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

Abstract

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.

‘Noisy, restless and incoherent’: puerperal insanity at Dundee Lunatic Asylum

“…The history of ‘puerperal mania’, madness associated with childbirth, has principally been documented by Marland (1999, 2003a, 2003b, 2004, 2012), who has explored the experience of the condition by women themselves and the evolution of the diagnosis in a changing professional landscape. Significant British work has also been conducted by Day (1985), Nakamura (1999) and Quinn (2002, 2003), and in the USA by Theriot (1990).…”

“…Although physician-accoucheur Thomas Denman had referred to ‘that aberration of the mental faculties, which sometimes, though happily very rarely, we have the opportunity of observing’ (Denman, 1807: 430), the condition was first clearly described in Britain by obstetrician Robert Gooch in an 1819 paper delivered to the College of Physicians (Gooch, 1820: 263). The idea that women following childbirth could be prone to violent or erratic behaviours, or extreme misery, had long been recognized by women and midwives (Marland, 2003b), but the nineteenth century saw a medicalization of childbirth and associated conditions, with women steadily removed from a province that was previously very much their own (Marland, 2012: 79). Puerperal insanity was a contested area sitting ‘uncomfortably somewhere between obstetrics and psychiatry’, a battleground for the opposing and competing interests of the rising psychiatric and obstetric professions, which nonetheless gradually ‘coalesced’ into a recognized ‘body of medical literature’ (Loudon, 1988: 76; Nakamura, 1999: 299).…”

Historical perspectives: a snapshot of women admitted to psychiatric facilities with psychosis or mania after childbirth in the late Victorian and inter‐war periods

“…Second, it became apparent that women with mania following childbirth could be curable. Asylum administrators encouraged the admission of women with mania into mental health facilities (Marland ). Frederick Norton Manning, the Inspector for the Insane in NSW from 1876–1898, believed that manic conditions resulting from childbirth should be treated in mental health facilities only (Norton Manning , ).…”