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Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America

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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 p 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.


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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 p 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.

30 review for Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America

  1. 5 out of 5

    Mehrsa

    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.

  2. 4 out of 5

    Michelle

    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 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.

  3. 4 out of 5

    Terzah

    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 b 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.

  4. 4 out of 5

    Laura

    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 !

  5. 5 out of 5

    Patricia

    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 info 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!

  6. 5 out of 5

    Keri

    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, glorificatio 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.

  7. 5 out of 5

    Laura

    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).

  8. 4 out of 5

    Amanda Schimke

    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.

  9. 4 out of 5

    Josh Kanownik

    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 s 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.

  10. 5 out of 5

    Kelly Magro

    "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 crumbl "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.

  11. 4 out of 5

    Alicia

    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 thou 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!

  12. 4 out of 5

    Stefanie

    I was lucky to read an early copy of Sarah Menkedick's Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America. In turn a lyrical memoir, researched reportage and feminist query into the anxiety of contemporary motherhood, Menkedick’s book explores the different ways fear is eroding maternal health in America. By using her own experiences and those of other moms, she's able to highlight diverse topics like the difference in maternity care for people of color, reproductive rights a I was lucky to read an early copy of Sarah Menkedick's Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America. In turn a lyrical memoir, researched reportage and feminist query into the anxiety of contemporary motherhood, Menkedick’s book explores the different ways fear is eroding maternal health in America. By using her own experiences and those of other moms, she's able to highlight diverse topics like the difference in maternity care for people of color, reproductive rights and reform movements, the legacy of female "hysteria" and more. Overall, Menkedick writes with the voice of an expert and an empath, making her reader feel both understood and empowered.

  13. 4 out of 5

    Jane Overbeck

    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 mus 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.

  14. 4 out of 5

    Gillian Cawiezell

    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 openin 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!

  15. 5 out of 5

    Liberty

    Outstanding work of journalism and creative non-fiction! Such insight into motherhood, expectations, healthcare, worry, cultural narratives about mothering, and anxiety that doesn’t perfectly fit into the right “checkboxes” for PPD and therefore goes undiagnosed. Loved the personal profiles of real women—a diverse cast!—and their experiences. Although I did not suffer from PPA or PPD, I could really relate to a lot of what is in this book. It is essential reading for our times.

  16. 4 out of 5

    Jenny Williams

    This book is an incredible achievement: deeply researched, profoundly timely, and gorgeously written. You don't have to be a mother to feel the resonance of Menkedick's insights and to see yourself in its pages. The interweaving of personal story with scientific investigation and reportage is masterfully done. Read it. Gift it. Discuss it. DO IT.

  17. 4 out of 5

    Rachel

    A fascinating and well-researched work. Sarah Menkedick gives voice here to an experience that is so common and yet oddly invisible -- I experienced crippling anxiety as a mother, as early as pregnancy, and yet I've rarely talked about it with other mothers. It is such an important book, a deeply feminist book. I received an Advanced Review Copy of this book through Goodreads Giveaways.

  18. 5 out of 5

    Sarah Sotirin

    I was interested in learning about the topic of PPD which prompted my purchase. This book gives light into the authors and her friends personal experiences more than I cared to hear about. The tone is negative and had an overly feminist thread that made it sound more like a vent session. Historical recaps felt like a forced connection.

  19. 5 out of 5

    Emily

    This book has comforted me in my affliction (I needed this 8-10 years ago when I was postpartum!) and afflicted me in my comfort (how can the racial disparities in healthcare be so significant?). I want everyone to read this book so that peri-partum mental health is better understood and supported.

  20. 5 out of 5

    Lorren

    Round up to 3.5 stars. Her writing is gorgeous and the truths she exposes about maternal health care are chilling but sometimes the two styles didn’t flow well for me and it felt jarring. Still an important and powerful book.

  21. 4 out of 5

    Tina

    I'm not a mom. And I don't necessarily want to be a mom. But I'm fascinated to read about the motherhood experience. And the parts of the book that centered on that were captivating. The historical recaps didn't feel necessary.

  22. 4 out of 5

    Mary Jayne

    I'm just so glad this book exists. The author has brought this ubiquitous but invisible narrative out of the shadows so masterfully. I feel seen. Must read.

  23. 5 out of 5

    Melissa

    Good book. Well written. Helpful. Easy to understand. I recommend this book

  24. 4 out of 5

    Cara

    This was so well researched, so needed, and so anger/sadness inducing. An important work. A must for mothers and those who love them.

  25. 4 out of 5

    Anna (Bailed to go to Storygraph! Username: acweber)

    Books have no business being this good!

  26. 5 out of 5

    Sarah

  27. 4 out of 5

    Tawney

  28. 5 out of 5

    Anna

  29. 5 out of 5

    Andrea

  30. 5 out of 5

    Ryan Tresser

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