Postpartum disorders and maternal aggression
...In England, support for hormones as the cause of *all* maternal aggression
against infants is enshrined in the law. In 1922, parliament introduced the
Infanticide Act, which reduced the crime automatically from murder to manslaughter
on the basis of insanity if a mother "had not fully recovered from the effect of
giving birth to such child, but by reason thereof the balance of her mind was then
disturbed." The point of the Infanticide Act was not that British doctors had
suddenly discovered a link between postpartum hormones and violent behavior.
To this day that link hasn't been categorically established.
The point was to rid the courts of the necessity of imposing murder sentences,
since juries had been refusing to convict women when the penalty was execution.
For instance, following five thousand coroner's inquests into child deaths held
annually in Britain in the mid-nineteenth century, only thirty-nine convictions
for child murder resulted, and none of those women were executed. Similarly,
in Canada, when a mandatory death penalty applied to the murder of children,
"courts regularly returned 'not guilty' verdicts in the face of overwhelming
evidence to the contrary."
In 1938, Britain revised its infanticide statute, extending the age of victims
from "newly born" to "under the age of 12 months." To justify this extension,
the revised statute cited "the effect of lactation" on a woman's mind. It was
decided, in effect, that breastfeeding could drive women mad. The experts who
proposed the revision to the courts privately believed that social and
psychological factors were more critical than biology. Studies consistently show,
for example, that preexisting histories of depression and life stress are a
common denominator in women with postpartum mental disorders. But psychiatrist
J.H. Morton defended the diagnosis of "lactational insanity" as being acceptable
to conservative judges and barristers. I was never proposed that the Infanticide
Act forgive mothers for killing older children, spouses or others, even while
said to be suffering from the same insanity.
Adopting the discreet position of British psychiatrists, the American Psychiatric
Association views childbirth as simply a trigger for a variety of psychiatric
conditions. The APA bible, the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV), has no listing for postpartum psychosis but cites "postpartum onset" for
certain mental illnesses, such as bipolar disorder and clinical depression. In
pre-World War II Britain, psychiatrists believed that "exhaustion psychosis" due to
sleep deprivation was more operative as a risk factor for mothers than hormonal
change. Recognized in both England and the United States, exhaustion psychosis
refers, essentially to being so tired that one can't navigate the shoals of reality
anymore. Anyone who has gone without sleep for a long period of time knows what it's
like. Truckers, doctor-trainees, nurses, soldiers and new parents can all describe
the experience of being so exhausted that they get delusional, disoriented,
extremely emotional. Mundane annoyances can trigger weird, wild rages and crying
jags. Pushed to the brink, people in this condition temporarily lose their grip.
Some hallucinate. When sleep deprivation combines with the constant demands of a
baby, a lack of support, and insecurity or resentment about parenting, a normally
well-balanced person can come perilously close to violence. This is not true just
of biological mothers. Fathers and adoptive mothers have been documented with post-
partum onset exhaustion psychosis.