The COVID-19 pandemic revealed structural inequality impacting the mental health of expectant and new parents worldwide. My ongoing ethnographic research since March 2020 explores how pregnant and postpartum people navigate mental health challenges under the threat of COVID-19. While there is evidence that disturbances in maternal mental health are triggered by hormonal changes and physiological stressors imposed on the body throughout pregnancy and childbirth, my work highlights the social component of psychological distress and disablement this population experiences.
Throughout the COVID-19 pandemic, mothers and birthing people struggled with insufficient social support and the burden of full responsibility for their own health and safety and that of their children. They contended with constraints that negatively impacted maternal mental health both before and during the pandemic: insufficient postpartum medical attention to ensure the mother is healing, lack of screening and treatment for symptoms of Perinatal Mood and Anxiety Disorders (PMADs), insufficient health insurance coverage in the postpartum period to cover medical and mental health expenses, income insecurity, lack of adequate maternity leave, social isolation, inadequate support with childcare as well as difficulty with feeding the baby, such as trouble with breastfeeding and formula shortages. Furthermore, numerous parents mourned the loss of their prior support systems from their extended families and communities as well as childcare provided by schools and other institutions for their other children.
The pandemic ensued shortly after I gave birth to my first child in 2020, giving me the opportunity to learn from my own lived experience of mental health challenges during my postpartum period, as well as from the experiences of other mothers forming a part of my new online community. My familiarity with mental health challenges throughout my pregnancy and postpartum period afforded me an immersion into the virtual world of global maternal mental health amidst widespread adoption of digital mental health platforms, including online therapy, psychiatry, medication management, and support groups forming a cyber village for mothers isolated from their families and communities due to quarantines and lockdowns.
Though my sample is global, for specificity this article focuses on virtual interviews primarily conducted with participants throughout the US who shed light on the state of maternal or perinatal mental health in this country. Shared themes across all my interviews with mothers demonstrate the presence of disabling social conditions in their postpartum experiences. In particular, these respondents described the grief and rage associated with being socially isolated while healing from childbirth and caring for a newborn, in some cases, entirely on their own.
While not all of the pregnant and postpartum participants in my study identify with psychiatric disability, many do. My participants most commonly identified with depression and anxiety. There was a singular reference to postpartum psychosis and one reference to self-harm and attempted suicide by another interlocutor. However, more illuminating than a list of psychiatric labels, my interlocutors reveal the multiple meanings of madness produced by parenting in a pandemic. This madness is all at once an affective state, an identity, and a methodology.
One of my interlocutors was a filmmaker working on a project on motherhood during the pandemic. When I asked her to share her observations from other women’s stories, in addition to her own, Gemma replied:
Female rage is real. There’s a lot of rage. And maybe it’s because I’m projecting my own, but I’m hearing it back. The emotional weight of being a mom and in a pandemic and trying to do all the things like there’s just a lot of rage and concern and worry and stress. I don’t know anybody who’s really happy right now.
It’s in between the rage or hopelessness of wondering, how are we ever going to climb out of this?
There was truth to Gemma’s observation, as rage was a reoccurring theme in my interviews as well, so much that I began to ask—how does the lived experience of madness articulated through maternal rage resist psychiatrization, create theoretical tools to center pregnant and postpartum bodyminds, and then create a mad/cripistemology? Mad/cripistemology theorizes survival practices enacted during intense affective states that contest ableist and sanist notions of neuronormativity. In this modification of the term “cripistemology,” I annex mad to crip to bring mad identities connected to mental or psychiatric disability to the forefront, as the discourse on madness and mental illness tends to be siloed in disability studies.
Despite the psychiatric or self-prescribed label my interlocutors ascribed to their experience, rage is the common thread throughout their narratives. For my interlocutors, rage is a form of madness that both encompasses and reaches beyond the often pathologizing labels of the Diagnostic and Statistical Manual of Mental Disorders. For parents, rage is a rational emotional response in the midst of chaos. In the early days of the pandemic, the public health response cast doubt about the extent to which parents could trust their children would be safe, especially with controversies circulating around the COVID-19 vaccine, mask wearing, and social distancing. Gemma commented:
A lot of people are outraged right now that people are not wearing masks, because the children are still exposed and most likely unvaccinated people are not wearing masks….
While anger at the injustices is a part of a mad/cripistemology produced by pandemic parenting, another component involves surrender—relinquishing linear notions of recovery or ideas of “going back to normal” and embracing a mad methodology of survival, dealing with the here and now in whatever form it takes. As La Marr Jurelle Bruce articulates, “Mad methodology, sometimes, entails letting go: relinquishing the imperative to know, to take, to capture, to master, to lay bare all the world with its countless terrors and wonders… sometimes we must let go to unmoor ourselves from the stifling order imposed on this world.”
For my interlocutors who describe rage as part of their experience of postpartum depression, this experience can be reconceptualized as a form of giving in to, not only the chaos of inhabiting a new body, with a newborn, in a new phase of life, but within the context of fears and unknowns of the pandemic.
Mad/cripistemology informed by pandemic parenting also confronts capitalist and neoliberal logics that isolate families from community support and tie their value to efficiency and productivity. Many participants expressed rage towards the herculean task of working from home while juggling domestic and childcare duties with little help from their partners. Esther, a white emergency care physician and mother of two in California, expresses her frustration:
My husband is not amazing at logistics so I end up being the logistics coordinator for the household, which sometimes makes me quite angry…
Expecting to have a relaxed and nurturing postpartum as she did with her first child pre-pandemic, Esther vocalizes her disappointment with the lack of support during her postpartum experience. Esther did not open up about the nature of her depression until towards the end of the interview. In a timid confession Esther concedes:
I have been having a little bit of postpartum depression rage and I feel like I missed a little bit of the sweet spot during my postpartum of spending time with my snuggly newborn baby.
After expressing her grief and sadness, Esther uncovers rage, resentment, and regret. The societal pressure on mothers to take care of everyone’s needs at the expense of their own further compounded Esther’s feeling of being robbed of her only window of opportunity to bond with her newborn.
Though the interview concluded shortly after Esther disclosed her rage, what she left unsaid spoke volumes. I sensed shame in Esther’s admission. As an ER doctor accustomed to managing crises and household logistics, Esther was used to being put together, to being in control. Instead of surrendering to the madness induced by rage, Esther suppressed it. Although Esther was working through her rage in therapy at the time of the interview, she waited many months before she could receive help, unable to fully acknowledge her rage for fear of feeling out of control. It was only once she gained access to a therapeutic space that she was able to come to terms with experiences of madness in the months prior.
One interlocutor, Stacey, a white disabled new mother in Boston explicitly identified as Mad and Neurodivergent and shared her pandemic parenting experience through the lens of madness. Navigating her daughter Piper’s first year of life at the outset of the pandemic in 2020, Stacy notes how the disruption of her rituals and routines exacerbated her autism-related sensory triggers. She recounts her desperation and a sense of losing control as social isolation made matters worse. Despite living with her partner Teri, Stacey explains her sense of being alone:
I had a suicide attempt in April of this year  and was very much triggered by my environment, and working nonstop and trying to work while taking care of my kid. I’m doing all this and it got to be too much. I don’t ever see a way out of this cycle and this routine of life.
Absent for Piper’s birth and first year of life while navigating a prolonged immigration process, Stacey’s partner did not know how to support Stacey in helping to care for Piper. Thus, Stacey felt alone in her co-parenting relationship with the sole responsibility for caretaking and financially providing, even when Teri was reunited with his family. Stacey’s situation demonstrates how the social isolation of the pandemic magnified the neoliberal function of the nuclear family placing the burden of the household’s needs on a single member rather than on systems of social support embedded in the larger community. Stacey clarifies:
What gets a lot of mentally ill parents or mad parents is the monotony of [taking care of our children in their younger years] is so hard to deal with because a lot of us have our own sensory triggers. We have our own rituals and routines that we need to do throughout the day, but we are continually disrupted with no way out.
Although Stacey does not explicitly use the word rage, I sensed anger behind her words. As a multiply-disabled person, she already lived in a world that invalidated her existence. This was even more the case when she lost access to the activities that maintained her wellbeing along with community support. Stacey’s isolation was felt as a form of torture known to many parents during the pandemic who had to keep their children alive while trying to keep their own head above water.
In such dire circumstance, Stacey’s suicide attempt can be understood not as a desire to end her life, but quite literally, the only “way out” of her distress—a way to surrender. Despite Stacey’s diagnoses, her story demonstrates that suicide need not be pathologized as a symptom of psychiatric illness, because more than that, it is as a response, a strategy, a mad method to address the struggles society refuses to address.
Although the COVID-19 pandemic presented unprecedented circumstances, pandemic parenting produced a mad/cripestimology that must be carried into our post-pandemic future if the US is to ameliorate its abysmal state of maternity and maternal mental health care. As Gemma the filmmaker states:
I want us to talk more freely and I want to destigmatize these challenges and every time someone comes out and speaks honestly and raw about their experience, I’m like, bravo. We need more of that. I’m hungry for that.
Like Gemma, I hope the experiences of parenting in a pandemic will fuel a collective hunger that will employ mad/cripistemologies to expand our understanding of psychiatric disability among pregnant and postpartum people. I yearn for a networked army of parents who insist that the DSM is not only insufficient to understand their rage and other feelings of anxiety, grief, and isolation, but also that the biomedical world that valorizes psychiatric diagnoses must acknowledge and address the profound lack of social support that we experience, even in our current “post-pandemic” present.