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.

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