Jessica Grose, SCREAMING ON THE INSIDE: The Unsustainability of American Motherhood

Jessica Grose, SCREAMING ON THE INSIDE: The Unsustainability of American Motherhood

Zibby speaks to New York Times opinion columnist and author Jessica Grose about her fierce and timely new book Screaming on the Inside: The Unsustainability of American Motherhood. Jessica shares the details of her complicated pregnancy, her thoughts on unrealistic parenting expectations and this country’s systemic constraints on mothers (like a complete lack of perinatal mental health care), and her suggestions on how to fix all of this (they include affordable childcare and normalizing asking for help). Finally, she talks about her impressive career in journalism and shares advice for mothers.


Zibby Owens: Welcome, Jessica. Thank you so much for coming on “Moms Don’t Have Time to Read Books” to discuss Screaming on the Inside: The Unsustainability of American Motherhood.

Jessica Grose: Thank you so much for having me.

Zibby: When I got this book and even heard the title, I was like, finally, yes. Thank you. I wrote this essay four years ago or five years ago. It was called “A Mother’s Right to Sanity.” It’s impossible. It’s just impossible. It’s untenable. Tell listeners about your book. I know all about your book. Tell listeners about your book and why you decided to make it into a book at all.

Jessica: I have been thinking about writing a version of this book for probably eight or nine years. I had a very difficult pregnancy with my older daughter where I had hyperemesis, which is uncontrollable throwing up. I like to joke that I leaned into a toilet, because that is what it felt like. I got extremely depressed because I had gone off antidepressants to conceive. I had just started a new job. I had to quit that job because I was so terrible at it. I just couldn’t show up because I was really sick. I realized in that moment, and even though I had been covering family policy before that and realized America does so little to support its parents, actually living through it myself in such a dramatic way was really galvanizing. Since then — my older daughter’s going to be ten in a couple weeks — I have been reporting and talking to, probably over the years, thousands of moms about the ways that our society falls short and the expectations they feel are all on their shoulders and that they are not given the tools to be the kinds of parents that they really want to be.

The pandemic really crystalized everything for me. I think it crystalized everything for a lot of parents who maybe had some inchoate idea that everything wasn’t working, but they were just trying to get through every day because there’s so much to do every day. Then with all of the social structures really falling apart in March 2020, I think more people realized, this is not working for me. This is not working for most people. Really, the pandemic is what made me be like, okay, this is the time for this to be a book-length project. The pandemic is in it, but it is not the main part of the book. It is one chapter. All of these ideals that we live with and put so much pressure on ourselves to live up to have been with us for forever, but certainly since the beginning of American society. They just shapeshift around whatever’s en vogue in the culture at the time. That’s the long and short of it. A lot in there.

Zibby: A lot in there. The throwing up in pregnancy, it was as if you had developed some sort of chronic illness with no treatment. Luckily for you, there was an end in sight, that the baby would come. Still, that doesn’t mean that it made any moment of that journey any easier. It so took over your life. I know you just mentioned you couldn’t work. The way you write about it and how you needed to be so close to a toilet at all times and how you tried so hard and nothing you did would really help, this sense of hopelessness and desperation and the fact that other people are all doing this and what supports there are, the telling of the medical odyssey part of this, not even odyssey, but just medical situation was so vivid and so awful for you. Oh, my gosh.

Jessica: Thank you. I really wanted to make it seem real. It was hard to write because plunging myself back into those feelings was not delightful. Just to connect it back to all these bigger-picture ideas, there is, as far as I know, one researcher who studies hyperemesis because there is no money in it. They don’t fund women’s health, first of all, the way that they fund — you always hear the statistic about how there’s more money going into erectile dysfunction than there is into most women’s health issues. I, years ago, interviewed the one woman who does research it. She researches it because she had it herself. She has a nonprofit that raises money for it because she’s not getting money from the big funders. What they say is, well, it resolves itself. It ends with pregnancy. It is one of the most common side effects. That’s not the word I’m looking for. It’s one of the most common disabilities and difficulties that women have during their pregnancies. It is debilitating, as I point out. To hear from the medical community at large, it’s not that big a deal because it resolves itself when you give birth — it is actually quite dangerous for some people. I was lucky enough where I was getting — I technically met the definition of hyperemesis because I lost five percent or more of my body weight in my first trimester, but I was keeping down enough where the baby was always okay. I didn’t even have the worst version of it. I didn’t even have the worst version, and it was completely debilitating. It ruined my life for the seven months that I was really stricken with it. It got better towards the very end of my pregnancy and then resolved completely when I gave birth. Just to tie it all in, there’s always these systemic things where it’s like, why don’t we have a fix for that? Because there’s no money in it, and we don’t care.

Zibby: You also highlighted the lack of research around going off antidepressants. Why do doctors always tell you to do this? I went off antidepressants for my last kid. It was rough going. Not to mention that just the fact of going off antidepressants usually takes a long time, and tapering. I don’t know if you read May Cause Side Effects by Brooke Siem. Did you read that book?

Jessica: No.

Zibby: It’s really interesting, about how when you go off, sometimes these other symptoms come back. You think that it’s the problem, but really, it’s the getting off of the meds itself that is causing these symptoms. It encourages people to just stay on again. It can cause psychosis and all sorts of stuff to get off the meds. Talk a little about your research in that and why this flippant, well, it might hurt the baby. I don’t know. Probably, just go off.

Jessica: That’s a medical knowledge gap because there is actually quite a bit of research on the older SSRIs, so you’re talking Prozac, things that have been around for twenty or more years. There is pretty robust research on it. It shows that the same risks that exist from staying on antidepressants are the same risks of being super anxious and depressed while you’re pregnant. Neither option is very good. They’re minimal. They exist. I don’t want to sugarcoat that. There are risks of low birth weight. I don’t have the stats in front of me, but there are risks. What always bothers me is it’s treated like an optional medication. Whereas if you needed insulin because you’re diabetic, of course, you would stay on it during pregnancy. It should be treated like every other medication where you weigh the risks and benefits, and you make an informed decision with your doctor. That might be going off, but that might be staying on. I think the problem is unless you have a psychiatrist who is well-versed in perinatal mental health, they just will not know the statistics. I had to look up the statistics. These are people who are educated. It’s just a very specific branch of maternal mental health.

I don’t remember if this made it into the book. I’ve just done so much research on all of this over the years. The model that is recommended to maintain mother’s mental health is an integrated model where obstetric practices also have a social worker in the practice. They have a social worker or a psychologist. You’re a one-stop shop. You’re not having to get referrals. You’re not having to go every which way. It is baked into the overall well-being of the mother and baby. That sounds like a dream. Not only are they expert, but they’re right there. That is what I would wish for any new mom, that they would have that level of support and understanding and also just acknowledgment that prenatal and postpartum mental health challenges are beyond common. They are so common. It’s twenty percent. A fifth of moms will have some sort of diagnosable struggle. That doesn’t even count just the heightened feelings that are not clinically significant of exhaustion. Your life is changing. It’s a transitional time for a lot of people. You’re getting no sleep. That’s what I always tell my new-mom friends. I’m like, just go to sleep for five hours, and see if you feel okay. Part of it is you’re just so freaking tired that everything feels unmanageable. I wish that mental health coverage were more baked into the systems that we have.

Zibby: I don’t even think perinatal mental health is a popular term. Nobody focuses on that. It would be great. You’re pregnant. Here’s the results. Here is your perinatal mental health counselor. Good luck. That would be lovely. This is an alternate wonderful world.

Jessica: A theme I come back to over and over again in the book is that countries that are as wealthy as the United States all do more for mothers and for parents. One thing that is very common in other countries that have national health systems is to have a nurse who comes to your house frequently in the weeks after you give birth. Just that, having someone come who can help you with breastfeeding, just talk to you, check in with you, can you imagine? How lovely would that be?

Zibby: I do feel like modern life in general — this is a larger point. We keep going faster and faster and adapting to all these things and doing more and all of this stuff. I think pregnancy, childbirth, the whole thing, nursing, it doesn’t really fit with the iCal schedules and the crazy pace of life. I remember as a new mom, I was just like, how am I supposed to do all this nursing and make any sort of plan? Then if I can’t make any sort of plan, how can I possibly maintain my other commitments and participate in X, Y, Z or work or write or whatever? It seems almost like, if only we could go back in time, that this current lifestyle speed does not really fit with this most elemental evolutionary part of our bodies.

Jessica: It’s true. One of the most fascinating parts of the book for me and one of the most interesting aspects of all the research that I did was reading women’s diaries and letters from hundreds of years ago. It’s not like they found breastfeeding or birth easy. They had, perhaps, fewer expectations on their time. I still remember reading these letters about women talking about their abscesses, the babies feeding all the time, how exhausted they were, how their husbands were not helping them. They were off doing god knows what. Even though that wasn’t even the societal expectation, that husbands should really be involved in nineteenth-century childrearing, these women still felt totally abandoned and angry. It’s sort of comforting to know.

Zibby: That makes me feel better.

Jessica: Even within the iCal demands on your time — my favorite was one woman who was writing a letter to, I think it was her sister, about giving birth. She was like, “It’s hell.” In some ways, things have really changed. In some ways, it’s same as it ever was.

Zibby: True. Plus, we have all sorts of medical advances, even though it’s not perfect, compared to .

Jessica: It’s true. Yes, very happy to have that epidural. Very, very happy that that was an option for me.

Zibby: There’s the childbirth, that early motherhood, but there’s being a mother, which also feels unsustainable and which you highlight, especially with your pandemic research and all the moms that you talked to. Obviously, it was so evident how unsustainable it all is. Talk to me about, over the lifespan of the mom, when does it get easier? Is there anything we can do to make it easier? Looking at it analytically the way you did with all the data, where’s the answer? Where’s the spotlight shining that is like, this is the path?

Jessica: I think the biggest thing to realize is that a lot of things that would make it easier are not individual solutions, so paid leave, health care that is not tied to jobs, universal sick days, things that would make a sick child not a crisis in your life or not an overwhelmingly kink to your schedule. Affordable childcare is huge and does not exist here. All of those things happening and advocating for them, if you have the energy to advocate for them, those things are super important. On the individual level, I think just honesty, asking for help. A lot of folks have so much trouble saying, I’m not doing okay. I need help. I need you to come sit with my kids for an hour so I can take a nap. I am going to lose my mind if I don’t go to the gym today. Just having a community where — obviously, you reciprocate that, but relying on our communities more than we have been. I think that there’s a lot of resistance to asking for help. Either you think you’re burdening people or you think you’re going to look like you can’t hack it because you need the help. I think just that simple asking for and offering help.

For us, and I know that this is not feasible for everyone, we have been blessed to live near my parents. We live near my parents. They are in great health. They help with our kids once a week. Just knowing they’re there, psychologically, in an emergency has been immeasurably helpful, especially the pre-pandemic era when my kids were really little. There were times where it was like, oh, my god, I am going to lose my mind. I’m going to really not be able to meet this commitment that I’ve made for work. They gave me the gift of life. They have enabled me to have kids. What’s generationally meaningful and resonant for me is my grandparents did that for my parents. My parents were both doctors. My mom was one of five women in her medical school class in the early seventies. It was unusual to be a woman in medical school then. Her parents were not only so supportive and encouraging of her to work and to be a professional, but they lived nearby. They were the backstop for childcare crunches and disasters. I think my parents feel like they are paying it forward, in a way. Not only am I grateful for it, but it is very meaningful because I was really close to my grandparents. That relationship, for me, was so important. I’m hoping that that is also for my kids, just having more grown-ups in their lives who love them and have fun with them. It’s a little bit saccharine, but it is true.

Zibby: It’s great. How did you become a reporter at The New York Times? Tell me a little bit more about that journey. I know you talked some about what you were doing in the past and all of that in the book, but for people who don’t know.

Jessica: I basically started in journalism as soon as I graduated from college. I actually thought I would be a culture reporter, so my first job out of college was at Spin, which I think no longer exists.

Zibby: I remember Spin.

Jessica: The music magazine Spin, I worked on their website, which in 2004 was just so not what websites are today. I always worked on the web side of publications. I worked there. Then I worked at the Zagat Survey. I was very terrible at that job. That was a real learning experience for me because I was like, wow, this is the first thing I am kind of failing at, because it wasn’t a good fit. It was a job that required a lot of copyediting, and that is my Achilles’ heel. I can do a structural edit. I can write. My grammar for myself is fine. I cannot do it for other people. I am not a good line editor. Anyone who has been edited by me, I’m like, does that comma go there? To this day, not my forte. I did that job. Then I worked at Jezebel in the first year or two it was around, which was an amazing experience and really got me more into women’s media. I had been more on the culture or lifestyle side. I worked at Jezebel for a year or two. Then I worked at Slate for three years, so more online media reporting, really learning how to shape a story.

I had amazing mentors there. They were mentors not only in writing, but also just really great models for me in seeing what a working mom could be like. At the time, I was in my twenties. I was like, this seems so hard. I’m already working so hard. How do you throw kids into this mix? It was really special and important for me to have those role models in Hanna Rosin and Emily Bazelon to say, oh, they’re doing it. They’re doing all the things, and they are doing all of the things well. I think about them. I’m still in touch with them and think about them a lot. I was at Slate. Then I took another job. That was the job I had to quit after two months because I was pregnant. Then I freelanced for three years when my older daughter was born and until she was about three. Then I just wrote for everybody. I wrote for a lot of business publications because they paid well. I wrote for Business Week. I wrote for Fast Company. I wrote for all of the women’s magazines, Maire Claire, Cosmo, anybody who would have me. I was just like, will your check cash? Great. It was great. I loved being freelance. I am very efficient. It was a good deal for me. I could be really flexible, which I wanted to be. I wanted to spend more time with my newborn. It was a great situation for me going into motherhood. Also, during that time, my first novel came out when I was seven months pregnant. My second novel came out after I had my second kid. Then I started working at Lenny, which was an email newsletter.

We knew that we wanted to have a second kid. We knew that we wanted to have a second kid and that we could not financially make it work unless I went back to a staff job. I started looking for a staff job just to have the regular income because freelance can be very streaky. I think we could’ve made it work, but I just couldn’t deal with that stress, the stress of the hustle, the stress of, this month, I had a windfall. Next month, who knows? With a second kid in the mix, I was like, absolutely not. I cannot do this hustle anymore. I helped found Lenny Letter, which was a newsletter and website. I had an amazing experience with the people that I worked with there. I was there for about three years. Then I went to The Times. That is the long path, many jobs, many different experiences, lots of different — I wrote. I edited. I managed. Now I’m just back to writing again. I am really enjoying it. I miss working with writers. I miss developing people and helping them move forward in their careers. That was really special for me. I do not miss being a manager. Only being responsible for myself is a relief. I’m really happy. Now I just write for The Times’ Opinion section. I love working for Opinion because I have a lot of opinions.

Zibby: That’s awesome. That’s so amazing. If you had one piece of advice for moms, not even for authors here, but just for parents, not even just moms, but parents, after all the research you’ve done and everything, given the structural constraints in which we live and operate and parent, what is the advice?

Jessica: This has been something that I’ve benefited from from all of this research. Anytime you feel guilty about something, just stop. Stop and think, why do I feel guilty? Do I feel guilty because of some nonsense, because I saw some other mom doing it and I feel bad because I’m not doing it, or because my mother-in-law thinks I should be doing it, or there’s some sort of societal pressure that says I should be doing this thing? Are you feeling guilty because it’s your own value and you’re falling short of your own value? In the first case, if it’s someone else’s values you’re not living up to, you can’t stop yourself from feeling that initial guilt. That’s just human. If it is someone else’s values that are making you feel bad about yourself, let it go. Just say, the person I am does not care about this thing. If it is something that is important to you, then it’s time for revaluation. What can I move around in my life so that I can do this thing that is important to me? It’s just really about trying to clarify your own values and what is important to you in your life absent of all of the societal pressures. I’m not saying that that is an easy thing to do. Every single day, I still am like, I am failing at something. I am a perfectionistic person. It is a strength and a weakness for me. It’s also the idea that you’re never going to get to this perfectly idealized state where you’re just actualized. Nothing bothers you. Nothing gets to you. That’s not realistic either. Trying to figure out what your actual values are, that’s also a lifelong project, so I think just spending your time on that rather than the ways that you’re falling short of other people’s expectations for you.

Zibby: I love it. Jessica, thank you so much. Thanks for coming on “Moms Don’t Have Time to Read — ” Thanks for coming on “Moms Don’t Have Time to Read Books,” or, clearly, make sentences today. Amazing. Thank you for putting this all together and helping so many people.

Jessica: Thank you so much for having me. I really appreciate it. If it makes you feel better, yesterday, I forgot the word for footnote. That is how broken my brain is. I was like, the little numbers that go on the end. That’s where I am in my mom journey, just forgetting words for things I should know the words for.

Zibby: I am with you. I’m like, garbage, garage, which is the right word? I don’t even know. Take care. I’ll talk to you soon. Buh-bye.

Jessica: Thanks so much.

Zibby: Thanks.

SCREAMING ON THE INSIDE: The Unsustainability of American Motherhood by Jessica Grose

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