Blurring reality with fiction: Exploring the stories of women, madness, and infanticide.

PROBLEM: Often, there is a sense of shock and disbelief when a mother murders her child. BACKGROUND: Yet, literary texts (plays, poems and novels) contain depictions of women experiencing mental illness or feelings of desperation after childbirth who murder their children. AIM: To further understand why a woman may harm her child we examine seven literary texts ranging in time and place from fifth century BCE Greece to twenty-first century Australia. METHODS: A textual analysis approach examined how the author positioned the woman in the text, how other characters in the text reacted to the woman before, during, and after the mental illness or infanticide, and how the literary or historical critical literature sees the woman. FINDINGS: Three important points about the woman's experience were revealed: she is represented as morally ambiguous and becomes marginalised and isolated; she is depicted as murdering or abandoning her child because she is experiencing mental illness and/or she is living in desperate circumstances; and she believes there is no other option. CONCLUSION: Literary texts can shed light on socio-psychological struggles women experience and can be used to stimulate discussion by healthcare professionals about the development of preventative or early intervention strategies to identify women at risk.

Soranus of Ephesus (98-138) on postpartum depression.

Although ancient Greek physicians described several mental disorders, their medical texts bring little information about postpartum depression as defined by modern medicine. Only one reference in ancient Greek medical literature - a passage from Soranus' Gynaeciorum libri IV - can be considered a clear presentation of this mental disorder. Soranus' interpretation seems to be firmly based on the tenets of the four humours.

A tricky object to classify: evidence, postpartum depression and the DSM-IV.

The concept of evidence has become central in Western healthcare systems; however, few investigations have studied how the shift toward specific definitions of evidence actually occurred in practice. This paper examines a historical case in psychiatry where the debate about how to define evidence was of central importance to nosological decision making. During the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders a controversial decision was made to exclude postpartum depression (PPD) as a distinct disorder from the manual. On the basis of archival and interview data, I argue that the fundamental issues driving this decision were related to questions about what constituted suitable hierarchies of evidence and appropriate definitions of evidence. Further, although potentially buttressed by the evidence-based medicine movement, this shift toward a reliance on particular kinds of empirical evidence occurred when the dominant paradigm in American psychiatry changed from a psychodynamic approach to a research-based medical model.

Can't a mother sing the blues? Postpartum depression and the construction of motherhood in late 20th-century America.

Popular depictions of 20th-century American motherhood have typically emphasized the joy and fulfillment that a new mother can expect to experience on her child's arrival. But starting in the 1950s, discussions of the "baby blues" began to appear in the popular press. How did articles about the baby blues, and then postpartum depression, challenge these rosy depictions? In this article, we examine portrayals of postpartum distress in popular magazines and advice books during the second half of the 20th century to examine how the unsettling pairing of distress and motherhood was culturally negotiated in these decades. We show that these portrayals revealed a persistent reluctance to situate motherhood itself as the cause of serious emotional distress and a consistent focus on changing mothers to adapt to their role rather than changing the parameters of the role itself. Regardless of whether these messages actually helped or hindered new mothers themselves, we suggest that they reflected the rarely challenged assumption that motherhood and distress should not mix.

Under the shadow of maternity: birth, death and puerperal insanity in Victorian Britain.

Death and fear of death in cases of puerperal insanity can be linked to a much broader set of anxieties surrounding childbirth in Victorian Britain. Compared with other forms of mental affliction, puerperal insanity was known for its good prognosis, with many women recovering over the course of several months. Even so, a significant number of deaths were associated with the disorder, and a large proportion of sufferers struggled with urges to destroy their infants and themselves. The disorder evoked powerful delusions concerning death, with patients expressing intimations of mortality and longing for death.

"Killed by its mother": infanticide in Providence County, Rhode Island, 1870 to 1938.

This article analyzes infanticide based on the Coroners' Records for Providence County, Rhode Island, from the 1870s to 1938 to determine doctors' and coroners' attitudes toward mothers who killed. The nineteenth century witnessed a medical discourse on the possibility of postpartum insanity as a cause of infanticide. While some women claimed temporary insanity, and some doctors and coroners legitimated this defense, its application to mothers who killed was arbitrary. They determined who deserved this diagnosis based on the woman's character, her forthrightness, and extenuating circumstances. Infanticide divided the profession nationally and at the local level and prevented doctors or coroners from speaking in a united voice on the issue. This article does not attempt to follow cases of infanticide through to jury verdicts. Instead, it provides an opportunity to analyze the circumstances women faced that led them to kill their newborns, and to analyze the responses of doctors and coroners to these mothers who killed. Unlike the findings of other studies, neither physicians nor coroners in Rhode Island were united in a claim of ignorance to save these women from guilty verdicts.

Las locuras puerperales en la Argentina 1880-1940 (clínica e historia) / The puerperal insanity in Argentina 1880-1940 (clinic and history)

El interés de esta comunicación radica en señalar algunos aspectos ligados al lugar que ha tomado el fenómeno de las locuras puerperales en nuestro país en el momento de instalación de las maternidades. Es preciso señalar que un trabajo previo de relevamiento de tesis y trabajos científicos acerca del tema, nos vimos sorprendidos por el pobre interés despertado en los alienstas de la época, pese al impacto social que-según suponemos-ha tenido el fenómeno de la locura puerperal. Asimismo cabe añadir la pobre estadística con la que contamos entre 1880 y 1940, y lo complicado que ha resultado el acceder a ella.

Las locuras puerperales en la Argentina 1880-1940 (clínica e historia) / The puerperal insanity in Argentina 1880-1940 (clinic and history)

El interés de esta comunicación radica en señalar algunos aspectos ligados al lugar que ha tomado el fenómeno de las locuras puerperales en nuestro país en el momento de instalación de las maternidades. Es preciso señalar que un trabajo previo de relevamiento de tesis y trabajos científicos acerca del tema, nos vimos sorprendidos por el pobre interés despertado en los alienstas de la época, pese al impacto social que-según suponemos-ha tenido el fenómeno de la locura puerperal. Asimismo cabe añadir la pobre estadística con la que contamos entre 1880 y 1940, y lo complicado que ha resultado el acceder a ella. (AU)

[Postnatal care in a cross-cultural and historical perspective]. / Barselomsorg i et tverrkulturelt og historisk perspektiv.

BACKGROUND: In most societies, birth and the immediate postpartum period are considered a time of vulnerability for mother and child. Rituals for major changes in the life cycle are common in most societies. The aim of this study was to present some examples of postpartum customs in a cross-cultural and historical perspective. We also present research on associations between postnatal care and mental health. MATERIAL AND METHODS: A systematic search was performed in Medline and the Science Citation Index Expanded (ISI) from 1966 until March 2003. Reference lists in books about pregnancy and birth from the library of the University of Oslo were used to get additional information. RESULTS: The postnatal period is defined as approximately 40 days in most cultures; most societies have special postnatal customs that include special diet, isolation, rest and help in the household. The resemblance between different cultures is striking. Many postnatal customs from rural societies that were common before 1950 have disappeared. The focus on rest and help in the household for the mother after delivery has been reduced. INTERPRETATION: We need more knowledge about the impact of different kinds of postnatal care on the mother's wellbeing.