Beyond the Clinical: Maternal Health and Wellbeing

Our era is characterised by a ‘work-family clash’ and there is evidence that trends towards gender equity have stalled. In 2006, a multi-nation study by the European Commission identified the Transition to Parenthood (TtoP) as a ‘critical tipping point on the road to gender equity’ (Lewis and Smithson 2006:13). It is in the early years after the birth of an infant that gendered roles can become entrenched, while at the same time the vast majority of couples are attempting to achieve a gender equal or egalitarian family form (Garvan 2010). The Commission’s report, which drew from quantitative and qualitative findings from eight countries on work–family boundaries, concluded that ‘gender shapes parenthood and makes motherhood different from fatherhood both in everyday family life and in workplaces’ (Lewis and Smithson 2006:13).

Particularly in this context, becoming a mother is often a profound and life-changing experience of important social, cultural and personal consequence. Cultural traditions and beliefs about what it means to be a mother are in flux and mixed up with interpersonal dynamics between the woman-as-mother and her infant. The birth of an infant is most importantly a social and cultural event that has been highly medicalised. Current trends include surveillance of pregnancies and the puerperium, along with interventions in birth, and high rates of Perinatal Depression and anxiety.  Marital dissatisfaction is high and there are legendary issues related to identity for women-as-mothers across the industrialised world.

In the face of significant social change the associated health and welfare services are struggling to respond. There is much work taking place within the Humanities that is highly relevant to practitioners. Midwifery, Family Child Health Nurses, Social Workers, Psychologists and family practitioners are critical touchstones with women and their families. These practitioners are in a position to assist individuals or couples manage significant twenty-first century pressures. However, while there continues to be an emphasis on a biomedical model of health to the exclusion of this wider social and cultural context of change, an opportunity is lost. The issues associated with the ‘transition to parenthood’ such as changes to the sense of self, changes to relationships, changes to the life course, negotiating more housework, and finding a line between self and baby are topics that could be integrated within these related health programs when they are not present.

Sociologists agree that changes to gendered practice are the single most significant development in the later part of the twentieth century. Yet maternal and child health services, particularly in the early years after the birth, are enmeshed within a medical model that most often assumes a gendered breadwinner framework for care. While wage setting has moved to an independent worker model, health and social welfare policies are targeted to maintain families within a new ‘mixed economy of care’. These are issues canvassed by Michael Fine (2007) using a sociological lens. As long as aspirations towards gender equity are caught within this web of care and repacked as a work-family balance, the health and wellbeing of women and their families will suffer. The European Commission have identified the Transition to Parenthood as a critical life stage, but while our institutional framework fails to adequately respond, practitioners who are working with women and their families can assist their clientele navigate very real 21st century tensions.


Joan Garvan graduated from the Australian National University in December 2010 with a doctorate in Gender and Sociology. Her thesis was concerned with the experience of women in the early years after the birth of an infant and she has set out to work in the gap between the academic literature and practitioners such as Midwives, Maternal and Child Health Nurses, Social Workers and Psychologists who are working with women and their families. She has launched an internet site at:  and offers an online Professional Development Course: Beyond the clinical perspective: Perinatal depression and the mother’s life. The course focuses on research on Perinatal depression and the Transition to Parenthood, relevant materials from within Midwifery and Maternal and Child Health, Social Work and Psychology, along with contemporary literature from across the humanities on being a mother. Through online discussion participants engage with topics that arise from the course content while maintaining a continuing dialogue about program development and practical outcomes. Joan can be contacted at


Fine, Michael. (2007). A Caring Society? Care the Dilemmas of Human Service in the 21st Century, U.K.:Palgrave/Macmillan.

Garvan, Joan. (2010). Maternal ambivalence in contemporary Australia: Navigating equity and care, Doctoral thesis, Australian National University see:

Lewis Suzan, and Janet Smithson. (2006). Gender parenthood and the changing European workplace: Young adults negotiating the work-family boundary TRANSITIONS Final Report. U.K.: European Commission.

The Literary Imagination of Alice Munroe

By Tom Ue

Back in 2008, in an article for The Underground UTSC’s Official Student Paper, I responded to a review of Canadian writer Alice Munro’s Best: Selected Stories that was published in The Calgary Herald. In it, Naomi Lakritz criticized Munro’s stories for being “choked with trivial details,” although these stories lead readers nowhere. “Alice Munro’s world is unremittingly grey,” wrote Lakritz: “It may be one of the seven deadly sins of CanLit to utter a critical word about Munro, but the sin of a scanty plot is an even bigger one. This collection can’t rightfully be called stories. They’re unsatisfying sketches of characters who wander through depressive environments, observing the idiosyncrasies of those around them. Yet, those idiosyncrasies are there simply for the sake of being there; they do not lead to climaxes or denouements.”

Quill & Quire’s Derek Weiler dismissed Lakritz’s claims, “it does seem painfully apparent that Lakritz simply hasn’t read much literary fiction before.” Both Weiler’s response and Lakritz’s review provoked heated debate amongst readers of Quill & Quire’s online forum. One reader, “Charles,” claims: “You can agree or not with the opinion of Naomi Lakritz, but to her credit she’s laid out a certain amount of analysis of the book.”

Certainly, Lakritz’s use of the term “Aargghh” in response to samples of Munro’s dialogue does not, in the opinion of the present writer back in 2008 or today, require much “la[ying] out” or fall under the category of literary “analysis.” From Lakritz’s review, one would not have gathered that she was describing an over 500-paged collection that anthologizes some of the Canadian writer’s best works—including “The Bear Came Over the Mountain,” the story from which Sarah Polley’s 2007 Academy Award-nominated film Away from Her was adapted, and “Runaway,” the title story from the 2004 collection. In fact, Lakritz’s review does not even refer to Margaret Atwood’s insightful introduction to the collection, an essay published in The Guardian. According to Atwood, “Munro’s stories abound in such questionable seekers and well-fingered ploys. But they abound also in such insights: within any story, within any human being, there may be a dangerous treasure, a priceless ruby. A heart’s desire.”

Munro’s career has been a long and prestigious one. Since her 1968 Governor General’s Award-winning début, Dance of the Happy Shades, she has redefined the short story form, using the genre to explore issues of maternity, love, and loss. Regarding Runaway, which won the Giller Prize over Miriam Toews’ outstanding novel A Complicated KindnessVanity Fair writes: “The great Alice Munro proves again why short-story writers bow down to her.” This sentiment was shared by Time magazine’s Mona Simpson, who declares that Munro deserves the Nobel Prize for Literature.

It is a pleasure to return to this debate about literariness and the short story form, and to celebrate the Nobel Prize for Literature for Munro, one of the most generous writers of our time, and one who has contributed significantly to the short story form. In his essay “The Fantastic Imagination,” Victorian writer George MacDonald tells authors: “The best thing you can do for your fellow [i.e. reader], next to rousing his conscience, is — not to give him things to think about, but to wake things up that are in him; or say, to make him think things for himself.” Perhaps, we should, as MacDonald suggests, think more carefully and critically about what we read, and see what things stories like Munro’s awaken for us.

An early version of this entry was published as “Recent Review of Alice Munro’s Best: Selected Stories Sparks Online Feud.” The Underground UTSC’s Official Student Paper 28.05 (2008): 11. Print.

Tom Ue is Social Sciences and Humanities Research Council of Canada Doctoral Fellow and Canadian Centennial Scholar in the Department of English Language and Literature at University College London, where he researches Shakespeare’s influence on the writing of Henry James, George Gissing, and Oscar Wilde. Ue has taught at University College London. He was a Visiting Scholar in the Department of English at Yale University, and the 2011 Cameron Hollyer Memorial Lecturer, and he has held an Everett Helm Visiting Fellowship. He has contributed essays on Thomas Hardy, Gissing, Wilde, and with John James, Sherwood Anderson and James Cameron.

Although Ue specializes in nineteenth-century literature, he cares deeply about, and writes on, many aspects of intellectual history. His work has appeared in a number of journals including the Journal of Gender StudiesThe Gissing JournalNew Writing: The International Journal for the Practice and Theory of Creative WritingShakespeare Bulletin, and Variants: The Journal of the European Society for Textual Scholarship, and he contributes to Film International and the TLS. He is editor of World Film Locations: Toronto (Intellect Books, 2014), which coincides with the city’s 180th anniversary, and he has published widely on Sherlock Holmes. He is concurrently at work on a shorter piece on photography and phonography and their impact on the forms of late-Victorian and Edwardian writing. This is an opportunity to do some preliminary work towards a monograph on legal theory and the British novel in the nineteenth century.