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‘Women, Reproduction and Mental Illness in the “Long” Twentieth Century’: A Two-Day Workshop, University of Warwick


'A Mother and Child in a Maternity Ward', (1962) Credit: Wellcome Collection.

On 8-9 April 2024, we hosted our final project workshop at Warwick, exploring the theme of ‘Women, Reproduction and Mental Illness in the “Long” Twentieth Century’. Over the two days, participants presented on a wide range of topics related to motherhood and mental disorders, mental illness around menopause, teenage motherhood, and the relationship of mental illness to abortion and infertility. Although the subject of women’s mental health and reproduction has engaged historians, sociologists and feminist and literary scholars since the 1970s, the papers presented at the workshop built on these earlier insights in novel and engaging ways. The workshop papers explored how understandings of reproduction and mental illness were shaped by gender and sexuality, social class, religion, politics and activism, war, institutional practices, crime and violence, and the media. They also considered how society identified and responded to mental illness among women and how far diagnosis and explanations of mental breakdown were shaped by social, cultural, emotional and medical factors, as well as the interventions of different agencies and experts, women themselves, their families and communities, voluntary organisations and medical institutions. The papers opened up questions about how feminist health campaigns and organisations lobbying for change in policy, legislation and service provision explained mental illness among women and, in some cases, utilised explanatory frameworks of risk to mental wellbeing to underpin and strengthen their campaigns.

 

The workshop was organised under five themes, across the two days.

 

DAY ONE

Mothers, Violence and Mental Illness

Our first session opened with Alison Pedley’s (University of Roehampton) analysis of Broadmoor case files, family letters and press reports. Alison explored the varied responses of women who had killed or attempted to kill one or more of their children during their incarceration, and the often sympathetic, supportive and caring roles of family members. Alison highlighted how crucial family ties and support were in maintaining contact with female relatives in Broadmoor and pressing for their loved one’s release from the institution. She also drew on Sian Busby’s account in The Cruel Mother (2004) of her great grandmother Elizabeth (‘Beth’) Wood, who drowned two of her babies in 1919 and spent two years in Broadmoor. The life stories Alison presented revealed the lasting emotional impact of such calamitous events on family life.

 

Louise Benson James’ presentation (University of Ghent) provided a literary analysis of two novels by the modernist writer Djuna Barnes, Ryder (1928) and Nightwood (1936), examining what fiction can tell us about the perceived relationship between reproduction and mental health in the interwar period. Louise argued that these texts took a defiantly and vehemently anti-procreative stand, incorporating graphic visual and textual depictions of pregnancy and birth. The first novel, Ryder, described the impact of excessive pregnancies and painful traumatic births, resulting in death and madness. In Nightwood, the response of the protagonist, Robin, to pregnancy and birth prompted physical and mental wandering, dysmorphia, body horror and infanticidal tendencies, with the novel also highlighting dominant social concerns about heredity and inherited mental weakness.

 

Citing several well-documented cases, Kelly-Ann Couzens (University of Warwick) examined maternal mental illness and crimes against children during the Second World War in England and Wales, posing the question: what made war distinctive in terms of infanticide? Kelly began her paper by noting the doubling of cases of infanticide and concealment and the appreciable rise in trials for infanticide following the passage of the Infanticide Act of 1938 and the social upheavals caused by the war. Highlighting the importance of press reports as a source, Kelly-Ann argued that infanticide was increasingly being understood within the press and in the courtroom as reflective of broader anxieties about the decline in morals and mobilisation of women in response to the war. The war also saw a change in the location of crime scenes outside of domestic spaces and a highly liberal application of the defence that women accused of these crimes were mentally ill.

 


Cover of Siân Busby's The Cruel Mother (2004)

Diagnosing and Understanding Mental Disorder

Hilary Marland (University of Warwick) opened the next session with her exploration of changes in diagnosing maternal mental illness around 1900, when the Victorian classification ‘puerperal insanity’, which linked mental breakdown resolutely to the experience of childbirth, began to be questioned. Drawing on evidence from two London asylums, Claybury and Colney Hatch, she examined the very different approaches adopted within these institutions to categorising and explaining mental illness postpartum. While Claybury clung tenaciously to the Victorian definition, Colney Hatch quickly adopted new psychiatric terminology, framing childbirth merely as an associated cause of mental breakdown. In continuity with Alison’s paper, Hilary highlighted the central role of the family in shaping institutional responses to maternal mental illness. In particular, she explored how family members might intervene to offer their own explanations of the woman’s mental breakdown, associating this with difficult childbearing careers, painful deliveries, miscarriage and the deaths of young children.

 

Drawing upon a rich array of official reports, medical texts, journals and asylum records, Jenny Smart (University of Cambridge) explored the increasing incidence of, and medical interests in, insanity related to the ‘climacteric’ or ‘change of life’ from the middle of the nineteenth century, but most markedly in the last quarter. This trend stood in contrast to the growing challenges the diagnosis of ‘puerperal insanity’ faced in the same period.  Drawing on the examples of Derbyshire and Norfolk pauper lunatic asylums, Jenny questioned how far climacteric insanity was associated with reproduction or ageing. She argued that, despite it increasing prevalence, the disorder did not become a 'default' diagnosis for middle-aged working-class women and that it was associated with the violation of norms of femininity, community and family, as well as the medicalisation of the female body.


Udodiri Okwandu presenting her paper 'The War on Postpartum Psychosis: Dr Elizabeth B. Davis, Family Planning and Racial Uplift in 1960 Poor, Black Harlem'.

DAY TWO

Activism, Advocacy and Agendas

Laura Kelly (University of Strathclyde) explored how, in the 1980s, post-abortion syndrome (PAS), characterised by feelings of guilt, regret and depression, began to be weaponised by Irish anti-abortion activists, including prominent members of the Catholic Church, who viewed abortion as a threat to motherhood. Drawing on archival sources, the publications of anti-abortion groups and medical professionals and press accounts, Laura highlighted how the Irish anti-abortion movement and PAS were strongly shaped by American anti-abortion campaigners. Two key groups, the anti-abortion counselling service CURA and Women Hurt by Abortion, consistently highlighted the risk of PAS by utilising women’s own testimonies to present themselves as compassionate and acting in women’s interests, situating women seeking abortions as ‘victims’ rather than ‘murderers’.

 

Turning to the United States, Udodiri Okwandu (Harvard University) described how the emphasis on family planning as a solution for poor childbearing women experiencing postpartum psychosis reinforced the pathologisation of Black mothers in major urban centres in the 1960s and 1970s. Focusing particularly on the work of Elizabeth Bishop Davis, a Black American psychiatrist and psychoanalyst working at Harlem Hospital Center, Udodiri demonstrated how a strong association was made between maternal mental illness and the cycle of poverty by health professionals who advocated racial uplift using female sterilisation. Udodiri argued that far from offering a solution to poverty and the strains placed on women with large families, this approach instead mirrored and reinforced eugenic approaches, while also erroneously propagating the idea that postpartum mentally ill women were poor, urban, hyper-fertile and Black.

 

Continuing the theme of advocacy, Rachel Moran’s (University of North Texas) presentation explored the role of women therapists working in postpartum mental health in the late 1980s and early 1990s, describing how, for many, their own postpartum distress had prompted interest in the subject. Drawing on extensive oral histories and the archives of advocacy groups, Rachel showed how these women built their careers by combining practice with media appearances and education. They also established several activist groups, notably Postpartum Support International (PSI) and Depression After Delivery (DAD), and came to play leadership roles in these organisations. Rachel’s paper also analysed the extent to which the work of these activists was linked to feminist ideas, noting that as white middle-class women, their focus and practice were embedded within their own class and directed toward paying patients. Rachel also highlighted how the approaches adopted by these women therapists displaced non-professional women activists and sped up the medicalisation of postpartum depression in the US.


Associate Professor Rachel Moran sharing her paper 'Professionalizing the Postpartum: The Rise of Advocate Psychologists in the 1980s'.

Narratives, Testimony and Media

Zara Christmas (University of Oxford) opened the next session with a presentation on the pathologisation of teenage pregnancy in late twentieth and twenty-first century England. Drawing on expansive interview testimonies, autobiographies and media accounts, she placed teenagers’ thoughts and feelings about their pregnancies at the centre of her analysis, showing how their views diverged from the problematised and stereotyped accounts of teenage pregnancy propagated by media, sociologists and health professionals which dominated this period. Zara’s paper revealed the complexities of holding the dual identities of mother and teenager, the flimsy nature of mental health support and the broad and diverse responses of young mothers to their experiences of pregnancy and motherhood. Combining quantitative and qualitative data, she demonstrated how the moral panic surrounding teenage pregnancy increased in press reports despite actual numbers of teenage pregnancies dropping sharply in the twenty-first century, and her presentation also demonstrated how society stigmatised teenage mothers more than teenage fathers.

 

Fabiola Creed’s (University of Warwick) paper explored how features on postnatal depression were presented on BBC radio Woman’s Hour in post-war Britain. Fabiola explored how the initially ‘taboo’ subject, first discussed on-air by a medical professional in 1960, gained increased coverage in the 1970s and 1980s and was accompanied by a shift to include, and then amplify, the voices and views of women who had recovered from postnatal depression.  Drawing on BBC archives, oral history collections, autobiography and press reports, Fabiola’s paper highlighted how the programme reflected changing attitudes towards maternal mental illness, health advice, and treatment approaches more broadly, especially the role of women with lived experience in articulating and explaining mental illness.

Dr Fabiola Creed speaking at the 'Women, Reproduction and Mental Illness in the “Long” Twentieth Century’ Workshop.

Emotions, Experiences and Mental Health

Drawing largely on Mass Observation testimonies and oral histories, the final session opened with Tracey Loughran’s (University of Essex) unpacking of emotional histories of in/fertility and involuntary childlessness in Britain between the 1960s and the 2000s. Tracey set her discussion against a broader backdrop of new fertility treatments, changing attitudes towards childlessness, sexual liberation and increased reproductive agency. Taking a longitudinal approach, Tracey explored women’s attempts to narrate life histories and experiences of in/fertility, often in unsuspected places, when writing about unrelated topics. In particular, she engaged with the case study of one anonymous contributor to the Mass Observation Archive, who repeatedly spoke to the theme of infertility in her submissions to the study across her lifetime. Tracey’s paper highlighted methodological approaches and challenges in exploring how we can locate and interpret difficult stories, as well as the relationship between experience, representation, and expression.

 

In the final presentation of the workshop, Jill Kirby (University of Sussex) discussed the language and experiences of menopausal women from the 1970s to early 2000s in Britain. Noting that around the time of menopause, women were often described as ‘mad’, subject to mood swings, irrationality, anger, irritability and depression, Jill argued that many of the wide-ranging symptoms associated with this reproductive change were not recognised as hormonal. Drawing on women’s testimony in Mass Observation and Nova magazine, Jill examined the lived experience of mental ill health around menopause and the impact of this on day-to-day lives. Her paper also argued that despite the impact of feminism, women often confronted silence, limited support from family and the medical profession, and their own lack of knowledge and information about menopause


'Premak: The No. 1 Treatment in the Menopause Now Has A No. 2' , (1975-1979), Credit: Wellcome Collection.

Collectively, the ‘Women, Reproduction and Mental Illness in the “Long” Twentieth Century’ workshop deepened our knowledge and understanding of the complex relationship between women’s mental illness and reproduction across the twentieth century. The presentations also stimulated much discussion about using sensitive and sometimes sensational material, emphasising the difficulties in deciding how much personal information about a historical subject should be disclosed, even when this material is accessible through other formats in the public sphere. The breadth of topics, geographical settings and methodological approaches covered by the workshop papers illustrate the novel and substantive contributions being made in the historiography of women’s mental and reproductive health while also pointing to exciting avenues yet to be explored in these histories.

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