Museum of Health Care Blog

“Pondering the infiltration of the maternal Mental Hygiene movement and Attachment Theory into the minds and maternity manuals of Canada can shed light onto the progression of maternal mental health treatment across the decades.”

During my stint revitalizing many of the Museum’s education programs for off-site use as part of the our ongoing corona-virus pandemic response, I noticed that a particular program pertaining to children’s mental health had been temporarily removed for further research and development. More so than practically any other healthcare subject, mental health topics have acquired a need in recent decades for routine updating and research to compensate for centuries of misinformation. Consequently, the historic misunderstanding of mental health topics has oftentimes resulted damaging treatments and harmful beliefs about effected individuals. 

While having a particular interest in the history of psychiatry in Canada myself, I went about an earlier work assignment excavating books from the Museum’s small reference library with this topic in mind. My co-worker and I stumbled upon several parenting and maternity manuals dating between 1953 and 1970 that took me from the world of children’s mental health, to the many evolving iterations of the maternal “mental hygiene” movement spanning across mid 20^th century North America. The 1950’s to the later 1960’s saw waves of young workingwomen leave their positions vacant for returning soldiers of WWII to fill, and (seemingly) contently peruse earlier social roles as housewives and mothers.^[i] However, a unique problem soon presented itself to a postwar Canada eager to see veterans restored to their prewar positions; how does one convince young women with no desire to leave the workforce to pursue a life of domestic bliss? After all, restoring national birth rates of war-ravaged countries to prewar numbers was a breaking new industry itself in need of a fleet of new recruits. 

The ensuing maternal “mental hygiene” movement, and British psychologist John Bowlby’s Attachment Theory soon made their way into countless marriage and maternity informational manuals in 1953. The manuals inform young working-class women that resistance towards becoming mothers, or concern over symptoms of pregnancy related to mental health indicated that a woman was mentally unhygienic. Attachment theory touted that only mothers were innately capable of serving the fostering the emotions of children; therefore, all children of working mothers would be condemned to lives of emotional deprivation and a stunted development. ^[ii] Lucky for working mothers today, Bowlby’s revised his original theory to acknowledge that no single parent can hold a monopoly on the emotional development of children based strictly on gender after further observation^[iii]. Nonetheless, pondering the infiltration of the maternal Mental Hygiene movement and Attachment Theory into the minds and maternity manuals of Canada can shed light onto the progression of maternal mental health the treatment across the decades.

The Book: Facts for the Childless Couple (1953)

  The earliest book from the Museum’s reference library from 1953 (Facts for the Childless Couple) addresses engaged couples prior to their nuptials. In accordance with the mental hygiene movement, all mentally healthy, well-balanced women innately yearn to become mothers. Perusing any competitive and economic social endeavors during prime childbearing years is reported to decrease chances of conception with age, and “rob women of desired motherhood”. ^[iv] The Statistics Canada portrait of generations from 2011 argues otherwise, as the Canadian national birth rate of 1953 was on a steady incline towards the peak of the Baby boom.^[v]

If the threat of sterility was an inadequate selling point for a life of domesticity, the book engages talking points of maternal deprivation theory for one of the first times since Bowlby’s earliest observations in the same year in 1953. The authors warn its readers that children’s deprivation of their mother’s presence in particular was single handily responsible for the moral degradation of children. Whether it is the threat of sterility, the fear of being categorized as a mentally unhinged, or potential blame for the moral failings of future generations, these earliest iterations of attachment theory certainly made the bliss of motherhood more appealing. 

The Book: The Modern Method of Birth Control (1954)

The next maternity manual had its debut only one year after the previous manual in 1954 (The Modern Method of Birth Control) and differs in terms of why mentally hygienic women should peruse pregnancy rather than how. While this manual maintains that “the cardinal rule of a married woman is to become a mother”, it also brings many of the first socially acceptable reasons why pregnancy may be differed without any mentally unhygienic motivations to the fore.^[vi] The authors reason that psychical complications and financial limitations are legitimate reasons for even the most moral and stable women to delay childbirth. The line between proper mental stability and poor mental hygiene is crossed however when a young woman’s natural instinct for mothering fails to take effect outside of these exceptions.

The Book: Preparing for Motherhood (1956) 

  Two years later in 1956, a monumental shift in maternity social etiquette swept across maternity literature when expecting fathers were encouraged to take a proactive role in their wives’ pregnancies, and help their wives navigate their “curious little emotional swings” along the way in (Preparing for Motherhood).^[vii] Many of the psycho-physiological symptoms of pregnancy we are aware of in the 21^st century were still shrouded in misinformation in 1956. However, this manual openly discusses socially taboo pregnancy topics including mental health challenges, and informs women that “even the normal ones” go through emotional upsets.^[viii] While experiencing worry, depression, tension, fatigue and feelings of being trapped by an undesired pregnancy are common; these challenges are presented as fleeting moments in time that all healthy women will overcome with enough mental fortitude.

The Book: Obstetrics for Nurses (1960) 

The sixties brought new developments in psychology to nursing with (Obstetrics for Nurses) in 1960. For professionals involved in maternity care, this text underpins the role of fear in poor mental health, and details how certain women supposedly lose their mental stability. Though the labor process and delivery of a baby is often viewed as a strictly physical ordeal, the text argues that pain management depends on the psychological condition of the mother and her positive or negative attitude towards motherhood.^[ix] Rejection of pregnancy, painful delivery or anything less than an enthusiastic yearning to become a mother is simply caused by the woman’s own fear of the process. The ability to derive personal enrichment from pregnancy and motherhood is key.

The Book: The Canadian Mother and Child (1970) 

The final maternity manual (The Canadian Mother and Child) jumps forward by a decade to 1970. Not every piece of advice has changed since the last decade. Mothers are encouraged to combat fear with new relaxation and breathing techniques, and to ensure their labor experiences go smoothly by going in with a positive attitude even if a pregnancy is undesired. This manual does however make an important leap forward in reassuring mothers that not all psycho-physiological symptoms of pregnancy can be completely mitigated with sheer optimism.^[x]

Accepting limitations to their social lives and financial hardships are said to reduce the likelihood of severe mental health repercussions from pregnancy. However, the text warns that many new mothers experience the “baby blues” regardless, and should visit their doctors when they do.^[vi] Mention of the “baby blues” in this 1970 text is the first reference to postpartum depression among our maternity manuals at the Museum. Informing young mothers of all potential mental health repercussions of pregnancy that present through no fault of their own is a marked step forward to modern standards of patient care. 

Final Thoughts

  The authors of The Canadian Mother and Child’s own acknowledgment of widespread misinformation sounding maternal mental health, which was often fed directly to expecting mothers through similar maternity manuals for decades emphasized the need for dispel ill-intentioned mistruths and begin earnest research into the subject. A 2006 study later found that a varied form of postpartum depression occurs with up to 80% of mothers in the first weeks following birth as a result of physical hormonal fluctuations, not because of a reluctance to accept a fate of motherhood as ill-meaning researchers once claimed.^[vii] Present research has also come to understand that earlier maternity manuals’ refusal to discuss more unpleasant truths of early motherhood, including the realistic chaos of parenting is gravely misleading, and can exacerbate chances of developing postpartum depression.^[viii] 

The authors of The Canadian Mother and Child were indeed right to warn mothers of the very real risks pregnancy posed to mental health after all. Mental health resources now arm women with the skills necessary to cope with inevitable hardships of pregnancy, and facts . Modern research has also found effective coping strategies to mitigate its effects and fight outdated myths of regarding mental health during pregnancy and postpartum periods. 

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About the Authour

Meaghan McDougald

(Public Programs Assistant, Summer 2020)

Meaghan recently completed an undergraduate degree in history at Queen’s University, with plans to return to Queen’s in the fall to begin her Bachelor’s of Education! Her main areas of interest include the history of the United Kingdom of Great Britain, and the history of psychiatric medicine. Meaghan’s experience of quarantine during the COVID19 pandemic has allowed her to expand her cooking skills, and discover the many hiking locations that Kingston and the surrounding region has to offer.

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References

^{[i] Franzblau, Susan H. “II. Historicizing Attachment Theory: Binding the Ties That Bind.” Feminism & Psychology 9, no. 1 (February 1999): 22–31.} 

^{[ii] Tizard, Barbara. “Looking Back: The Making and Breaking of Attachment Theory” The Psychologist. The British Psychological Society. October, 2009. https://thepsychologist.bps.org.uk/volume-22/edition-10/looking-back-making-and-breaking-attachment-theory}

^{[iii] Hamblen, E. C. Facts for Childless Couples. Springfield, Illinois: Charles C. Thomas, 1953.}   

^{[vi] “Portrait of Generations, Using the Age Pyramid.” Statistics Canada; Census of Population 2011. Last modified December 21st, 2015. https://www12.statcan.gc.ca/census-recensement/2011/as-sa/98-311-x/2011003/fig/fig3_2-2-eng.cfm#archived}

^{[v] Welton, Thurston S. The Modern Method of Birth Control. New York: Grosset & Dunlap Publishers, 1954.}   

^{[vi] Meaker, Samuel R., Preparing for Motherhood; a Manuel for Expectant Parents. Chicago, Illinois; The Year Book Publishers Inc., 1956.}   

^{[vii] Fitzpatrick, Elise and Eastman, Nicholson J., Obstetrics for Nurses. 10th ed. Philadelphia, Pennsylvania: J. B. Lippincott Company, 1960.}   

^{[viii] LeClair, Maurice, and A. W. Johnson. The Canadian Mother and Child. Douglas & McIntyre in Co-Operation with the Health Services and Promotion Branch, Health and Welfare Canada and the Canadian Government Pub. Centre, Supply and Services Canada, 1973.}   

^{[ix] Green, Fiona J., “Coping with Change; Integrating Feminist Praxis with Maternal Health Promotion and Education.” Journal of the Association for Research on Mothering 11, no 1 (2009): 11-25.}   

^{[x] Knaak, Stephanie, “Having a Tough Time; Towards an Understanding of the Psycho-social Causes of Postpartum Emotional Distress.” Journal of the Association for Research on Mothering 11, no 1 (2009): 80-94.}   

Recommended Reading

Mcleod, Saul. “Bowlby’s Attachment Theory.” Simply Psychology. Last modified in 2017.  https://www.simplypsychology.org/bowlby.html 

Tizard, Barbara. “Looking Back: The Making and Breaking of Attachment Theory” The Psychologist. The British Psychological Society. October, 2009. https://thepsychologist.bps.org.uk/volume-22/edition-10/looking-back-making-and-breaking-attachment-theory