just breaks through all the noise of amateur writing on the topic of motherhood. The personal stories had me shedding plenty of tears again buried over the past six years on my journey as a mother. This book is without a doubt helping me redefine and examine my identity as a mother in the most therapeutic manner. And it is inspiring me to determine how to empower myself and all the moms with whom I wouldn’t be able to survive!
September 6, 2020
Very useful book about the paralyzingly fear that is common after birth. Good perspective about biology and evolution. Removed a star for the obvious bias against birth interventions, because as a person who has had a life saving (and frankly, wonderful) C section I am very tired of the “natural birth” / “your body was made for this” dogma that stigmatizes bodies that aren’t capable !
January 29, 2021
This book is amazing! I truly don’t know where to start with how and why I think this book so so important for everybody to read. Yes it is a book about postpartum anxiety but it is also about all the becomings of motherhood in general AND it is a seriously outstanding intersectional feminist text on the history of motherhood in America.
August 18, 2021
3-4 stars… early on in the book, I noted some comments based on research that were just not true, with citations that were an article about a word-of-mouth statement and that really rubbed me the wrong way. I felt like the authors attempt at making this emotional and practical plea more scientific fell flat for me and was a bit oversensationalized. I did, however, truly enjoy and appreciate the stories and observations on how motherhood is dismissed and becoming problematic for so many these days - that was really relatable.
December 6, 2021
Wish I could give it 6 stars! A wonderful look at motherhood and the challenges women face. I read many pregnancy and parenting books, and this is the one I found to be the most accurate. It described parts of motherhood that everyone with a baby knows but doesn't say.
June 30, 2022
Maybe 4.5 stars. The anecdotes are so helpful and validating. The writing in between is a bit academic and dense. But I really enjoyed this book and am so glad I read it.
August 27, 2023
This book is an absolute trip. It’s a raw look at a whole spectrum of mood disorders and pregnancy including ppd and ppa. I wish I had this book after my first child. You don’t know what you don’t know. While reading this book it came abundantly clear to me that I very definitely had ppd and ppa. I also probably have some ptsd from both of my c sections for different reasons. I had planned on tying my tubes after my second baby and I double checked it was noted in my chart at EVERY appointment knowing that in labor you are in no place to advocate. While in labor I was like my tubes and a nurse was like signing this it means no babies ever. I said ya I know! What if one of your babies die? What if give me the paper. I was tested multiple times in my second pregnancy (above the norm) for gestational diabetes even though I never was even close to the cut off. I don’t think they looked out for gestational hypertension. 4 days post partum I ended up back in the hospital with EXTREMELY high blood pressure and kidneys functioning at 23% or acute kidney failure. Look out for moms and mothers to be. Share your stories to shift understanding. I love my babies and always have but just in the last year…maybe 1.5 years. That ppd fog has lifted. I now can enjoy motherhood fully. I knew I had a higher risk I read all the stuff and still fell victim. I recommend this to all moms. New and veteran.
August 8, 2020
Lots of interesting thoughts and information, a many things are beautifully expressed, although I found the book a bit uneven. Some parts seemed to have only the loosest connection to the topic, there wasn’t much practical advice, and as someone who didn’t experience postpartum mental issues, I wasn’t a fan of her argument that they are because you care more and they make you a more caring person. I also got tired of the crunchiness: persistent distrust of the medical establishment, glorification of home birth, a lengthy discussion of the author weeping while burying her placenta at the foot of a tree in a special family ceremony, etc. I still learned a lot, so I consider it a worthwhile read.
October 30, 2020
Terrific. Much larger scope and impact than the title indicates. Loved the mix of women’s stories and info from experts. The central discussion on risk and who is held responsible for risk felt very relevant beyond motherhood for the pandemic. I will be thinking about this book for a long time. Minor note but I liked how the author used podcasts as sources (haven’t seen that done much).
November 2, 2020
This book is a conversation the world needs to have. Mental health is part of who we are; and mothers deserve to be cared for as their bodies and brains undergo massive changes. They deserve to be heard, believed, and tenderly supported. This is often not the case, and Sarah is helping us see the cracks in our society that desperately need tending.
May 13, 2023
Hefty and long. Not a light read—dense. But so so good. I’ve already recommended it to my therapist and midwives 😂
July 20, 2024
Everyone should read this book
February 1, 2021
Honestly, for me reading this book has actually been quite transformational. I didn't really have too many expectations going into it and didn't realize how much I needed this book until I read it. I also didn't realize how much I didn't know about postpartum changes until I read this book. Becoming a mother is a huge transformation and this was the first book I've read that really tackles that transformation. I didn't experience PPD like any of the women in this book, but it meant a lot to me to read their experiences. And I really appreciated how the author put into words some of the confusing emotions I have felt at times as a mother of 2 young kids, of missing my old self, trying to understand my new identity, and not always feeling like my work and time as a stay at home mom is valued or respected by society. Of course, I love my children more than anything and seriously cannot imagine life without them, but yeah, it's a joyful, but complicated transformation. Highly recommend this book and am going to buy my own copy.
While I did love the boom, I found it to be a bit too strongly biased against birthing interventions. The life of my first daughter was saved due to an emergency C-section. I had very low amniotic fluid throughout the pregnancy and during a twice a week ultrasound it was discovered there was no fluid and baby was in distress. She was also breech. She was born prematurely and spent 3 weeks in NICU. While she is overall healthy now, she still has some health issues. Of course, nobody wants unnecessary interventions for anyone, but I feel like there is so much negativity surrounding csections. Sometimes it’s necessary to save the life of baby and/or mother. I also would have expected a little more about how Prematurity and time spent in NICU increase the risk tremendously for PPD.
While I did love the boom, I found it to be a bit too strongly biased against birthing interventions. The life of my first daughter was saved due to an emergency C-section. I had very low amniotic fluid throughout the pregnancy and during a twice a week ultrasound it was discovered there was no fluid and baby was in distress. She was also breech. She was born prematurely and spent 3 weeks in NICU. While she is overall healthy now, she still has some health issues. Of course, nobody wants unnecessary interventions for anyone, but I feel like there is so much negativity surrounding csections. Sometimes it’s necessary to save the life of baby and/or mother. I also would have expected a little more about how Prematurity and time spent in NICU increase the risk tremendously for PPD.
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December 9, 2021I feel like I can't give this one a star rating. It was a slog and a half for me - super dense and suffering a little bit of trying to cover so much (arguably very important) ground when I think it could have benefitted from some paring back and focusing. I felt a little ping ponged between the various dilemmas/crises she was covering - all very important to shed light on, but I felt like she was trying to just do too much here. Perhaps that's because the issue is so pervasive and broad. I loved the stories of the women she spoke with and wish she had focused more on their stories and woven her research in more of a storytelling way using these stories, but then it would have been a different book!
December 2, 2021
There is a lot of important information in this book, but it is way too long and probably should have been divided into at least 2 books instead. One book is the crisis of fear and anxiety for American mothers. This is serious and deserves to be witnessed and discussed so that solutions can be found. The other is about the deeply entrenched racism that exists in the US and how that has impacted maternal experiences. Both a serious topics (this book is not uplifting) and I hope the conversation around motherhood moves into the mainstream. Most women suffer in silence, not realizing that there is another way to parent.
January 23, 2021
This probably speaks to the need for the topics in this book to be covered a lot more in society, but I was too uncomfortable to finish it. While I love my child, the first few months of his life were extremely difficult and my emotions were very painful. So while I thought reading this would feel reassuring and maybe give me wisdom to bestow on future moms, it just took me back to that painful time. Obviously this is more about me than the book. I bet objectively it’s very good, just not for me right now.
October 26, 2020
Let me start by saying I have great respect for Sarah Menkedick for writing this book. It is important topic, she clearly cares, and she did her homework. To quote some of the mothers in the book it is absolutely “fucked up” that there aren’t a ton of books available on the topic. The sheer scope and lack of available research are not her fault. It is an incredible achievement to put together a cohesive book on this topic as a first-time book author without a science background.
That said, the scope of this topic is too vast and there are too many gaps to recommend this book outright. Individuals may love this book and find the answers they are looking for. There is a lot of evidence, exploration and anecdotes on the topic that people may find helpful. I am sure being a man doesn’t help, but this is not a consistent problem for me in books intended for a female audience (plus the author specifically says it is for men as well). I’ll go into a few topics where the book falls short in hopes that the work here continues. It really is fucked up how little America spends on high-quality research across the board on issues that have a big impact on millions of lives.
The title of the book includes “America” and I don’t know why that qualification exists. The first anecdote in the book actually comes from Mexico! There is no exploration of comparisons to other countries at all in the book. Nothing to indicate America is better or worse than other countries. The author just happens to live in America. I would really like to know if fear is worse in America and the book has no answers.
The title of the book also has “Crisis” in it and quickly calls out an epidemic without supporting it. Clearly many women are struggling. Part partum depression is a clinical condition for a reason and usually with clinical conditions there are people on a spectrum that do not meet the full diagnostic criteria. Changing the definition to cover anxiety in a small sample increased the percentage, but the percentage is still a small minority and there is no context. How long does it continue? How does it compare to other population level anxiety stats? Anxiety affects somewhere between 1 in 5 and 1 in 3 people in the US. Women do show a higher incidence than men, but my initial research did not find any link there to being a mother. Married parents had the lowest levels of anxiety in any group in one study I found. I’m left wondering if mothering is the cause or just one of many life events that make existing anxiety harder to deal with. Some other data points to think about. Our World in Data has a chart that puts US female anxiety rates at 8-9% from 1990-2017 vs ~5% for men. Germany and Iran both have very similar numbers. The WHO source data show that female anxiety rates do not change much from 15-19 up through the 50-54 age group with a peak at 45-49.
The books has many anecdotes about bad healthcare. I’m a highly educated white male with an advanced degree and I can still get bad healthcare. I’m horrified every time I learn more about how our health systems were established and what they are based on. I just read Bessel VanDer Folk’s book on trauma and learned that PTSD didn’t exist as an official diagnosis in the DSM until 1980 and ICD in 1992! In Deadliest Enemy I was shocked by the history of AIDS and Toxic Shock Syndrome. The history of antibiotic treatment of ulcers is also insane. It was known in the 1950’s but didn’t become generally accepted until the exact mechanism was discovered in the 1980’s. Our systems suck across the board unless you fit specific diagnostic criteria. Always do you own research and get a 2nd opinion if something is important. Being female and a mother can’t help, but there is no magic solution here.
My biggest issue with the book is the lack of husbands. What can they do to help? There are no answers here. It is a shame. We are supposed to be partners. To have and to hold in sickness as well as health. To support each other. One man in the book took twelve weeks off work to support his wife and was just an afterthought. Why did he bother? Did he do something wrong? Did it matter? I have to believe that a loving spouse is a large part of the solution to the problem. They seem to help many women according to the population level anxiety and depression statistics.
That said, the scope of this topic is too vast and there are too many gaps to recommend this book outright. Individuals may love this book and find the answers they are looking for. There is a lot of evidence, exploration and anecdotes on the topic that people may find helpful. I am sure being a man doesn’t help, but this is not a consistent problem for me in books intended for a female audience (plus the author specifically says it is for men as well). I’ll go into a few topics where the book falls short in hopes that the work here continues. It really is fucked up how little America spends on high-quality research across the board on issues that have a big impact on millions of lives.
The title of the book includes “America” and I don’t know why that qualification exists. The first anecdote in the book actually comes from Mexico! There is no exploration of comparisons to other countries at all in the book. Nothing to indicate America is better or worse than other countries. The author just happens to live in America. I would really like to know if fear is worse in America and the book has no answers.
The title of the book also has “Crisis” in it and quickly calls out an epidemic without supporting it. Clearly many women are struggling. Part partum depression is a clinical condition for a reason and usually with clinical conditions there are people on a spectrum that do not meet the full diagnostic criteria. Changing the definition to cover anxiety in a small sample increased the percentage, but the percentage is still a small minority and there is no context. How long does it continue? How does it compare to other population level anxiety stats? Anxiety affects somewhere between 1 in 5 and 1 in 3 people in the US. Women do show a higher incidence than men, but my initial research did not find any link there to being a mother. Married parents had the lowest levels of anxiety in any group in one study I found. I’m left wondering if mothering is the cause or just one of many life events that make existing anxiety harder to deal with. Some other data points to think about. Our World in Data has a chart that puts US female anxiety rates at 8-9% from 1990-2017 vs ~5% for men. Germany and Iran both have very similar numbers. The WHO source data show that female anxiety rates do not change much from 15-19 up through the 50-54 age group with a peak at 45-49.
The books has many anecdotes about bad healthcare. I’m a highly educated white male with an advanced degree and I can still get bad healthcare. I’m horrified every time I learn more about how our health systems were established and what they are based on. I just read Bessel VanDer Folk’s book on trauma and learned that PTSD didn’t exist as an official diagnosis in the DSM until 1980 and ICD in 1992! In Deadliest Enemy I was shocked by the history of AIDS and Toxic Shock Syndrome. The history of antibiotic treatment of ulcers is also insane. It was known in the 1950’s but didn’t become generally accepted until the exact mechanism was discovered in the 1980’s. Our systems suck across the board unless you fit specific diagnostic criteria. Always do you own research and get a 2nd opinion if something is important. Being female and a mother can’t help, but there is no magic solution here.
My biggest issue with the book is the lack of husbands. What can they do to help? There are no answers here. It is a shame. We are supposed to be partners. To have and to hold in sickness as well as health. To support each other. One man in the book took twelve weeks off work to support his wife and was just an afterthought. Why did he bother? Did he do something wrong? Did it matter? I have to believe that a loving spouse is a large part of the solution to the problem. They seem to help many women according to the population level anxiety and depression statistics.
May 31, 2021
Thank you to Knopf Books for gifting me a copy of this book via a Goodreads giveaway. Menkedick interweaves research, interviews, and her personal examples to bring light to the connection between mental health and motherhood -- a circumstance more common than one might think. This is one more area that needs to be talked about and addressed in maternity appointments, in birthing classes, post-birth appointments, and in general.
I'd guess that most people know from the news about women who have suffered from postpartum depression and have become suicidal or homicidal, but this book discusses the spectrum of disordered thinking surrounding pregnancy that includes anxiety. Menkedick presents a helpful discussion of what this anxiety can look like and what we could do as a society to improve things. After reading this, I think some sort of screener before hospital dismissal and/or during well-baby/well-mom checks could be helpful or maybe just having greater availability of information for parents and caregivers. Joy is considered the normal, expected response to birth; when the resulting feelings are more complicated, guilt, embarrassment, and shame can ensue. The knowledge the author shares opens this conversational avenue. One story she includes helpfully suggests that "anxiety isn't normal, but it's common."
The implications of poverty and race in the history of motherhood went pretty in-depth, and were less interesting to me than the mental health focus, but it is useful to consider how the concept "motherhood" has developed and how it connects with the idea of womanhood.
I'd recommend this book to women and also to any person providing medical or mental health to women.
I'd guess that most people know from the news about women who have suffered from postpartum depression and have become suicidal or homicidal, but this book discusses the spectrum of disordered thinking surrounding pregnancy that includes anxiety. Menkedick presents a helpful discussion of what this anxiety can look like and what we could do as a society to improve things. After reading this, I think some sort of screener before hospital dismissal and/or during well-baby/well-mom checks could be helpful or maybe just having greater availability of information for parents and caregivers. Joy is considered the normal, expected response to birth; when the resulting feelings are more complicated, guilt, embarrassment, and shame can ensue. The knowledge the author shares opens this conversational avenue. One story she includes helpfully suggests that "anxiety isn't normal, but it's common."
The implications of poverty and race in the history of motherhood went pretty in-depth, and were less interesting to me than the mental health focus, but it is useful to consider how the concept "motherhood" has developed and how it connects with the idea of womanhood.
I'd recommend this book to women and also to any person providing medical or mental health to women.
July 11, 2021
* I received a free copy of this book through a Goodreads Giveaway.*
In Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America Sarah Menkedick blends her personal experience with thorough research and interviews with other mothers to explore the contemporary experience of motherhood in the United States.
During that journey, Menkedick covers a wide swath of subject areas and materials such as cultural history, the history of medicine, findings of medical studies, psychology and American history. The organizing point of this is Postpartum Depression and Anxiety. From her personal experiences, all the thoughts that spiral from the deep dread concerns of "what if my child....?" And it is important to remember this is was all written ahead of the COVID Pandemic.
Throughout the book, Menkedick continually demonstrates that the American birthing system is centered on the healthy birth of the child with little thought, concern, or care opportunities for the mother. Either from her personal experiences or the interviewees, Menkedick details struggles to be heard by medical professionals or overcoming the trauma of poor care or journeys through a mental health care facility.
Childbirth is a life changing event for a family, this book demonstrates that we should be doing more to challenge the viewpoint of motherhood being just a great and wonderful thing that glosses over the trauma and incredible amount of work such a transition necessitates.
Recommended for anyone planning to have children.
In Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America Sarah Menkedick blends her personal experience with thorough research and interviews with other mothers to explore the contemporary experience of motherhood in the United States.
During that journey, Menkedick covers a wide swath of subject areas and materials such as cultural history, the history of medicine, findings of medical studies, psychology and American history. The organizing point of this is Postpartum Depression and Anxiety. From her personal experiences, all the thoughts that spiral from the deep dread concerns of "what if my child....?" And it is important to remember this is was all written ahead of the COVID Pandemic.
Throughout the book, Menkedick continually demonstrates that the American birthing system is centered on the healthy birth of the child with little thought, concern, or care opportunities for the mother. Either from her personal experiences or the interviewees, Menkedick details struggles to be heard by medical professionals or overcoming the trauma of poor care or journeys through a mental health care facility.
Childbirth is a life changing event for a family, this book demonstrates that we should be doing more to challenge the viewpoint of motherhood being just a great and wonderful thing that glosses over the trauma and incredible amount of work such a transition necessitates.
Recommended for anyone planning to have children.
October 3, 2020
"The mother I thought I would be, the mother I have been forced into becoming because of anxiety, and the mother I actually want to be have all blurred and made me more unknown to myself than ever. All I truly know is that I feel the loss of the mother I dreamed of being. What do we make of that big squeeze between who we believe we once were, who we imagined we would be, and who we have become? Motherhood is often the first true test of self in a woman's life. How much holds up, how much crumbles, how much mutates?"
I could see myself in so many of these pages. This book explores the history of motherhood throughout time with a particular focus on fear and anxiety. This was heavily researched and at times felt like reading a doctorate thesis. It was still somehow very accessible I think because of the addition of the author's personal narratives and interviews with other mothers mixed in. Overall, I feel somehow better and also worse about my anxiety after having read this. For anyone who has ever asked themselves "why am I like this?" Know this: it's not all in your head, and it's not your fault.
I could see myself in so many of these pages. This book explores the history of motherhood throughout time with a particular focus on fear and anxiety. This was heavily researched and at times felt like reading a doctorate thesis. It was still somehow very accessible I think because of the addition of the author's personal narratives and interviews with other mothers mixed in. Overall, I feel somehow better and also worse about my anxiety after having read this. For anyone who has ever asked themselves "why am I like this?" Know this: it's not all in your head, and it's not your fault.
September 7, 2023
Sonia got better. She feels more comfortable as the mother of a two-year-old than as the mother of an infant. But she is wise enough to know that it's not over, and that maybe her fear and anxiety and depression will never really end. "I can't say, well, I'm not in this postpartum depression anymore, because I don't even know." There is no normal to return to. As Sonia puts it, "My old life is gone, my old self is gone." This happens regardless of a woman's particular experience with motherhood, whether it is traumatic or joyful. Her old self is gone. Her notion of what a self is and how it's defined, its steadfastness and purpose, is forever changed. (pg. 353)
I highly recommend this book to everyone, especially those who plan to become pregnant and new parents. It was eye-opening and validating in ways I didn't know I needed. I keep striving to return to the person I was before I gave birth. But she is gone. In her place is someone new and different. This new person experiences much more anxiety than I'd like. Yet, there is no going back, only moving forward. This is me, a mother, an anxious person, doing my best. And that's enough.
I highly recommend this book to everyone, especially those who plan to become pregnant and new parents. It was eye-opening and validating in ways I didn't know I needed. I keep striving to return to the person I was before I gave birth. But she is gone. In her place is someone new and different. This new person experiences much more anxiety than I'd like. Yet, there is no going back, only moving forward. This is me, a mother, an anxious person, doing my best. And that's enough.
October 4, 2020
I want all of my mom friends to read it! And maybe my pregnant friends, though I'm worried it'll terrify them (but if they're prone to anxiety, it might actually be helpful).
I really appreciated the socio/political/historical contextualizing of the "grooming of mothers as risk managers" beginning in pregnancy and the "American cultural tendency to fetishize reproductive risk over other types, demanding a purity and absolutism in this context that would be seen as absurd in everyday life." I thought she made a very compelling link between these social expectations and postpartum depression (particularly postpartem anxiety).
I also really liked the style of weaving in other works of literature, be they on the mothering experience, on anxiety, etc. And I appreciated the many vignettes. She also goes deep into the role of racism on BIPOC (particularly Black) mothers' experience. And on how the medical establishment (including mental health/social work) has so utterly failed mothers.
A rage-inducing book in all the best ways!
I really appreciated the socio/political/historical contextualizing of the "grooming of mothers as risk managers" beginning in pregnancy and the "American cultural tendency to fetishize reproductive risk over other types, demanding a purity and absolutism in this context that would be seen as absurd in everyday life." I thought she made a very compelling link between these social expectations and postpartum depression (particularly postpartem anxiety).
I also really liked the style of weaving in other works of literature, be they on the mothering experience, on anxiety, etc. And I appreciated the many vignettes. She also goes deep into the role of racism on BIPOC (particularly Black) mothers' experience. And on how the medical establishment (including mental health/social work) has so utterly failed mothers.
A rage-inducing book in all the best ways!
September 6, 2023
Incredibly well-researched and thought-provoking, Ordinary Insanity should be required reading for everyone—not just mothers. The modern-day, personal stories mixed in with little-known history teach the reader the origins of the American motherhood paradigm while also highlighting how deeply our patriarchal society affects us still. While I found myself skimming the author’s own journal-like entries describing her experiences with OCD, I recognize that those portions of the book are necessary to support the author’s thesis of taking the shame out of everyday mothering experiences and encouraging mothers to share their truths. This book has also expanded my own reading list! Absolutely loved reading it.
April 17, 2022
I did not finish this book so I can only comment on the first half. It was dense and filled with information. The first chapter on neurobiology is amazing and should be required reading for every parent.
The author is a great writer, and the book is clearly well researched, but without a science background I find myself questioning a lot.
I gave up after the second story of a woman reporting intrusive thoughts ends up at inpatient psych. Yes this is true, and it is so clear the medical field is behind in treating PPD. But it was overwhelming to me and I had to put it down. Maybe I will finish someday in the future
The author is a great writer, and the book is clearly well researched, but without a science background I find myself questioning a lot.
I gave up after the second story of a woman reporting intrusive thoughts ends up at inpatient psych. Yes this is true, and it is so clear the medical field is behind in treating PPD. But it was overwhelming to me and I had to put it down. Maybe I will finish someday in the future
May 29, 2020
This book does a great job of pointing out difficulties in the expectations of motherhood today. In an effort to avoid all risks with our children, are we placing too many rules on parents and diminishing the joy of the experience? This book gives many examples of this, pointing out the anxiety that results and the loss of a carefree self. It helped me to understand why I still fall into feeling the need to micromanage my children’s lives, even though they are in their 20s and 30s! This is a must read that will help parents avoid losing themselves during parenthood.
July 19, 2020
I was excited to read this book after seeing a virtual author event with Sarah Menkedick hosted by Magic City Books in Tulsa. She writes openly and with the backing of years of solid research to pull back the curtain that has long enshrouded motherhood in the U.S. The content is heavy and definitely hit home for me personally. It also holds encouragement for mothers who have been impacted by postpartum anxiety and/or depression without any context or support for their experience. It’s eye opening and powerful. I fully recommend it to anyone!
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