Dr Kirsty Budds is a critical health psychologist and qualitative researcher. She is a Chartered Psychologist and member of the BPS Division of Health Psychology. Her key research interests are in the topics of women's reproductive health and parenting. She is a mother of two young boys.
How do norms about intensive mothering affect women’s choices about starting a family?
I think it has a real impact on when women feel like they're ready for motherhood.
The discourse of motherhood and the norms of our motherhood are really intensive and child centred. Everything has to be about the baby or the children as they grow up. It gives the impression that if there’s anything else that you might want to do in life it is incompatible with motherhood. Whether that be travelling or developing a career or anything else. We get the impression that once you’re a mother you can only focus on your children. What I think that does is it makes women feel like they have to get all these other things out of the way first. I’ve done interviews with women who had babies over 35 and that was one of the things which came through strongly. In their 20s they felt they wouldn’t have been ready because there were all these other things that they needed to do first before they could devote themselves wholly to their children.
As well as all our strong cultural ideas about what makes a good mother, there are norms about what makes a good family unit. You have to be with your partner for a certain amount of time, in a strong stable relationship. There’s a trajectory we should follow. Live together, get married, have kids. All that stuff takes time and money and luck. It’s not necessarily in your control.
There’s also an expectation, particularly for middle class women, that you go to university and develop a career and that children come after that.
So it’s pretty tough: there seems to be a very narrow window between 30 and 35 where it's acceptable for women to have children. Anything outside of that is viewed as fair game for scrutiny.
The wide acceptance of the middle class trajectory and the correct order of things also has another effect. Women who do want to start a family a bit younger who then have fertility issues are often fobbed off. They are told there’s no need to worry as they’ve got so much time. But they haven’t got time. If they want to start a family now then their fertility matters now. At both ends of the age spectrum women’s choices are constrained.
You’ve written previously on how responsibility for the health of future children is put on women rather than all adults. Why is that and what impact does that have?
The first thing to say is that this happens in relation to preconception health but also across lifetimes. Women are often positioned as being responsible for the health of anyone who needs care. Joan Wolf has written about how risk management has become a key feature of intensive mothering. The idea that women should anticipate and manage any risk that might be there for their child throughout their lifespan.
We see similar ideas when women are encouraged to avoid a whole list of things in case they are pregnant, or in case they will soon be pregnant. It’s important to be clear here- there is some merit to this advice for some toxins – e.g. in the case of smoking – though the evidence around low to moderate alcohol consumption is less convincing, for example. However, when there is a bodily connection between mother and child and harmful toxins can pass from one to another, it makes sense to try and limit that within reason. But what’s interesting is the gendered disparity. The health of eggs and sperm are both important so why the intense focus on women being so careful? This relates to Cynthia Daniel’s work on reproductive masculinity and the idea that men are considered more tangential to reproduction and reproductive health.
With men seen as secondary to reproduction it makes sense that we would be less concerned about a man’s exposure to environmental toxins, less concerned about any impact on a future baby. As we’re less concerned, we do less research and less is known about the connection between the health of the father and the health of their child. It’s usually women who present with fertility issues and it’s often assumed to be to do with them rather than being a male factor or a combination of factors. This all helps to shore up the fascination we have with women’s reproductive health.
Fundamentally we’re more relaxed about controlling female bodies than male ones. Women’s bodies are less fully their own than the bodies of males. We’re still partly seen, at least subconsciously, as vessels.
This comes through really strongly when we think about preconception health. Policies aiming to boost preconception health often combine women trying to conceive, women who might have an unplanned pregnancy and women ‘at risk’ of pregnancy. But that could just be any woman from about 14-50 couldn’t it? We’re telling women they’ve got to act as if they are pregnant, even though they’re not, even though they’re not hoping to be. We’re seeing women in terms of their potential for pregnancy.
Implications
This has different implications for different groups of people. For women trying to conceive, the focus on women’s health rather than the health of both parents places more responsibility on women and therefore more blame for poor outcomes. If we're saying that women's preconception health matters more than men's then when something goes wrong, of course we’re more likely to assume the cause was related to what the woman was doing, what her health was like before or during the pregnancy. Women might be inclined to blame themselves for losing a pregnancy if they drank some alcohol before they even knew they were pregnant. Thoughts about the health of their sperm at the point of conception wouldn’t even be on most father’s radars.
There’s also a creeping commercialisation of our focus on women’s reproductive health.
Lots of places want to sell you advice and products which play into the idea that your fertility is your responsibility as a woman.
When I analysed newspaper articles about preconception health that was a strong narrative. We’ve probably all seen article headlines like the Top 10 things you can do to boost your fertility. For some women that might be empowering, it might make them feel like they have some control, and like there's something they can do, especially if they're struggling. But equally it's problematic because there are a lot of things about reproduction that we don't have control over. These articles can mean that women delay seeking help- they might think ‘I’ll just try these [really expensive!] prenatal vitamins’ or ‘I’ll just change my exercise regime, maybe that will help’ when there may be some underlying cause impacting fertility they have little control over.
I’m concerned that the more that conception gets presented as within a woman’s control then the more likely it is that women will blame themselves for not conceiving when they are trying to, but the chances are that the cause will be beyond their control.
I think there are also interesting implications for women’s wellbeing of some of the behavioural advice women receive. Take alcohol. Women are often advised to avoid alcohol altogether whilst trying to conceive. Some people conceive quickly but for others it takes months or years. Having a drink with friends is an important part of many people’s social lives but some of the women I surveyed ended up withdrawing from social interaction because they felt their friends would assume they were pregnant if they weren’t drinking and they didn’t want to be asked about being pregnant when actually they were struggling to conceive. Withdrawing from social interaction and support networks is a damaging unintended consequence of what on the surface seems like relatively straightforward health advice.
That’s often the case.
Each individual bit of advice: don’t drink, don’t eat that, don’t do that, buy this, might sound fine in isolation. Each bit of advice might have some supporting evidence, even compelling evidence. But we routinely forget or refuse to think about the mother, or potential mother, as her own person.
Our parenting takes a ‘child centred’ and ‘child first’ approach. Lots of women’s health advice takes a ‘foetus first’ approach where whatever is best for the foetus is necessarily best overall, with no space for questions. What we’re seeing now is going further still, because we’re talking about people who are not yet pregnant so we’ve got a ‘hypothetical foetus first’ approach.
Interested in reading more from Kirsty?
Budds K; Eldred L; Murphy C (2024) Promoting empowerment or intensifying reproductive burden? Accounts of preconception health adjustments among women trying to conceive. Psychology & health, pp. 1-21.
Budds K (2020) Fit to conceive? Representations of preconception health in the UK press. Feminism and Psychology
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