Depressed about equity

Postnatal Depression Awareness week has passed with little fanfare and yet perinatal Depression is a serious health issue. In an environment that shies away from the social-cultural context of health, gender and depression are held together through a continuing focus on individual solutions to the exclusion of social change. While the recent adoption of the universal Paid Parental Scheme is a welcome relief, balancing work and care calls for institutional change including cultural shifts both in the workplace and at home.

We have reached a new 'high water mark' in attempts to achieve gender equity and tensions between work and family are caught up within this maelstrom. The vast majority of couples aspire to a gender equal or egalitarian family form and most manage reasonable outcomes before a baby comes along. The joy that accompanies the birth, however, can turn to frustration and disillusionment with everyday attempts to share the care, the mounting housework, and the continuing necessity of bringing in a wage. Many couples struggle. This is a continuing theme in online blogs and forums.

My research found a huge gap between the expectations and the experience of women-as-mothers. The sense of self is importantly connected to wellbeing and issues related to identity are commonly associated with early motherhood.

This is evident through a significant international body of research on the Transition to Parenthood, but also through an emergent genre on mothering/motherhood seen through texts, newspapers and magazine and television segments. Across the developed world between ten and twenty per cent of new mothers experience symptoms of depression and/or anxiety in the first year after giving birth, with the rate of depression during pregnancy also high. Sadly, many women go undiagnosed, with the effect evident within families and throughout the community.

In 2009, the Federal Government allocated $55 million over five years towards the National Perinatal Depression Initiative. Thirty million went to State and Territory Governments for routine and universal screening, support services and training for health professionals and five million to the national depression initiative, beyondblue. Twenty million has also gone to the Allied Psychological Services to build the capacity of the Divisions of General Practice.

This emphasis is on screening and individual treatment programs - a biomedical model of health that is based on a physiological understanding that is treated with an individualized response: medication and/or talking cures. The condition is pathologised whereby the experience of depression is understood as a product of a biological deficiency, a chemical imbalance.

And yet we are reminded in the recently released study by the AMP-NAPSEM titled Race against time, that almost double the number of women than men are feeling rushed or pressed for time due to family demands.

Soon after the Maternity Services Review wound up in 2009, a discussion guide was released for a Draft National Framework for University Child and Family Health Services. Yet, two years down the track there is no sign of a final report. Why?

The Maternal and Child Health Services are a critical touchstone between families and the health system. We need some national guidelines for the new Family and Child Health Nurses that include programs to assist individuals or couples negotiate these very real 21^st century tensions.

Gender equity calls for continuing institutional change in the workplace but also a rethinking of educational systems that rely on someone being around for the three o'clock pickup and the twelve-week holiday program. What is going to happen when this generation of grandmothers won't be there to fill the gaps?