A new study from the University of Warwick exposes the stark disparities within society that have long supressed the voices of marginalised women dealing with postnatal depression.
Titled "The Last Taboo of Motherhood?", and funded by the Wellcome Trust, the project sheds light on how societal structures have stigmatised working-class, unmarried, teenage, disabled, lesbian, and ethnic minority mothers in the delivery of maternity care and responses to maternal mental health throughout the 20th century.
Researchers, Dr Fabiola Creed and Professor Hilary Marland, reveal that a lack of resources and safe spaces has perpetuated a cycle of underrepresentation, leaving these women feeling unheard and dismissed.
Many women experiencing postnatal depression in the 20th century felt unable to share their experiences due to the shame attached to poor mental health following childbirth, a time that was meant to be one of happiness and fulfilment.
The researchers show how this fear of sharing started to change, mainly after the 1980s. Women began to write about and discuss their personal experiences; and campaigned with health professionals and organisations like the National Childbirth Trust for improved services and a better understanding of postnatal psychosis and depression.
Hilary Marland, Professor of History at the University of Warwick, said: "Our research unveils the distressing reality faced by women dealing with postnatal depression across the 20th century. It is important that we recognise, and address inequalities faced in the past and ensure support is available for all mothers."
The research explores the impact of historical events such as migration, feminist movements, changes in the provision of health services and the growth in mass media on the physical and mental health of mothers and their families in Britain.
Dawn Cannon, Director of Warwick Infant and Family Wellbeing Unit at the Warwick Medical School, added: "Pregnancy, birth, and the transition to parenthood is a time when a woman's health and wellbeing and that of her infant and family can be greatly affected. Poor perinatal mental health is associated with higher risks of postpartum complications.
"The research from the University of Warwick highlights that high quality maternal and child health (MCH) services need to provide competent and empathetic care. Society has a responsibility in shaping the infant mental health capacities of its future generations. Perinatal mental illness is a major global public health concern with 1 in 10 women suffering anxiety and depression antenatally.
"Women need to be treated with respect and dignity within a supportive environment that aims to reduce the stigma of perinatal mental health conditions."
Among other things, Professor Marland's research highlights how the shift to hospital deliveries and increased use of childbirth technology after the 1950s resulted in feelings of isolation, anxiety, stress, and depression in new mothers.
Dr. Creed's research spotlights a pivotal moment in the discussion surrounding maternal mental health. Nemone Lethbridge's controversial play, "Baby Blues," was aired by the BBC in December 1973 as part of the 'Play for Today' series and addressed taboo topics like infertility, caesarean section childbirth, infanticide, and suicide. The play had a very mixed reception and triggered a shift in discussions around maternal mental illness.
Although heavily criticised, it also prompted acclaim and directly led to the creation of Depressives Anonymous (DA) in 1974, a grassroots self-help group which is still going and stands as a testament to the enduring legacy of Baby Blues.
Dr. Creed's research also analysed changes in the presentation of postnatal depression in BBC's Woman's Hour in the second half of the 20th century. Her study revealed that, while Woman's Hour was launched in 1946, it wasn't until the 21st century that maternal mental health became a regular feature. Dr. Creed traced the shift from doctor's-only narrative being permitted to the growing numbers of women describing their personal experiences of mental illness on the programme.
The findings underline the critical importance of understanding the historical context and societal influences of how postnatal depression was approached by women across different backgrounds. The findings reinforce the importance of listening to the voices of people with first-hand experience and acknowledge that women who have experienced maternal illness are central to shaping support systems and services.
