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

    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. 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. 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. 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. 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 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.

  • ‘Women on the Edge: Motherhood & the Family in Turmoil in the Twentieth Century’: Workshop Summary

    On the 7 – 8 September 2023, Dr Kelly-Ann Couzens and Professor Hilary Marland and hosted a two-day workshop at the Centre for the History of Medicine, University of Warwick, entitled ‘Women on the Edge: Motherhood & the Family in Turmoil in the Twentieth Century’. The event was generously funded by the Wellcome Trust as part of the ‘Last Taboo of Motherhood? Postnatal Mental Disorders in the Twentieth Century’ (2021 – 2024) project and arranged with the help of our Research Centre Coordinator, Keri Husband. The objective of the workshop was to bring together scholars working in history, criminology and law, whose research explores the relationship between motherhood, mental or emotional states, and criminality within the family, in the long twentieth century. More specifically, we were keen to focus on the role psychiatric, legal, “expert”, and popular thinking has had in understanding “deviant” female behaviour in the past. We were also interested in reflecting upon sources and critical approaches for recovering these complex histories as well as discussing the challenges researchers have encountered in tackling these themes on both a personal and methodological level. DAY ONE The workshop commenced on Thursday afternoon with some brief opening remarks, welcoming speakers to the University and detailing how the themes of the event linked with the ‘Last Taboo of Motherhood’ project. Our first session, entitled ‘Perspectives, Sources & Ethical Considerations’ commenced with a paper by Associate Professor Lydia Plath (University of Warwick). Plath’s paper, titled: ‘What To Do With a Plank of Wood? Some Reflections on Writing About Sexual Violence and Its Aftermath in Victorian England’ explored the discovery and response to a piece of wood in Plath’s childhood home that detailed an alleged rape in 1886. Disturbingly, the source suggested that the survivor may have been ‘in the family way’ (become pregnant) because of the attack perpetrated upon her. Plath discussed how this source could be used as a springboard to interrogate broader issues of sexual violence within working-class communities in rural Worcestershire in the 1880s and to explore the liminal and precarious position of women who worked in the local glove trade. Her paper also explored the materiality of the plank of wood as a historical source and the ethics this unique record posed for the development of Plath’s research on this topic. Following a short break, we began our second session with three papers on the theme of ‘Medicine, Diagnosis & Treatment in the Past’. The first paper was by Dr Alison Pedley (University of Roehampton) and titled: ‘We are still far from possessing an adequate comprehension of the psychology of pregnancy: Criminal Lunacy and Puerperal Mania in Broadmoor Criminal Lunatic Asylum, 1895-1960.’ Pedley’s paper traced change and continuity within the medical regimes of Broadmoor’s chief medical superintendents from the late-nineteenth century to first half of the twentieth century. In particular, she explored the published research produced by doctors David Nicholson (superintendent from (s/f.)1886-1896), Richard Brayn (s/f. 1896-1910), John Baker (s/f. 1910-1920) and Stanley Hopwood (s/f.1938-1952) on women diagnosed as suffering from mental disorders associated with pregnancy, childbirth or lactation. Pedley was also interested in tracing the links these clinicians made between these mental illnesses and suicidal or homicidal behaviours. Although these doctors oversaw and treated a diverse group of patients in their role as asylum superintendents, Pedley highlighted that female ‘criminal lunatics’ who harmed themselves and/or their children while insane, proved a subject of repeated and sustained interest for Broadmoor’s leading medical officials. Her paper also raised important questions around the extent to which psychiatric experts linked maternal mental illnesses to subsequent bouts of mental instability, such as during the menopause (climacteric insanity). Pedley also raised the issue of the role asylums occupied at times as places of both care, and obstetric quarantine, for women suffering from mental illness. Dr Morag Allan Campbell’s (Independent Scholar) paper: ‘She will be watched carefully: The Conditional Release of Women Prisoner’s From Perth Prison’s Criminal Lunatic Department’ was an excellent follow up to Pedley’s discussion of Broadmoor. Campbell offered a contrasting perspective on responses to maternal child killers within Britain, by exploring the Scottish context as a case study. Using newspaper reports and the institutional records of four women from the north-east of Scotland who had been former inmates of Perth Criminal Lunatic Department in the early decades of the twentieth century, Campbell traced the encounters these women had with the criminal justice system and the regimes of surveillance that followed their conditional release from the Department. Her research emphasized the power authorities exerted over women and their families, as well as the extent to which personal freedoms were curtailed for fear that the Department’s former inmates might relapse mentally or potentially re-offend once exposed to the stresses of poverty, childbearing and family life, once more. The final paper of the day was given by Professor Hilary Marland (University of Warwick) and titled: “A sophisticated blackmailer: Mothers, Maternal Mental Illness and Bonding in Post-War Britain’. Marland’s paper focused on the development of Mother and Baby Units (MBUs) in Britain after the 1950s, and the extent to which treatment for mentally ill mothers was informed by new ideas within psychiatry around attachment theory and infant bonding. Marland’s research demonstrated that the early pioneers of MBUs, like Gwen Douglas, Thomas Main and Desmond Barton, instigated a radical shift in the treatment of maternal mental illness by admitting mothers, alongside their babies, for treatment in specialized mental health units. This change in treatment practice was informed by the work of John Bowlby and others, who argued that a mother’s failure to bond with her new infant could have a harmful impact on the developing child. MBUs were considered a partial solution to this issue because they facilitated attachment and bonding by keeping mother and baby together at an important stage in the child’s development. The first day subsequently closed with a small drinks reception in the Faculty of Arts Building, followed by a dinner for the workshop speakers at Scarman Conference Centre. DAY TWO The first session on Friday morning was composed of two papers on the theme ‘Framing the Offence of Infanticide in England and Wales’. It began with a joint-paper given by Dr Rachel Dixon (University of Hull) and Professor Tony Ward (University of Northumbria) entitled: ‘On the Edge of Infanticide: Mothers Killing Infants Aged 1 – 18 Months, 1870 – 1938’. Dixon and Ward’s paper explored how mental responsibility was defined and negotiated in cases of maternal child killing and the law from the late-Victorian era to the inter-war years in England and Wales. This period saw significant agitation for reform of the law on infanticide, culminating in the implementation of the current Infanticide Act 1938. Dixon and Ward were particularly interested in how the language adopted in infanticide legislation to describe a woman’s mental state at the time of the killing (namely that the ‘balance of her mind was disturbed’) paralleled the practice adopted in coronial inquests of suicide cases. Dixon and Ward also underscored the close links between maternal mental illness, suicide and child murder within their research, a theme that echoed Pedley’s findings within the context of Broadmoor Asylum. The speakers also discussed how marital status and respectability shaped the responses of courts to mothers who killed, with harsher responses likely to be meted upon single women, rather than their married counterparts. The development of infanticide law in the inter-war years was also the subject of Dr Kelly-Ann Couzens’ (University of Warwick) paper: ‘[O]ne ‘of those little wayside domestic tragedies of life: The Infanticide Act 1938 and the Inter-War British Family’. Couzens’ paper explored the role of Viscount Bertrand Dawson of Penn, a royal physician and peer in the House of Lords, who was instrumental in drafting and promoting an infanticide bill that would be legislated (with minor amendments) as the Infanticide Act 1938. Dawson was an important figure in the British medical profession throughout the first half of the twentieth century and was deeply interested in eugenics, birth control and national “fitness”. Couzens argued that Dawson’s involvement in infanticide law reform should be seen as a function of his professional status and identity, unique personal politics and deeply held concerns over population decline worsening in the mid-1930s. As with Dixon & Ward’s paper, Couzens’ research also revealed that marital respectability played an important role in justifying compassionate legal and political responses to women that killed their children, with Dawson keen to frame his Bill as protecting respectable married women from the harshness of the prevailing laws. As a whole, this session highlighted promising new directions of research within the historiography of the Infanticide Acts, as well as exposing challenges in researching histories at the junction between mental illness, law and policy. The second pannel of the day focused on ‘Motherhood and the Criminal Justice System’ and included two papers focusing on the Irish and English and Welsh contexts, respectively. The session began with Lynsey Black’s (Maynooth University) paper: ‘Murder and Motherhood in Ireland, 1922 to 1964’. Black analysed the profile and criminal justice response toward women prosecuted for murder in Ireland from independence to the mid-1960s. Importantly, most female defendants surveyed in Black’s research were charged with the killing of their own children, making it important for Irish courts to account for violence that challenged acceptable notions of femininity, respectability and morality. Nevertheless, compassion and flexibility could be exercised within Irish courtrooms to such women, especially by jurors who could return verdicts at odds with the weight of prosecution evidence or find in opposition to the sympathies of the sitting judge. Black’s paper emphasized prominently that pathologizing women as sinful, “mentally defective” or (to a much lesser extent) insane, offered discursive mechanisms by which female offending could be explained away. However, these explanations obscured the significant role structural factors (such as poverty, the burden of single motherhood, community opprobrium and the rural/city divide) had in shaping, and making sense of, female offending. The final paper of the workshop was given by Professor Lizzie Seal (University of Sussex) and titled: ‘Themes of Motherhood in Cases of Racialised Women Accused of Murder and Attempted Murder in Britain, 1950 – 1970’. Seal’s paper explored how ideas of “motherhood”, femininity and emotion emerged within media reporting surrounding the prosecution of four racialized women charged with murder, manslaughter or attempted murder in post-war England and Wales. Seal’s analysis revealed that ideas of motherhood were central to evoking sympathetic responses to violent women, even in instances where the alleged victim was not a child themselves, but the defendant’s partner or spouse. In the case of ‘Willie May P’, charged with the manslaughter of her adulterous husband in 1960, the British press framed the defendant positively as a wife and mother who had suffered as a victim of her husband’s cruelty. Seal also highlighted how racial discourses and paternalistic attitudes shaped the treatment of female offenders at trial too. In the case of ‘Dorette L’, who while heavily pregnant fatally struck down her partner with a water jug, the judge was keen to emphasise that Dorette L was a ‘simple creature’ whom psychiatric evidence had shown to be of ‘low intelligence’. Cumulatively then, this session underscored how ideas of motherhood and femininity were central to framing lay, legal, and media responses to criminal women, regardless of place, identity or victimology. The findings of Black and Seal’s research contribute our understandings of the interaction between motherhood, identity and criminal justice in the British Isles during the twentieth century. ROUNDTABLE The final session of the workshop was a summary and roundtable discussion. This provided an opportunity to close the workshop by reviewing some of the key questions, themes and ideas that had emerged in the research presented across the two-day event. The roundtable opened with a discussion of motherhood as a central, recurring and nebulous theme that united all papers. Questions were raised as to what it meant to be a “mother” in the past, who decides if someone is a “mother” or not, and to what extent this role or identity may be tied to time or place. This topic remains central to lay, legal, expert and media reactions to child murder cases, as historically a woman who kills her own children, has been seen to commit an “unnatural” or “deviant” act that transgresses the expectations, and instincts, of her sex. Conversation then focused on policing the boundaries of “good womanhood” and the role surveillance and institutional settings have had in monitoring and shaping women’s mental states in the past. It was noted that marital status and respectability emerged as a surprisingly strong theme across the workshop papers. Indeed, it was striking how dominant married or unmarried motherhood was to diagnoses of mental illness, regimes of treatment for mentally ill women, and to representations of female offenders in the past. Debate also centred on the extent to which it was possible for scholars to recover the voice and perspective of women as defendants, patients and historical actors, more generally. Asylum records and criminal case files are sensitive records, often subject to restrictions on public access that can last decades. This was remarked on as a particular challenge for scholars using medical and legal records for their research on twentieth-century developments. The workshop closed with a brief discussion of future directions within this field and of historical cases that had stayed with researchers personally. Of note was the extent to which family history research by members of the public had intersected, in sometimes highly fruitful ways, with the formal historical and legal research of some workshop participants. Following the closing roundtable discussion, that lasted approximately one hour, the ‘Women on the Edge’ workshop concluded with a late lunch on Friday afternoon before the company parted ways.

  • From a ‘transitory state of insanity’ to ‘a marked sexual degenerate’: Diagnosis, Expertise and Criminality in a 1929 Scottish Infanticide Case

    On 4 August 1929, thirty-year-old housekeeper Euphemia Paton Blake, made a shocking discovery on the rural property of Easter Upper Urquhart Farm in Fifeshire, Scotland. Lying abandoned and bloodied in a cornfield known as the ‘Orchard Park’ were the remains of a female infant whose throat had been recently slit by a razor blade. In Blake’s mind, there was little mystery as to who had murdered the child. Indeed, an hour before she had made the discovery, the housekeeper had observed her employer’s daughter, twenty-one-year-old Elizabeth Cam Birrel Page, standing ‘100 yards from the house. She had no shoes or stockings on, and when she entered the house she locked herself in the bathroom.’[1] While this behaviour would have been unusual in and of itself, Blake had also noted changes in the physical appearance of Page for some months prior, leading her to suspect that the young woman may have been concealing a pregnancy. George Page senior had also been struck by his daughter’s unusual behaviour that day, recalling that when his daughter ‘came in on the day in question she was soaking wet and had a look that he would never forget. It made him speechless.’[2] At the November High Court trial before Lord Moncrieff in Dundee, evidence led by Crown counsel clearly demonstrated that Page had killed her child. However, her motives for killing were less clear. Consequently, the trial centred on the more complex question of whether she had been fully responsible for her actions at the time of the offence. Page pleaded ‘not guilty’ to the charge of murder, claiming that she was insane ‘or in such a state of mental weakness as to make her irresponsible for her actions’.[3] In support of this argument, testimony was given by three doctors, including William Boyd, medical superintendent to the Fife and Kinross Asylum, to suggest that ‘the accused was suffering from a transitory mental disorder at the time, which would render her unaccountable for her actions.’[4] The Crown made little effort to contest this defence, and a jury ‘which included five women’ acquitted Page of the charge on the grounds of insanity.[5] The acquittal of the ‘girl mother’ (as she was dubbed in the Scottish press) was met with applause according to The Scotsman and Page was allowed to leave the dock to join her father and friends in celebration of the verdict.[6] Yet her journey through the Scottish criminal justice system was far from over. What happened next to Elizabeth Page can be pieced together from the flurry of handwritten minutes, correspondence and medical reports, held within her prison records (HH18 series) that are now kept in the archives of the National of Records of Scotland in Edinburgh.[7] In correspondence between Page’s solicitor, John Campbell, to the Secretary of State for Scotland one week after the trial, it emerged that the happy courtroom scene had been quickly broken up. As Page prepared to join the crowds who waited to greet her outside the court building, authorities moved to re-apprehend and detain her in the nation’s dedicated facility for dangerous criminal lunatics, Perth Criminal Lunatic Department (CLD).[8] Given that Page had recovered her mental state following the offence and been certified as sane by prison doctors while awaiting trial, Campbell believed that the favourable trial verdict justified an ‘immediate order be issued’ for his client’s release. Yet the solicitor’s request posed a significant problem for prison authorities. Under the provisions of Section 88 of the Lunacy (Scotland) Act 1857, an acquittal on the grounds of insanity warranted the ongoing custody of Page as a criminal lunatic ‘until His Majesty’s pleasure be known’ in Perth Prison’s CLD (hereafter ‘the Department’).[9] However, Page’s admission records to the Department following her trial indicate that prison doctors continued to view her as ‘now recovered’, and thus, no longer suffering from a mental disorder.[10] From mid-November to early-December 1929, Scottish prison and state officials pondered the question of what to do with Elizabeth Page. In cases where an insane inmate no longer presented a danger to the public, transfer to an ordinary asylum could be warranted. Alternatively, conditional liberation could be conferred when a detainee was considered by authorities to be well enough to be released back into the community. Such “liberation” was far from total for former prisoners however, and encompassed years of ongoing restriction and supervision by carefully appointed guardians and prison doctors.[11] The shortest period an inmate had spent in the Department before conditional liberation had been granted was one year and six weeks, for the lesser offence of assault to the danger of life.[12]  Although prison doctors regarded Page as sane, John Lamb, Permanent Under-Secretary of the Scottish Office, noted that no recommendation for her conditional liberation had been made by medical or prison staff. Moreover, it was felt that ‘serious work in making any exception in the present case’ would need to be undertaken to instigate Page’s conditional release. Given the seriousness of her offence, the lack of precedent in a comparable case and the evident unwillingness to trigger the mechanisms for release, Page remained incarcerated in the Department. However, Page’s family also sought her release. On 3 March 1931, Page’s brother, John Page junior, wrote to Scottish authorities asking if his sister’s ongoing incarceration might be reviewed once more. Page junior felt that his sister’s crime had been the consequence of ‘[n]ot having a mother to confide in and look after her in the time of trouble’ and that she had ‘in her destraction (sic) caused her child’s death’.[13] In response to the family’s request, the Department medical superintendent, Dr Charles Bruce, sent a report to the Scottish Office conveying his expert opinion as to the mental state and custodial prospects of Page. Although noting that Page was cognizant of the enormity of her offence and had ‘shown herself to be amenable to discipline and industrious to a moderate extent’, Bruce advised against her release into the care of her family. In his March 1931 report, Bruce now diagnosed Page as ‘emotionally weak’ and ‘a girl of rather low intelligence, whose moral sense is weak. It would be difficult to classify her as moral imbecile, but she could rather be regarded as an abnormal type amounting to the higher grade ranks of mental defection.’[14] As Stephen Watson’s work has shown, the prison environment provided particularly ample opportunity for medical officers, like Bruce, to observe and assess the history, conduct and behaviour of inmates, while under sustained periods of institutional discipline and supervision.[15] From the latter decades of the  nineteenth century onwards, such practitioners had established themselves as ‘experts’ in the detection of mental deficiency, especially cases of suspected ‘moral imbecility’. A nebulous and vague term, ‘moral imbecility’ was applied to individuals whose moral sense and judgement was considered lacking, often evidenced by heinous or persistent criminal offending and resistance to regimes of prison reform and discipline.[16] We see this process of pathologisation occurring in the Page case, in which Bruce argued that her perceived low intelligence, violent criminal history and ‘weak’ moral sense made her a less than ideal candidate for conditional liberation. Bruce was also concerned about the environment Page would return to and the impact this might have on her ‘continued good behaviour’. While her brother was evidently keen for her return, her father, George Page senior, was in a poor personal and financial position by March 1931. Not only was he financially struggling as an ‘undischarged bankrupt’, but he was also battling with the fallout from his daughter’s crime. Bruce noted that Page senior regarded himself as ‘an object of scorn to the neighbours because of his daughter’s lapse.’[17] Alternate release into the care of Page’s aunt in London was also considered. However, both Bruce and Dr Robert Alexander Fleming (former President of the Royal College of Physicians in Edinburgh and Medical Adviser to the Department) were concerned about Elizabeth Page’s alleged sexual propensities. Throughout March and April 1931, references were made for the first time in the files to Page’s alleged ‘sexual weaknesses and her dislike of hard work’.[18] In a short, but particularly damning extract of her case, Fleming concluded ‘a very unsatisfactory case. She appears to be a marked sexual degenerate and I do not recommend any action as regards conditional liberation at present.’[19] While it is unclear upon what basis Bruce and Fleming made their assessments of Page’s sexual dissipation (or what the nature of this conduct actually amounted to), it was noted in a subsequent medical report that Page’s aunt was mother to five children, including three sons, the eldest of which was twenty-years-old.[20] One can surmise that doctors were concerned that Page’s purported sexual impropriety might have a corrupting influence on her aunt’s children and lead, in the worst case, to another illegitimate pregnancy and the repetition of the circumstances leading to her previous offending. Consequently, George Page junior’s request for his sister’s release was formally denied on 24 April 1931. It is also probable that broader eugenic concerns over racial fitness and degeneracy shaped the medical opinions voiced by Bruce and Fleming. In a time in which population decline and race had become subjects of national (and international) concern, the inter-war medical profession took an active interest in barriers to discourage the ‘mentally defective’ or those of ‘inferior’ or ‘bad stock’ from having children. In Scotland, such concerns were notably voiced by psychiatrist David K. Henderson, who in a 1934 address to the Medico-Chirurgical Society in Edinburgh urged the profession to: take stock of our position and appreciate the responsibility which devolves on us medically as the safeguarders of the health of the nation. It is our duty to encourage the growth and development of healthy families, while at the same time approving of the restriction of vitiated stock by segregation, sterilisation, or contraception.[21] Although conjecture, the reports and correspondence of Bruce and Fleming suggest that these doctors shared Henderson’s dark and prejudicial racialised outlook. In diagnosing Page as a ‘high-grade mental defective’ who was also a ‘marked sexual degenerate’ their medical opinion justified her ongoing segregation and restriction to the Department, while also expediently serving the interests of state officials who were reluctant to consider release. While the language and attitudes voiced by these medical practitioners may seem perplexing and abhorrent to us today, both doctors likely saw themselves as tangibly safeguarding ‘the health of the nation’ amidst a backdrop of heightened anxiety over its future. Nevertheless, in June 1934, typed correspondence between the Secretary of the Prison Department for Scotland and medical officers, suggests that Page’s continued incarceration presented an issue.  Proposals were made to transfer her to the care of institutions for mental defectives (in Larbert and Kirkintilloch) or an asylum in Cupar. However, low institutional capacity and questions over her suitability for custody in an ordinary asylum as a ‘sane’ woman, proved stumbling blocks for officials. Despite concerns about the potential dangers, Bruce suggested that the conditional liberation of Page to her aunt in London was the only feasible solution for her future supervision and care.[22] Following continued positive reports of her ‘placid’ mental state[23], prison officials raised the question of conditional liberation with the Lord Advocate’s Department in October 1934.[24]  Prosecutors were revealed to be amenable to Page’s conditional liberation ‘if due safeguards [could]… be devised to protect the woman from her own sexual proclivities.’[25] Consequently, a condition was inserted into the order for her conditional liberation that authorities were to be notified by Page’s guardians should she become (or be suspected of being) pregnant.[26] Elizabeth Page was conditionally liberated into the care of her aunt, uncle and Chelsea doctor, D. Duncan Craig, on 7 November 1934. Two years later, in November 1936, her final prison records indicate that she had found some modicum of independence and normality beyond the shadows of the Department, having gained employment as a live-in domestic servant in London. Although still closely monitored by authorities, Page was able to accompany her employers on their holidays to the seaside and stay in their home, rather than reside permanently with her uncle and aunt. Moreover, the monthly reports of her guardians had reduced to quarterly reports, a development that Bruce noted to be ‘in the interests of the patient by both her uncle and Dr Craig, who considered that she should have some responsibility of her freedom.’ [27] Page’s story, as revealed through her prison files, ends at this point. Nevertheless, the case remains unsettling, and many questions remain. The diagnostic somersaults performed by medical experts that led Elizabeth Page to be variously labelled as ‘temporarily insane’, ‘sane’ and then finally, a ‘high grade mental defective’, are disturbing, and powerfully underscore how ideological and pragmatic factors shaped diagnosis and practice in Scottish forensic psychiatry during the 1920s and 1930s. The extent to which Page’s five-year incarceration in Perth Criminal Lunatic Department was driven by expediency on the part of officials or the ideological beliefs of her medical guardians, as opposed to the interests of Page and her loved ones, remains speculative. Indeed, the case raises, though does not resolve, important issues around balancing the rights and liberties of mentally ill patients (and their families) with those of the public and state, especially in a time in which deviant sexualities and abnormal mental states were complexly entangled in broader anxieties over race, national progress and civilization. ENDNOTES [1]‘Strathmiglo Child Murder Charge’, Dundee Advertiser, 7 November 1929 in Criminal Lunatics Files: Elizabeth Cam Birrel Page, 1929 – 1934, National Records of Scotland, HH18/143, n.p. (no page number given). [2] The testimony of George Page, senior, quoted in Ibid. [3]‘Strathmiglo Child Murder Charge’ in HH18/143. [4] Ibid. [5] ‘Girl Mother Acquitted’, The Scotsman, 7 November 1929, p. 7. [6] Ibid. [7] The HH18 series of ‘Criminal Lunatic Files’ covers 1853 – 1964. It is not the only series of CLD patient files. For example, the HH17 series ‘Criminal Lunatic (Perth) Records’ covers a comparable period, 1867 – 1946. Due to data protection laws, the accompanying investigation and trial records of the Page case (ie. JC26 & AD15 series) are not open. [8] ‘Letter from John Campbell to the Secretary of State’, 15 November 1929 in HH18/143. [9] ‘Extract of the Verdict Against Elizabeth Cam Birrel Page as taken by Alexander Rae, Circuit Clerk of Justiciary’, 6 November 1929 in HH18/143. [10] ‘Insane Prisoners – Admission: Elizabeth Cam Birrel Page’, 7 November 1929 in HH18/143. [11] For an excellent study of the conditional liberation process in relation to women charged with child murder held in Perth CLD, see: Jonathan Andrews, 'The Boundaries of Her Majesty's Pleasure: Discharging Child-Murderers from Broadmoor and Perth Criminal Lunatic Department, c. 1860-1920', in Mark Jackson (ed.), Infanticide: Historical Perspectives on Child Murder and Concealment, 1550-2000, Aldershot & Burlington, Ashgate, 2002, pp. 216-248. Another invaluable exploration of cases drawn from the Forfarshire and Fife areas between 1841 – 1910 is: Morag Allan Campbell, 'This distressing malady': Childbirth and Mental Illness in Scotland, 1820-1930, Unpublished PhD Thesis, University of St Andrews, 2020, pp. 223-267 especially. [12] Minute correspondence of ‘Mr Duke’, 4 December 1929 in HH18/143. [13] Letter from George Page junior, to E M Urquhart’, 3 March 1931 in HH18/143. Urquhart appears to be a Dunfermline solicitor that Page junior, engaged to take up his sister’s case. [14] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 12 March 1931 in HH18/143. [15] Stephen Watson, 'Malingerers, the 'Weakminded' Criminal and the 'Moral Imbecile': How the English prison Medical Officer Became an Expert in Mental Deficiency, 1880-1930', in Michael Clark and Catherine Crawford (eds), Legal Medicine in History, Cambridge, New York & Melbourne, Cambridge University Press, 1994, pp. 223-241. [16] Ibid, pp. 223, 232-233. [17] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 12 March 1931 in HH18/143. [18] Ibid. [19] ‘Extract of a Report by Robert A. Fleming to John Lamb’, 15 April 1931 in HH18/143. [20] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 25 March 1931 in HH18/143. [21] D. K. Henderson, 'Psychiatry and Race Betterment', Edinburgh Medical Journal, vol. 41, no. 8, 1934, p. 116. [22] ‘Letter from C.D. Bruce to J Fulton’, 19 June 1934 in HH18/143. [23] ‘Letter from C.D. Bruce to W Muir’, 18 September 1934 in HH18/143. [24] ‘First to L.A.’s Dept for any…’, 2 October 1934, Untitled Minute II in HH18/143. [25] ‘CC think this woman might’, 5 October 1934, Untitled Minute Signed ‘MMC’ in HH18/143. [26] ‘Letter from the Secretary of the Prisons Department for Scotland to John Lamb’, 29 September 1934 in HH18/143. [27] ‘Extract of a Report by C.D. Bruce as to Elizabeth Cam Birrel Page’, 26 March 1936 in HH18/20

  • ‘Born in the Asylum: Insanity of Pregnancy and Unwed Mothers around 1900’

    In a previous blog of January 2022, I described the admission and treatment of women suffering from puerperal insanity in two large London asylums, Colney Hatch and Claybury, around the turn of the twentieth century. As well as confining women who became mentally ill shortly after giving birth, a significant number were admitted during their pregnancies, with a diagnosis of ‘insanity of pregnancy’. They were retained in asylums partly for their own safety, as women suffering insanity of pregnancy were seen as particularly vulnerable to suicide. Many subsequently delivered their babies in the asylum. While most of the women diagnosed with insanity of pregnancy were married, single women were also frequently admitted, and asylum doctors noted that these women were particularly liable to mental breakdown.[1] At Claybury Asylum, 56 cases of insanity of pregnancy were admitted between 1894 and 1902; 14 of whom were single women.[2] A destitute girl throws herself from a bridge. Etching by G. Cruikshank, 1848. Wellcome Images During the nineteenth century, single mothers, particularly those who gave birth to more than one illegitimate child, often found themselves condemned for their immorality. However, they were also likely to be considered as objects of pity, their mental breakdown said to be prompted by heightened feelings of shame, grief, fear and anxiety about their futures. Dr John Conolly, physician to London’s Hanwell Asylum between 1839 and 1852, described how ‘anxiety, the fear of abandonment, and the pressure of poverty’ were conspicuous causes of puerperal insanity and that ‘some of these causes operate more strongly when the mother is not married’.[3] Even in extreme cases, when such mothers were accused of infanticide or attempting to destroy their newborn child, doctors and courts connected such actions to their desperate circumstances. Such women were described as being victims of betrayal by the men who had abandoned them, alone, in a situation of want, obliged to work, yet in terror of their pregnancies being discovered, all circumstances which exacerbated their mental distress.[4] Maternity hospitals, in contrast to asylums, recorded relatively few cases of puerperal insanity, as women were generally discharged within a week or so of their deliveries, before their mental disorder manifested itself. Those that did occur were more likely to be women giving birth out of wedlock. Edinburgh based obstetrician, Dr James Simpson commented that unmarried mothers were ‘far more under the influence of depressing moral emotions’ and liable to develop puerperal mania. Their ‘terrible predicament’ then exacerbated the condition.[5] Writing in 1882, Dr Ernest Mackintosh of the Glasgow Maternity Hospital noted the general distress unmarried mothers faced in their daily lives and talked of the ‘overwhelming shame’ of local mill workers and seamstresses who were subject ‘to cold, calculating desertion’ by the fathers of their unborn children. Following delivery these women gave way ‘to paroxysms of weeping’, which threw their nervous systems into disorder.[6] Not all responses, however, were sympathetic, and by the late nineteenth century childbirth out of wedlock was increasingly linked to hereditary influences. Joseph Wiglesworth, Assistant Medical Officer at Rainhill Asylum in Liverpool, referred to ‘old offenders’ in a language more associated with criminality than mental illness. Women who had attacks of mania after their first confinements out of wedlock, he argued, were likely to become insane again after each subsequent delivery of an illegitimate child. He dismissed the notion that shame and grief prompted their condition, attributing their mania to the same ‘defective inhibitory power’ that caused single women to become pregnant in the first place.[7] Robert Jones of Claybury Asylum was more sympathetic, claiming that, especially in first pregnancies, single women faced ‘the moral shock of disappointment and shame in addition to… nervous exhaustion’. Yet, he also described the role of hereditary predisposition, ‘the baneful influence of an evil heredity’, in nearly 50 per cent of the cases of insanity associated with reproduction at Claybury Asylum, and an enormous 82 per cent in cases of insanity of pregnancy.[8] Claybury Asylum plan, 1891, Hospitals and asylums of the world. Vols. 1-2, by Henry C. Burdett. Wellcome Images. While it is likely that birth in the asylum was a relatively common occurrence (Jones claimed 49 cases of insanity of pregnancy were delivered in Claybury between 1894 and 1902), we know very little about the circumstances of the deliveries or how the women were cared for.[9] Asylum case books tended to simply note the date of delivery, to report if the birth was straightforward or protracted, and briefly described the woman’s recovery. Similarly, little information is given about the fate of the baby, though most appear to have been removed to the care of relatives or to a local workhouse. Unusually, a ‘birth book’ has survived in the archives of Claybury Asylum, which recorded deliveries in the asylum between 1893 and 1955. It also recorded baptisms taking place at the asylum, vaccinations, and the removal of the newborn to the workhouse or by the husband or other relatives. Occasionally, the baby remained with the mother and they were discharged together. Sadly, amongst the most striking features of the birth book were the large number of stillborn babies and the deaths of babies shortly after delivery. Of the six babies delivered between October and December 1893, two were stillborn and two died shortly after birth. The mother was single in all but one of the cases where the infant died.[10] Asylum cases involving single mothers were typified by a blend of despair at the desperate circumstances these women found themselves in, alone, stigmatised and facing extreme poverty, and concerns about their loose morals and poor hereditary status, particularly if they were admitted on more than one occasion to the asylum. In the case of Maud E., admitted to Colney Hatch in May 1900, the hereditary connection was stark, as Maud herself was illegitimate. The initial diagnosis was vague, and it was Maud’s mother – perhaps reminded of her own plight two decades previously – who explained to the asylum doctors that Maud’s melancholia resulted from ‘worry resulting from her pregnant condition’. Aged 21 and a former housekeeper, Maud was noted in the casebook to be depressed and delusional. She refused food claiming it was poisoned, and her melancholia took a religious form, her ‘arms stretched out and praying’. An uncle who also visited, described Maud as previously bright and capable but she became worried ‘over the trouble she had got into’. Maud was delivered of a baby boy in August; forceps had to be used and she was also given chloroform. For a few days Maud denied that she had delivered the baby. However, shortly after the case book noted that ‘she was now satisfied that it was hers’. Maud went on to make a good recovery and was discharged together with her baby in November 1900 after six months in the asylum. The photograph below depicts a happy outcome with the mother and baby leaving Colney Hatch in good health. However, as a young single mother, Maud and her baby were likely discharged to a difficult and uncertain future.[11] London Metropolitan Archive, H12/CH/B/11/47, Case book for female patients, Dec. 1899-Aug. 1900. [1] For responses to cases of puerperal insanity taking place out of wedlock during the nineteenth century, see Hilary Marland, Dangerous Motherhood: Insanity and Childbirth in Victorian Britain (Houndmills: Palgrave Macmillan, 2004), ch. 6 and especially pp.154-8. [2] Robert Jones, ‘Puerperal Insanity’, British Medical Journal, 8 and 15 March 1902, 579-86, 646-51, pp.579, 580. [3] John Conolly, ‘Description and Treatment of Puerperal Mania’, Lancet, 28 March 1846, 349-54, p.350. [4] See Marland, Dangerous Motherhood, ch. 6 and Cath Quinn, ‘Images and Impulses: Representations of Puerperal Insanity and Infanticide in Late Victorian England’, in Mark Jackson (ed.), Infanticide: Historical Perspectives on Child Murder and Concealment, 1500-2000 (Aldershot: Ashgate, 2002), 193-215 for the relationship between insanity and infanticide in Victorian Britain. See Kelly-Ann Couzen’s blog of October 2022 on the 1922 Infanticide Act and use of the insanity plea. [5] James Y. Simpson, Clinical Lectures on the Diseases of Women (Edinburgh: Adam and Charles Black, 1872), p.567. [6] Ernest Aeneas Mackintosh, ‘Mental Excitement in the Lying-in: Its Importance with Regard to Maternity Hospitals’, Edinburgh Medical Journal, XXVII (July 1881-June 1882), April 1882, 899-904, pp.900, 904. [7] Joseph Wiglesworth, ‘Puerperal Insanity: An Analysis of Seventy-Three Cases of the Insanities of Pregnancy, Parturition and Lactation’, Transactions of the Liverpool Medical Institution, 6 (1885-86), 349-62, pp.358-9. [8] Jones, ‘Puerperal Insanity’, p.585. [9] Ibid., p.579. [10] Redbridge Central Library, Claybury Asylum, Birth Book 1893-1955. [11] London Metropolitan Archives, Colney Hatch Asylum/Friern Hospital, H12/CH/B/11/47, Casebook for Female Patients Admitted Dec. 1899-Aug. 1900.

  • ‘Women and Mental Illness in Post-War Britain’ Workshop Summary

    University of Warwick, 13-14 April 2023. On 13-14 April 2023, I organised a two-day workshop at the University of Warwick on ‘Women and Mental Illness in Post-War Britain’, with Professor Hilary Marland and the support of our Centre for the History of Medicine Coordinator, Keri Husband. The workshop was kindly supported by the Wellcome Trust, Warwick’s Centre for the History of Medicine and the University of Warwick’s Global Research Priority, Health. The aims of our workshop were to bring together scholars from different career stages, universities, projects and disciplines to exchange ongoing research on women's mental illness in post-war Britain and explore new subject matter, approaches, issues and ethical considerations in the field of women’s mental health history. The workshop focused largely on motherhood and mental illness in connection with our Wellcome-funded project ‘The Last Taboo of Motherhood? Postnatal Mental Disorders in Twentieth Century Britain’. Other interconnected and novel histories were also shared, including research on asylums (Dr Louise Hide) and orthorexia and clean eating in the twenty-first century (Dr Louise Morgan). The papers also addressed the issues of using new kinds of sources and the ethics of working with sensitive materials. Day One Panel One: Gender and Mental Health On the first day, after a brief introduction where everyone explained their synergies with the workshop, our first panel explored ‘Gender and Mental Health’. Dr Fred Cooper (University of Exeter) examined women’s mental health through his paper ‘Formidable Discontents: Loneliness, Gender, and Feminism in Post-war Britain’, which focused on the 1950s. Building on the work of Penny Tinkler, Martin Moore and Eleanor Wilkinson, Cooper shared his ongoing research, including experiences of urban and suburban living for housewives. Cooper used an impressive range of visual sources to illustrate the changing tensions and issues regarding privacy, class, companionship and attempts to rectify the decline in neighbourly communities and support networks to resolve loneliness. Next, Professor Tracey Loughran (University of Essex) spoke about ‘“Ordinary” Unhappiness and Alienation in Women’s Life Stories, c. 1960-1990’. Loughran is the PI of the Wellcome-funded ‘Body, Self and Family: Women's Psychological, Emotional and Bodily Health in Britain, c. 1960-1990' project, which created an intersectional history of gender, body and the self from the bottom-up rather than the top-down. She highlighted the critical issue of normalising unhappiness and how “ordinary” narratives go unnoticed and remain under-researched as they do not stand out during interviews or in the archive. Loughran suggested that we revisit our sources and subjects, and reflectively put ourselves in the interviewees’ shoes (i.e., how do we use humour and distractions to minimise our own unhappiness in everyday discussions?) to become more conscious and better researchers. Panel Two: Student Mental Health in the 1960s. The second panel explored ‘Student Mental Health in the 1960s’. Dr Sarah Crook (Swansea University) presented a remarkable paper, ‘Contested Spaces: Women Undergraduates and Mental Illness in Post-war Britain’. She illustrated how the medical experts working within some British universities were quick to attribute mental health issues that arose among female undergraduates to their family lives, relationships, and personal issues rather than consider the tertiary environment – or ‘Contested Spaces’ – that they were newly experiencing. Crook, positively concluded, however, that women were highly influential in both shaping and improving universities’ mental health provision from the 1960s onwards. I (University of Warwick) then illustrated in my paper on ‘Mental Health, Marriage, Motherhood and Education, c.1960-1975’ how women had to “drop in and out” of their marriages, childrearing duties, education and work – and in turn prioritised or ignored their mental health issues – to survive a significant culture change in expectations by the early 1960s. Feminist literature, like The Myth of Superwoman (1975), has exposed the challenges of needing to be a ‘perfect’ housewife and ‘the new career woman who could have it all’ by the early 1970s. I argued that these pressures also existed in the previous decades. Panel Three: Chronic Illness and Mental Health The third and final panel of the day focused on ‘Chronic Illness and Mental Health’. Dr Andrew Burchell (University of Warwick) shared his fascinating research undertaken with Professor Mathew Thomson in ‘Narrating Chronicity: Biographical Voices, Gender and Illness from the Mass Observation Project Archive’, focusing on mental health narratives from the Mass Observation Project. This constituted part of the Wellcome-funded Cultural History of the NHS Project. Burchell explained how we could access the narratives in the archive for our own research. He also revealed how they can speak back to their readers, both challenging and disrupting our attempts to find historical patterns in everyday life and health matters. Dr Hannah Elizabeth (London School of Hygiene and Tropical Medicine and the University of Edinburgh) then shared an extraordinarily moving and vital paper, ‘Recovering Experiences of HIV-affected Pregnancy in Edinburgh’. The paper is part of Elizabeth’s broader Wellcome-funded project, ‘What’s love got to do with it? Building and maintaining HIV-affected families through love, care, and activism in Edinburgh 1981-2016’. In their paper, Elizabeth used memoirs, oral histories, counselling manuals, training material and print press coverage to expose problematic cases and the discrimination associated with HIV diagnosis throughout pregnancy and at birth. They also suggested ways to sensitively re-tell these narratives without stripping people's agency. Day Two Panel Four: Mental Health and Institutions of Help and Harm The opening panel for the second day explored the theme of ‘Mental Health and Institutions of Help and Harm’. Dr Louise Hide's (Birkbeck, University of London) project, ‘Hiding in Plain Sight: Cultures of Harm in Residential Institutions for Long-term Adult Care, Britain 1945-1980s’ is also Wellcome-funded. Hide’s reflective paper considered how asylum patients of the 1960s and 1970s were unethically shown in television documentaries when the medium became popular. In her words, historical research on these sources then ‘objectifying[ly]’ turns the ‘medical gaze to the historian’s gaze without their [the patients] consent’. She explained how this can also be done through the internet and through social media in a world of endless channels of dissemination. Hide then suggested ways to become more responsible researchers and think carefully about how people could unethically use and circulate our own research outputs and ways to avoid it. Panel Five: Confinement, Motherhood and Mental Health Our fifth panel, ‘Confinement, Motherhood and Mental Health’, started with our project PI Professor Hilary Marland’s (University of Warwick) paper on ‘Motherhood, Guilt and Mental Illness in Post-war Britain’. Marland focused on the setting up of Mother and Baby Units (MBUs) after the 1950s and the involvement of the National Childbirth Trust (NCT) in promoting the extension of support and treatment to mothers experiencing postnatal mental illness, highlighting the tensions between the care of the mother and concerns about how the mother’s mental illness might hinder bonding and the infant’s development. Marland's paper also showed how the narratives of NCT mothers reflected upon similar tensions. For her paper on ‘Confined Motherhood in Pandemic-Era Postpartum Psychosis Narratives’, Georgia Poplett (University of Durham) then gave an energised paper on a gothic horror novel The Upstairs House (2021) and film The Babadook (2014). The film is based on a single mother who battles with her son's fear of a monster in the house, but soon discovers the sinister presence around herself. As an interdisciplinary researcher (Creative Writing and Medical Humanities), Poplett addressed the ethics and considerations of using testimonies to write fictional representations of postpartum psychosis. I particularly liked the metaphor of the Babadook confined to the basement, symbolising people’s dormant but ever-present mental health issues. Panel Six: Mental Health in the Twenty-first Century Our final panel ‘Mental Health in the Twenty-first Century’ brought us to present day issues in mental health research. Dr Louise Morgan's (University of Warwick) novel paper, ‘Orthorexia and Clean Eating in Twenty-First Century Britain’, grounded in the broader history of eating disorders, discussed orthorexia's origins and ‘genderless[-ness]’ in relation to clean eating. The term 'orthorexia' was coined in 1998 and refers to an obsession with 'healthy' eating. When considering women’s prevailing obsession with body size and dieting particularly since the post-war period, orthorexia is a topic of monumental significance. Morgan illustrated how social media influencers can reach broader audiences and might hold more authority than medical professionals in ‘clean eating’ debates. And finally, Charli Colegate (University of Sheffield) presented her research on ‘Positionality and Ethical Questions in a Qualitative Study of the Reproductive-related Experiences of Women with a History of Severe Mental Illness’. As a sociologist, Colegate valuably showed us historians how to conduct more fruitful interviews by explaining to interviewees the reason behind our interest in mental health research. By disclosing this information, the relationship between interviewer and interviewee is more equal. Like Loughran and Hide, she offered another method of deploying our personal experiences and positionality as researchers in our writing to improve our practice. She also reflected on the motives behind people agreeing to be interviewed. Finally, she addressed the differences in communication based on the different modes of interview, from phone and video calls to in-person interviews. Concluding Roundtable Discussion The workshop concluded with a roundtable discussion, which returned to the questions of sources, ethics and care in the context of our historical subjects, interviewees and our own positionality as researchers. Building on Dr Ute Oswald’s (University of Warwick) question on the first day, we discussed the pros (e.g., safety) and cons (e.g., agency-stripping) behind anonymising narratives and returned to the issue of how the expanding opportunities for dissemination, including public engagement, might risk the integrity of our research and the contributions of our historical subjects and interviewees. Dr Jade French (University of Loughborough) noted the abundance of sources we can work with – including more novel social media sources, as Morgan had illustrated in her paper – and the difficult decision-making behind choosing which work best for mental health research. We also spoke about ethical approval procedures at universities, the timing of applications as our projects unfold and develop, and how university processes might focus largely on legal issues. We discussed how to offer better protection for the subjects we are historicising through anonymity, as well as safeguarding our own wellbeing when working on challenging subjects. Hide and another attendee, Dr Jessica Hamett (University of Bristol) also spoke about the Challenging Research Network, and the regular online seminars which provide support and reflective conversations for researchers working in challenging areas. Although the workshop roundtable may have raised more questions than answers, we now have a stronger network of researchers to consider and better resolve issues surrounding mental health research.

  • ‘...the law is illogical and unjust’: The Problems with the Infanticide Act 1922

    On 23 February 1928, Northern Irish obstetrician and gynaecologist, Dr Anne Louise McIlroy, gave an address to members of the British Medico-Legal Society.[1] Among the varied audience were men and women of the medical profession, barristers, judges, criminologists, psychiatrists and politicians, who collectively shared an interest in issues pertaining to law and medicine. McIlroy used her short paper, entitled ‘The Influence of Parturition Upon Insanity and Crime’, to argue that the law of infanticide was in ‘an archaic state’ and ‘require[d] further amelioration’.[2] As a doctor who practised, taught, researched and campaigned on women’s health issues, especially the provision of maternity services and improving the experience of childbirth for mothers, McIlroy’s paper covered a subject close to her heart. Moreover, her criticism formed part of a broader chorus of voices being raised against the provisions of the Infanticide Act 1922 in inter-war Britain. In this blog, I provide a concise overview of some of the key criticisms of the Act, highlighting the divergent views within the British medico-legal community toward the law, maternal mental illness and child killing. The lack of consensus over the Act, whether it should be reformed and how this could be achieved, became a central focus of the meeting. Through this debate, historians are also offered insight into changes taking place within contemporary psychiatric thinking which called into question the long-standing acceptance by the medical profession of the existence of distinct reproductive insanities in women. As discussed in my previous blog, the Infanticide Act 1922 established that a woman could be found guilty of the crime of infanticide if the balance of her mind was disturbed at the time of killing her ‘newly born’ child. Prior to the passage of this Act, infanticidal women were prosecuted for murder, and, if found guilty, sentenced to death. [3] Practically, such women were never executed. Under the new law, the crime of infanticide punished women as if they had been guilty of manslaughter, rather than murder. When the first prosecution brought under the new legislation was heard at Lincolnshire assizes, the presiding judge had been quick to laud the legislation as ‘a wise and humane piece of legislation’ that made it unnecessary ‘to put a girl on trial for murder’. Newspapers had also reported favourably on its impact, with the Aberdeen Press & Journal viewing the Infanticide Act as ‘only a single illustration of the remarkable increase in the attention which Parliament in recent years has devoted to the woman’s point of view’.[4] The feminist periodical The Vote was less positive in its assessment of the Infanticide Act, arguing that the burden of punishment for child murder still fell disproportionately on accused women. In a retort to Justice Lush’s positive assessment of the outcome of the Emma Temple case, the article remarked, ‘We should like to know why Mr Justice Lush has nothing to say about the responsibility of the father in such a case?’ and argued that the father should also appear in court and be questioned on how he would provide for the infant.[5] Criticisms were heaped on the legislation from all quarters with each passing year. Judges and lawyers argued that it was unclear who had the jurisdiction to bring in a bill for infanticide and that the Act was badly drafted.[6] Moreover, successive criminal cases problematised the once seemingly ‘humane’ provisions of the Act. Mary O’Donoghue was found guilty of the murder of her illegitimate four-week-old son following her trial on 13 October 1927.[7] Although her capital sentence was commuted, O’Donoghue appealed her conviction on the grounds that the trial judge should have advised the jury that they had the power to return a verdict of infanticide. Following consideration by the Court of Criminal Appeal three weeks later, O’Donoghue’s appeal was quashed. Significantly, the decision seemed to establish that for a mother to be charged with the infanticide of her ‘newly born’ child, the infant could not be older than a calendar month at the time of its death. While the change in law had offered protection toward women who killed children less than a month old (and so informally defined as ‘newly born’) mothers who fatally harmed older children were still tried for murder and sentenced to death. The ‘black cap farce’ was a shorthand used in the press to describe the courtroom spectacle of sentencing such women to execution, though they would always be reprieved. The phrase also embodied disquiet with the stigma such women acquired through the public spectacle of being labelled a ‘murderess’ in the courtroom. Although the Infanticide Act had gone some way to addressing this issue, the exclusion of mothers like O’Donoghue from its provisions, drew increasing criticism throughout the 1920s and 1930s. A little over three months since the outcome of the O’Donoghue trial, McIlroy referenced the decision in her address before the Medico-Legal Society. For her, the case threw into stark light the problematic language of the Infanticide Act, particularly the lack of clarity over what age limit should be applied to a ‘newly born’ infant, and whether it exceeded a month or even a few weeks.[8] McIlroy also explained that ‘In medicine the definition of a newly born child is somewhat vague. Obstetricians look upon the newly born or neonatal infant as one less than ten days old. But this period is frequently extended to one month for purposes of mortality statistics and diseases.’[9] In addition to clarification on the term ‘newly born’, McIlroy argued that the Infanticide Act and the broader law on murder failed to offer adequate protection to mentally disturbed mothers and was thus ‘illogical and unjust’.[10] In particular, she perceived that the existing law was more sympathetic to infanticidal women who killed their children ‘in a moment of mental anguish’ despite knowing their actions were wrong, than toward mothers who killed while suffering from diagnosed puerperal insanity and who were consequently tarnished with the label of murderess through a verdict that adjudged them ‘Guilty but insane’.[11] McIlroy also asserted that mothers who killed their children while labouring under puerperal or other forms of reproductive insanity, needed to be marked out as a special group of offender and treated differently by the criminal law, for: Motherhood is a necessity for the race. It is the factor of motherhood that makes the woman insane and causes her when suffering from a disease due to motherhood to destroy her offspring. There is a marked difference between a murder committed by a person suffering from general paralysis or even paranoia, and one committed by a mother in the delirium of childbirth or exhausted by nursing.[12] Influenced by eugenic thinking, concerns over citizenship and the fitness of the inter-war population, McIlroy reminded her audience that motherhood was not simply a private, domestic activity, but was instead central to the agenda and future success of the British state. After all: ‘Motherhood is a sacred and patriotic service, and no woman should run the risk of being branded as a murderess because she happens to fall a victim to one of the diseases incident to pregnancy.’[13] McIlroy’s address sparked a varied response, including some hostile reactions. For those in sympathy, like Justice Travers Humphreys, the 1922 Act was problematic in failing to offer a definition of the term ‘newly born’.[14] Moreover, its existence would have been unnecessary he argued, were it not for the spectre of the ‘black cap farce’ that left ‘a judge assuming the black cap and sentencing to death a person who, as he and everyone else knew, was not in the l[e]ast danger of being hanged and who would probably be released in a few weeks.’[15] Doctor F. J. McCann suggested that ideally the Act should only apply to those who killed neonates (children less than 24 hours old), as the existing provisions of the insanity defence could be deployed for women accused of the murder of older children while mentally unsound.[16] Another doctor, M. I. Finucane disagreed. He had given expert evidence in a recent criminal case and felt that the Act should extend to women who killed during the puerperium, six weeks after birth. This time limit, Finucane argued, would encompass not only the physical and psychological changes associated with delivery, but also cover the broader period in which women were at higher risk of suffering from a disturbed mental state.[17] While for Lord Baron Riddell, former solicitor and director of the popular and sensationalist Sunday paper News of the World, the problematic verdict of ‘Guilty, but insane’ should be avoided altogether when mothers killed while mentally unstable and be replaced with a verdict of ‘Infanticide’.[18] Psychiatrists and criminologists, like Hubert Bond and William Norwood East, had more profound problems with McIlroy’s assertions and the existing Act. For Bond, whose experience as an asylum medical superintendent put him in proximity with the mentally ill, dominant psychiatric thinking found little evidence to suggest that disorders linked to pregnancy and reproduction – such as puerperal or lactational insanity – were discrete psychiatric illnesses at all. While conceding that mental illness may emerge at times of physical and psychological crisis in the reproductive lives of many women, Bond could not sustain the view that such insanities existed distinctly in their own right, remarking: ‘there is no mental disorder (psychosis) which, by its mental symptoms and in the absence of knowledge otherwise gained can be recognized and diagnosed as due to childbearing.’[19] Norwood East, whose research focused on criminality and mental illness amongst men, went further still. East challenged the perceived exceptionalism of child killing as a gendered offence that required distinctive treatment of women under law, noting that: Fatherhood equally with motherhood was a necessity for the race, and fathers were sometimes tried for killing their children and found insane. One of the contributing factors in such a case was the stress of providing for their families, and it would be difficult for juries to draw a distinction between motherhood and fatherhood.[20] McIlroy’s address to the Medico-Legal society was certainly not the first, nor would it be the last attempt of a medical practitioner to publicly deliberate on the administration and future of the Infanticide Act 1922. The debate that followed her address, highlights both the lack of consensus within the medico-legal community over the existence of distinct forms of reproductive insanity and the wider issue of whether women who killed their children should be treated differently under the law. In a period in which a new generation of British psychiatrists were calling into question the old Victorian diagnoses of puerperal insanity and allied conditions, the record of the Medico-Legal society meeting in February 1928, captures a moment of tension and change in the history of psychiatry, as well as from within the medical profession itself. The divergent views the medico-legal community expressed toward maternal child killing and the role mental illness may (or may not) have occupied in these cases, partly explains why reform of the Infanticide Act was so slow in coming. Another decade would pass after McIlroy gave her contentious paper before the law would finally be repealed and replaced by the Infanticide Act 1938, which is still on the statute books today. ENDNOTES [1] A. Louise McIlroy, 'The Influence of Parturition Upon Insanity and Crime', Transactions of the Medico-Legal Society, vol. 22 (1927-1928), p. 53. [2] Ibid., p.61. [3] Infanticide Act 1922, c. 18. [4] 'Laws "For Women"', Aberdeen Press & Journal, 2 November 1922, p. 4. [5] 'New Infanticide Act', The Vote, 3 November 1922, p. 4. [6] See for example: 'The Infanticide Act: Recorder On A "Badly Drafted" Measure', Gloucester Journal, 17 January 1925, p. 9; 'Murder Charge in Gloucestershire: Baby's Body In A Box', Cheltenham Chronicle, 23 May 1925, p. 6; 'Killing Newly Born Children. Judge and Grand Jury. Women Wrongly Accused of Infanticide', Portsmouth Evening News, 29 October 1929, p. 9. [7] See for example: 'What Is A "Newly Born" Child? Point Argued in Court of Criminal Appeal', Gloucester Citizen, 7 November 1927, p. 6. [8] McIlroy, 'The Influence of Parturition Upon Insanity and Crime', p. 56. [9] Ibid. [10] Ibid., p.58. [11] Ibid., pp.57-58. [12] Ibid., p.61. [13] Ibid., p.59. For an exploration of the provision of maternity services in twentieth century Britain and the emphasis on the needs of the state, see: Fabiola Creed and Hilary Marland, 'Improving Maternity Care through Women’s Voices: The Women’s Health Strategy Continues a Long Process of Advocacy', History & Policy, 15 February 2023, ,(accessed 25 April 2023). [14] Ibid., p.63. [15] Mr Justice Humphreys, quoted in ibid. [16] Ibid., pp.68-69. [17] Dr M. I. Finucane quoted in ibid., p.70. [18] Ibid. [19] Dr Hubert Bond quoted in ibid., p.64. [20] Norwood East quoted in ibid., p.72.

  • The Last Taboo of Motherhood: Exploring Postnatal Mental Illness in 20th-Century Britain

    By: The Project Team With generous funding from the Wellcome Trust, our project explores the history of maternal mental illness in twentieth-century Britain. It aims to understand the changes that took place in labelling, describing and diagnosing postnatal mental illness across the twentieth century. Moreover, it examines how these changes influenced care and treatment in a variety of institutional medical settings, including early twentieth-century mental hospitals, maternity hospitals, obstetric wards, and after the 1950s mother and baby units. Over the course of the twentieth century, an ever-expanding range of health professionals, including psychiatrists, obstetricians, midwives and health visitors, became involved in the care of women experiencing postnatal mental illness, as did a number of charitable, campaign and grassroots organisations; our project aims to chronicle the changing profile and influence of many of these different groups. To a large extent our project focuses on postnatal depression (PND) which was described and labelled by psychiatrist Brice Pitt in 1968, though many health professionals and women were aware of this condition before then. It is also by far the most common type of postnatal mental illness and one that continues to affect women in large numbers. We also explore changing responses to puerperal psychosis, which, although rarer in comparison, can be more dangerous and disturbing in its experience and presentation for sufferers and their families. To compare ideas about postnatal mental illness over time, we will also explore cases from the late Victorian period. Around 1900, many psychiatrists questioned whether conditions associated with childbirth existed as distinct categories of mental illness. Nevertheless, Victorian-era diagnoses of ‘puerperal insanity’, ‘lactational insanity’ and ‘insanity of pregnancy’ continued to hold currency in the twentieth century. We are discovering that criminal prosecutions and medico-legal literature dating to the 1930s and 1940s continued to draw upon these older diagnostic labels to make sense of mothers’ mental states. We are also greatly fascinated by the energetic debates that occurred throughout the twentieth century on the causes of postnatal mental illness, and the ways in which these were attributed to a range of medical, psychiatric, hormonal, and social or cultural factors. These debates went way beyond medical literature. We are discovering that organisations, such as the National Childbirth Trust (NCT), provided support and advice to women experiencing postnatal mental illness from the 1960s onwards. The NCT outlined a wide range of potential causes – amongst them a lack of support networks, poor housing, poverty, exhaustion and loss of employment outside the home, which left new mothers feeling isolated and frustrated. One of the organisation’s most powerful contentions, however, was that postnatal mental illness might be a direct result of the shifting place of birth from home to hospital, which women experienced as a loss of control and agency, leading to births that had been traumatic and lonely. The twentieth century was marked by huge changes that shaped women’s experiences of childbirth and motherhood. These included fundamental alterations in the delivery of childbirth services, notably the move from home to hospital, changing expectations about pain management, and the stepping-up of technological interventions in deliveries. Other significant changes also took place in women’s lives, as their status changed in the home, workplace and in relation to their reproductive autonomy. Our project also considers how far women’s lives were shaped by the rise of feminism, changing family structures and dynamics, and new ideals and practices of parenting. We also examine the impact of broader changes in British society, such as migration, two world wars, demographic change, shifting employment patterns, and alterations in the status and experience of women as subjects under the law. While white middle-class women tend to feature most strongly in narrative accounts and in organisational literature, we aspire to examine the experiences of a wide range of British mothers in terms of race and ethnicity, social class, disability and sexuality. Key to our project is the exploration of women’s own experiences of postnatal mental illness, drawing on a large body of narrative accounts, such as letters, memoirs, magazines, newspaper articles, legal depositions and oral history collections. We aim to understand why women wrote about their experiences and to assess their agency, as ‘experts by experience’, in shaping public and professional understanding of maternal mental illness. The project team also examine the role of the media – from the press and magazines to radio and TV – in offering information and support to women experiencing postnatal mental illness and in shaping public perceptions. We are discovering, for example, that the BBC’s Woman’s Hour broadcasted numerous episodes on postnatal depression, and was already discussing ‘post-puerperal depression’ by 1960, a topic it repeatedly returned to for decades to follow, even to this day. Some broadcasts generated a powerful response, including Nemone Lethbridge’s 1973 Play for Today, ‘Baby Blues’. The play triggered both outrage and a plea for support for women experiencing postnatal mental illness through the press. Television ‘clean up’ campaigners, medical experts, and mothers and fathers sent thousands of letters responding to ‘Baby Blues’ for several years after it was broadcast. In some contexts, the media exacerbated the stigma associated with severe postnatal mental illness. This applied particularly to the small number of women who, while suffering extreme forms of mental disturbance, committed infanticide or attempted to harm their children. Such incidences attracted extensive media attention while also shocking the families and communities closest to the women accused. However, we are also finding that some media accounts could be sympathetic, with press reports suggesting that women suffering from postnatal mental illness were fundamentally ‘good mothers’ whose natural instincts had been drowned out by anxiety, confusion and depression. In the courtroom, the insanity plea continued to be drawn on by medical experts and witnesses to explain infanticide or child harm. In such cases, a variety of medical practitioners - from local GPs and hospital doctors to prison medical officers and esteemed psychiatrists - drew upon their ‘expertise’ to explain the extreme and violent outbursts of women accused of shocking crimes. Drawing on legal records, medico-legal literature and press reports from English and Scottish cases, this project also seeks to better understand the ways in which a woman’s mental illness was seen as prompting the most extreme actions. Why ‘taboo’ in the title of our project? The contrast between expectations of motherhood as a time of joy and fulfilment and the anxiety and depression associated with maternal mental illness has not lost its ability to shock. Women might be castigated for their neglect of the home and children, or for their expressions of violence or anger. Throughout the twentieth century, many women suffering from postnatal mental illness were removed to asylums or mental hospitals for treatment and stigmatised because of this. Many women also described a reluctance about revealing their mental distress after childbirth, as it risked disapproval and censure for contravening expectations of ‘good’ motherhood. We are finding that this reluctance was particularly strong among poor or black and Asian women, women who also had poorer access to childbirth services and suffered other health inequalities. We have aimed here to give a flavour of some of the themes which we will be exploring in the coming months as we carry out our research in archives, libraries and online. Providing historical context and developing our knowledge of how postnatal mental illness was explained, treated and regarded in the past might enable us to better understand how it is responded to today. Future blog postings will provide more insights into our research sources and approaches, as well as expanding on our findings. We invite you to continue to read our blogs, which we will post every month or so along with other news about our project, including our exciting public engagement plans.

  • ‘Under the act… it was not necessary to put a girl on trial for murder’: The Infanticide Act (1922)

    One hundred years ago today – 31 October 1922 – newspapers across Britain reported the outcome of a landmark child murder case, heard at Lincoln Assizes. [1] Emma Temple, a nineteen-year-old domestic servant had been brought to trial the day before, charged with the murder of her newly born daughter. [2] The infant’s body had been disposed of late at night in an outside lavatory, seven weeks previous to the October trial proceedings. [3] A post-mortem examination by local doctor, C.W.T. Woods, confirmed that a tightly bound string ligature cut from the infant’s neck was the likely cause of asphyxiation and death. The Temple case embodied many of the characteristics typically associated with infanticides in this period. The victim was a newly born, illegitimate baby, whose body had been hastily and poorly concealed following its delivery and murder. In addition, Temple too matched the defendant profile commonly associated with this crime. Although only in the employment of butcher James Goose and his wife Kate for little over three months, the accused had given a favourable impression (despite her poverty), as a young, single woman, who was: ‘willing and kind, and of a good character’. [4] As historian Daniel Grey has observed: 'Historical studies of infanticide have stressed that it has generally been those single or widowed women defined as 'respectable', and thus had the most to lose both socially and economically if an illicit pregnancy was discovered, who have traditionally been most likely to commit the crime.’[5] What set this case apart was not the nature of the crime, nor the defendant in the dock, but rather the plea made by Emma Temple at trial. For this case was the first to come under the remit of the ‘wise and merciful provisions’ of the newly passed Infanticide Act (1922). [6] The Infanticide Act (1922) (hereafter ‘The Act’) was one of two major pieces of legislation passed in England and Wales in the inter-war years that specifically attempted to reform the law’s response to women who murdered their children in the aftermath of childbirth. The Act determined that: 'Where a woman by any wilful act or omission causes the death of her newly-born child, but at the time of the act or omission she had not fully recovered from the effect of giving birth to such child, and by reason thereof the balance of her mind was then disturbed, she shall … be guilty of …. infanticide, and may for such offence be dealt with and punished as if she had been guilty of the offence of manslaughter of such child.'[7] Significantly, The Act did not encroach upon a jury’s ability to return alternate verdicts of manslaughter, guilty but insane, or concealment of birth in child murder cases. [8] Prior to the enactment of the new legislation on 20 July 1922, women found guilty of the murder of their newly born infants had been sentenced to death, the same as any other defendant found guilty of murder under English criminal law (until the eventual abolition of capital punishment in 1965). From the 1850s onwards however, such women were never hanged, despite the pronouncement of the ultimate sentence by judges. Instead, capital sentences in child murder cases were commuted to imprisonment. The reasons for this situation were complex. Although it was widely accepted that child murder was an abhorrent crime that should be punished by the law, compassionate attitudes to mothers who killed – often in circumstances of personal, economic and psychological distress – prevailed in British courtrooms. [9] Proving ‘beyond a reasonable doubt’ that a mother had intended to murder her infant was especially challenging. In some cases, juries would find women ‘insane’ or guilty of the lesser offence of concealment of birth, even where evidence for the charge of murder appeared well-founded. The secretive nature of child murder, teamed with the limitations of early forensic medicine to prove foul play, made differentiating between accident, neglect and murderous intent, difficult. Moreover, medical and popular beliefs over the destabilising effect of birth upon the ‘vulnerable’ female mind and anger over the relative lack of punishment fathers received in such cases, encouraged jurors and judges to treat female defendants with sympathy and mercy. As scholars like Grey, Nigel Walker and Tony Ward have shown, the ensuing gap that existed between the criminal law as laid down, compared to how justice was practised in courts of law, sparked successive (though unsuccessful) attempts at legislative reform prior to 1922. [10] The reason for the passing of ‘The Infanticide Bill’ (formerly called the Child Murder (Trial) Bill) into law, remains a topic of significant debate among historians, and is a subject I plan to return to at length in a future blog. However, it is evident from these histories that multiple political, cultural and medico-legal factors coalesced at the opportune time to effect change in the handling of child murder cases in the summer of 1922. For Emma Temple, the first beneficiary under The Act, her plea to the new felony of infanticide resulted in a sentence of four months imprisonment. [11] At the coronial inquest into her child’s homicide, it had been revealed by expert witness Dr Wood, that Temple had been: ‘in a highly strung, nervous condition’ when he had examined her on the night of the crime. [12] On asking her where her child was, Temple allegedly gave no answer to the doctor other than to state: ‘I wish I could die’. At her trial on the 30 October, in pleading guilty to infanticide, Temple maintained that ‘at the time [of the alleged offence] she did not know what she was doing’. [13] Given the evidence of Temple’s former good character and the clear connection Dr Wood posited between the accused’s recent delivery, disordered mental state and ensuing murderous actions, it is little surprise that the Crown accepted her plea of infanticide. Presiding judge, Mr Justice Lush, joined counsel in lauding the new legislation as ‘a fresh step in the improvement of criminal law’ and ‘a wise and humane piece of legislation’ that made it unnecessary ‘to put a girl on trial for murder’. [14] In closing, it is worth highlighting the legacy of the 1922 Act across international borders. As psychiatrists Susan Hatters Friedman and Renée Sorrentino have observed: ‘Internationally, most infanticide laws are based on the 1922 British Infanticide Act (amended in 1938). Approximately two dozen nations have such laws, including Canada and Australia.' [15] While undoubtedly influential, time would reveal myriad problems with the Infanticide Act (1922). Though the conclusion to the Temple trial would suggest The Act was positively received and beneficial for some women, the new legislation also had many critics. In particular, the vague terminology of The Act - especially phrases such as ‘newly born’ - sparked debate about who the new legislation applied to and whether its provisions were adequate (or even necessary given existing criminal law). [16] Almost sixteen years after its passage, in June 1938, the ‘wise and humane piece of legislation’ so praised by Mr Justice Lush, was repealed in England and Wales and replaced by the Infanticide Act (1938) [17]. This new legislation extended the offence of infanticide to include women who killed their own children up to the age of twelve months. It also extended to women who murdered their children while: ‘the balance of her mind was disturbed by reason of her not having fully recovered from the effect of giving birth to the child or by reason of the effect of lactation consequent upon the birth of the child’. [18] Northern Ireland passed its own legislation in 1939. [19] The problems posed by the 1922 Act, the push to draft a piece of legislation that could better avoid the pitfalls of its forbear, and the enduring critiques associated with laws based upon gender difference, are subjects I plan to return to in future blogs on this site. NOTES [1] The case was reported in newspapers across mainland Britain and Ireland, such as in the English Daily Mirror, the Edinburgh Evening Telegraph, County Antrim’s Northern Whig and the Glamorgan Western Mail. [2] 'Young Mother's Guilt. Judge Deals With Her Under New Humane Act', Birmingham Daily Gazette, 31 October 1933, p. 5. [3] 'Tattershall Murder Charge: Accused Pleads “Not Guilty"', Skegness Standard, 4 October 1922, p. 6. [4] Evidence of Kate Goose, reported in ibid. [5] Daniel J. R. Grey, 'Parenting, Infanticide and the State in England and Wales, 1870 - 1950', in Hester Barron and Claudia Siebrecht (eds), Parenting and the State in Britain and Europe, c. 1870-1950: Raising the Nation, Cham, Palgrave, 2017, p. 75. [6] As described in 'Infanticide and the New Act', Exeter & Plymouth Gazette, 31 October 1922, p. 7. [7] Infanticide Act (1922), c. 18. [8] Infanticide Act (1922), c. 18, s. 1 (2). [9] For a very useful overview of the history of infanticide, explanations for child murder or concealment, and problems in proving these offences in courtrooms, see: Anne-Marie Kilday, A History of Infanticide in Britain, c. 1600 to the Present, Basingstoke & New York, Palgrave Macmillan, 2013. [10] Daniel J. R. Grey, 'Women's Policy Networks and the Infanticide Act 1922', Twentieth Century British History, vol. 21, no. 4, 2010, pp. 441-463; Nigel Walker, Crime and Insanity in England: Vol.1 The Historical Perspective, Edinburgh, Edinburgh University Press, 1968, especially pp. 127-136; Tony Ward, 'The Sad Subject of Infanticide: Law, Medicine and Child Murder, 1860-1938', Social & Legal studies, vol. 8, no. 2, 1999, pp. 163-173. [11] 'Young Mother's Guilt’, p. 5. [12] Evidence of Dr CWT Woods, reported in: 'Tattershall Murder Charge’, p. 6. [13] 'Young Mother's Guilt’ p. 5. [14] '"Most Wise New Act". Judge Glad Girl-Mother Need Not Be Tried for Murder', Daily Mirror, 31 October 1922, p. 2. [15] Susan Hatters Friedman and Renée Sorrentino, 'Commentary: Postpartum Psychosis, Infanticide, and Insanity—Implications for Forensic Psychiatry', Journal of the American Academy of Psychiatry and the Law Online, vol. 40, no. 3, 2012, p. 326. It should be noted however, that the USA uses the M’Naghten Rules/ALI Guidelines in establishing the parameters of mental competency in murder cases. [16] For two particularly good discussions of the passage of both Infanticide Acts and the problems this posed for English criminal law, past and present, see: Tony Ward, 'Legislating for Human Nature: Legal Responses to Infanticide, 1860-1938', in Mark Jackson (ed.), Infanticide: Historical Perspectives on Child Murder and Concealment, 1550-2000, Aldershot & Burlington, Ashgate, 2002, pp. 249 – 269; R. Kumar and Maureen Marks, 'Infanticide and the Law in England and Wales ', in James Alexander Hamilton and Patricia Neel Harberger (eds), Postpartum Psychiatric Illness: A Picture Puzzle, Philadelphia, University of Pennsylvania Press, 2016, pp. 257-274, [17] Infanticide Act (1938), c. 6. [18] Ibid [19] Infanticide Act (Northern Ireland) 1939, c. 5.

  • Postnatal Depression Testimonies, and ‘Reluctance’ in the British Library Oral History Collections

    My strand of the project explores the ways in which mothers narrated their personal experiences of postnatal mental illness and how the 'public' responded throughout twentieth-century Britain. As such, I spent a few months this year (2022) evaluating the invaluable oral histories held at the British Library (BL). When I first typed in ‘postnatal depression’ (PND) and related search terms in the catalogue, I was surprised to find references to more than sixty oral history interviews. Yet not one collection title linked directly to PND. Instead, alongside the ‘Mental Health Testimony’ collection, very short recollections – several only a few seconds to several minutes in length – on the topic appeared in collections that had no connection to mental health, including the ‘British Empire and Commonwealth’ and the ‘Potters of the Bernard Leach Legacy’ collections. [1] Nor were the interviews restricted to the actual ‘sufferer’; many interviewees were the sufferer’s partners, parents, siblings(-in-law), children or grandchildren, neighbours, the media, and, of course, healthcare professionals (midwives, health visitors, nurses, physiotherapists and psychiatrists) or healthcare providers (i.e., The International Women’s Public Health Group). A couple of the interviewees also spoke coldly and were unsupportive of the sufferers. Several ‘abandoned’ children, later speaking as adults, were raised by their grandparents or their father, and in these cases, both the children and guardians never forgave the suffering mother. This aftermath, however, was more typical before World War Two. Nonetheless, one woman, even in the 1990s, was still shocked when she learned that other mothers had developed PND, arguing ‘you [‘re supposed to] fall in love with [your child] as soon as they are handed to you’. [2] The BL interviews took place between the 1980s and 2010s. This coincided with the rapid expansion in PND narrative accounts from the 1980s onwards, published as books or in magazines, which illustrated the growing acceptability of both recounting personal experiences and destigmatising PND in Britain. Many of the interviewees reported family histories and spoke about their mothers or grandmothers experiencing PND as far back as the 1930s, which coincide with the earliest mentions of PND within the BL catalogue. [3] Several of the interviewed ‘sufferers’ had physical disabilities, including deafness, or pre-existing mental health diagnoses (i.e., bipolar, psychosis and depression). Interestingly a wide variety of religions were represented among the women experiencing PND, including Judaism, Christianity, Rastafarianism, Wicca, and Paganism. Across the late twentieth century, most interviewees were British, with a few Europeans (e.g., Swedish) one first generation Indian, and Jamaican. [4] By the 2010s, more mothers were interviewed from different nationalities and ethnicities, including Armenians, Nigerians, North Americans, and Canadians. Fathers suffering from postnatal depression were also interviewed for the first time in the 2010s. [5] However, most of the people recounting memories of postnatal depression originated from or were based in the UK; largely London and Birmingham in England, but also Scotland, Ireland, and Wales, though a few women experienced PND when they were visiting or temporarily living overseas. The often-buried testimonies within decades of interviews illustrate how postnatal depression was ubiquitous. Yet there were wide-ranging differences in experiences and reflections and intersectional differences no doubt heightened negative experiences. For example, working-class women were more likely to be institutionalised. Nonetheless, postnatal depression was not restricted by class, ethnicity, race, sexuality, education level, or age. Image credit: Sifis, oral history icon. In this blog, I want to focus on two different expressions of ‘reluctance’ within the interviews, and how they prompt reflections on the motivations behind interviews, and shape new considerations on the part of the interviewers. My first example looks at dismissal and irritability within one interview, and the second reflects heartbreak and an unwillingness to speak about certain topics. Dismissal When I read about interviews of ‘everyday’ women, or when I’ve conducted oral histories myself, interviewees are often eager to share their family history. [6] This was not the case for some of the BL interviews I listened to. M.H. was born in 1934 and in 2000, aged 66, she withstood a four-hour interview across one day as part of the ‘Mental Health Testimony Archive’. The archive holds 50 ‘life story video interviews’ with mental health survivors. The project was initiated by Mental Health Media (now a part of MIND) and funded by the Department of Health. [7] M.H. had an illness where she became ‘aggressive’, ‘nasty’ and had ‘blackouts’. She argued that this was a ‘physical’ illness as she ‘wasn’t really mentally ill’. She had developed whooping cough as a child, and she claimed that the lack of medical resources and instabilities of World War Two prevented a full recovery. She believed this caused her life-long illness. M.H. was isolated most of her life and said that she could not secure a job because of the stigma of mental illness. From start to finish, and before most interview breaks, M.H. was reluctant to talk about her past. She agitatedly emphasised that there was no need for her to be interviewed because she was ‘ordinary’. As a child, she was an ‘ordinary pupil’ and had ‘ordinary friends’, there was ‘nothing special’ about school life. Throughout her life, however, she was in and out of psychiatric hospitals, such as Belmont, Maudsley and later Graylingwell in the mid-1950s, where her condition worsened, ‘possibly … due to postnatal depression’. When in hospital, M.H.’s mother looked after her baby. She spoke briefly about her experience at Graylingwell, but did not expand on her postnatal depression, explaining that regular electroconvulsive therapy (ECT) had caused memory loss around that time period. When the interviewer repeatedly asked M.H. about her children across different time periods, M.H. dismissively changed the subject. Towards the end of the interview, M.H. became even more annoyed, arguing that she had a normal life and that it was not worth documenting; she even rolled her eyes and placed her head in her hands. [8] In contrast, the other PND sufferers also interviewed for the Mental Health Testimony Archive were happy to expand when talking about their lives in general. [9] Avoidance Another example of ‘reluctance’ in the interviews was the inability to talk about a sensitive topic. J.L. was born in 1923 and interviewed in 2011, aged 88, as part of the ‘National Life Stories: General Interviews’ collection. [10] From the mid-1940s onwards, J.L. tried to build a family with her husband. Throughout the interview, she spoke cheerily, quickly, with lots of laughter, and long dynamic monologues. The interviewer did not need to prompt her, and they both seemed comfortable and joked together. Although J.L. found motherhood ‘ghastly’ and lost all self-confidence when suffering from PND following the birth of her first child in 1948, she spoke calmly about her miscarriages, and her first-born’s diagnosis of epilepsy, following his ‘frightening’ seizures. Nonetheless, despite five interviews across five months – likely aiming to develop trust – the interviewer had to nudge J.L. into talking about the birth of her second child, her deceased daughter, M. When M was first mentioned, J.L. hesitated and swallowed loudly. After several pauses, J.L. joked ‘I was avoiding that, wasn’t I’. Speaking mournfully and slowly, J.L. explained that her baby, M, had only lived a few hours, and that J.L. was not allowed to see her because she had eclampsia. Following the traumatic childbirth and death of M, J.L. developed permanent deafness. Even though J.L. went into great detail about other heartbreaks across her life span, she did not mention M again after these brief moments. [11] Image credit: Christos Georghiou, Optical Illusion Mother Woman and Child Tree Faces. Reflections Listening to these two interviews, which were conducted roughly one decade apart, made me consider the motivations behind interviewing people who are reluctant to talk about their lives overall, or sensitive topics, and how this has changed over the decades. I wondered if these interviews would become publicly accessible if they were conducted today? I was also curious about who convinced M.H. to talk about her life in the first place – her children or grandchildren? And why did the interviewers press on in both cases? Were there gaps to fill, in terms of the type of disorder or geographic region, in the ‘Mental Health Testimony’ collection? M.H. may have listened to the interview afterwards and still consented to its public access? In regard to J.L., were there considerations about how she felt after the interview, given she had opened up about a harrowing life-changing event of sixty years ago? Was she in the company of close friends or family in sharing her story, or did the interviewer recommend support services after the interview? My conclusion has certainly raised more questions than answers. But in my view, such publicly accessible interviews – in institutions like the British Library – would benefit from additional notes specific to each interview that could help inform researchers about the nature and context of the source they are using. These notes could briefly summarise the collection’s objectives, and the reasons why certain interviewees were selected. A brief comment on the relationship developed by the end of the interviews would also be useful. From my perspective, the interviewers’ continuous prompts, despite the interviewee’s reluctance, seemed almost cruel and unethical. Yet some easily accessible contextual notes on these interviews may have revealed that both participants agreed to try and work together to broach these sensitive topics across the interview process. The inclusion of this contextual information, and perhaps more, would greatly help researchers when they revisit these types of interviews years or decades later. __________________________________________________________________________________ NOTES [1] UBC034/618, British Empire and Commonwealth Collection, British Library, 1998; C1330/23, Potters of the Bernard Leach Legacy, British Library, 2009. [2] C900/12563, Millennium Memory Bank, British Library, 1999. [3] C466/182/01-04, NLSC: Artists' Lives, British Library, 2004. [4] Ibid.; C900/05003, Millennium Memory Bank, British Library, 1998; C900/04623, Millennium Memory Bank, British Library, 1999. [5] BNR000137875, ‘Do you welcome more support for new fathers with post-natal depression?’, Broadcast Radio News, British Library, 2018. [6] Angela Davis, Modern Motherhood: Women and Family in England, 1945-2000 (Manchester University Press, 2012), pp.6-7. [7] British Library, ‘Mental Health Testimony Archive’, 2000. Accessed 21 November 2022: [8] C905A/39/01, Mental Health Testimony Archive, British Library, 2000. [9] C905A/42, Mental Health Testimony Archive, British Library, 2000; C905A/28/01, Mental Health Testimony, British Library, 1999; C905A/42/01, Mental Health Testimony Archive, 1999. [10] National Life Stories and British Library, ‘National Life Stories: A History’, updated 2018. Accessed 21 November 2022: [11] C464/79/01-11, National Life Stories: General Interviews, British Library, 2011.

  • ‘Gestation with nervous disturbance': Childbirth and Mental Disorder in Early 20th-Century Asylums

    In February 1904, Florence H. was admitted to Claybury Asylum with a diagnosis of acute puerperal mania.[1] Aged 23 and a resident of Islington in north London, the birth of her first child was given as the ‘exciting cause’ of her illness. The entry in the asylum casebook described how Florence ‘had tried to get at baby’ and to throw the three-week-old child out of the window. She was raving, restless and noisy and was taken to the asylum on a stretcher under restraint. ‘She chatters and sings incoherently’, it was noted in her case history. The diagnosis of puerperal insanity was confirmed by Medical Superintendent, Dr Robert Jones, a week later. Florence was initially kept in a padded room where she was said to have been ‘constantly moving about’ and to ‘turn somersaults’. She was noted to be in poor health, was coaxed to eat by the nurses and thereafter ‘took nourishment abundantly’. After ten months in Claybury, Florence was reportedly much better, and in February 1905, a year after her admission, she was discharged recovered to a local workhouse.[2] Over the last few months, I have been exploring the early twentieth-century casebooks of two major London lunatic asylums and the admission of patients experiencing mental disorders attributed to pregnancy, childbirth and breastfeeding. The first, Colney Hatch Asylum in North-East London, opened in 1851 and served the most deprived and densely populated areas of London’s East End. The second, Claybury Asylum in Woodford Bridge, Essex, was established over four decades later in 1893, as London’s fifth County Council asylum. By the early twentieth century, London County Council had built up one of the largest asylum systems in the world, and in 1907 its ten asylums housed over 20,000 patients. The records of both institutions present challenges for researchers. Access to archives involving patient records is restricted to casebooks over 100 years old for reasons of both confidentiality and sensitivity, and Claybury has few surviving casebooks for this period. Meanwhile, Colney Hatch has an exceptionally full run of casebooks but a number of these have been closed to researchers due to their extremely fragile state. Nonetheless, these sources provide valuable testimony about how women suffering insanity related to childbearing were diagnosed, their backgrounds and their experiences in the asylum. Dr Robert Jones, Claybury’s Superintendent, had a special interest in mental breakdown related to childbirth. He published extensively on puerperal insanity in British and American medical journals, declaring in 1902 ‘that gestation is attended with much nervous disturbance in many, and some nervous disturbance in all’.[3] Claybury provided Jones with ample material for his publications. Childbirth was listed as a major cause of mental breakdown, and between 1896 and 1902 259 women were admitted with diagnoses of insanity of pregnancy, confinement or lactation.[4] Florence H.’s experience cited above is representative of numerous women admitted to Claybury and other London asylums in the early years of the twentieth century. The majority of women suffering puerperal insanity were brought to Claybury within a few weeks of their confinement, and many were discharged relieved or cured within a year of admission. Some were sent home, others removed to the workhouse. While puerperal insanity was often associated with hereditary causes and instances of mental illness in the family, social and economic factors were also deemed significant. Jones also appeared to empathise with the plight of his female patients, highlighting in his published work the stress resulting from overwork, penury and domestic troubles.[5] In terms of treatment, there was little in the way of medical or pharmaceutical intervention. Though sedatives might be prescribed, attention was primarily devoted to encouraging the women to rest, eat and take on a regular routine. Given the impoverished backgrounds of most patients, many were poorly nourished on admission and were ‘coaxed’ to eat by spoon feeding or use of a feeding tube. Unlike current day treatment, where ideally women keep their babies with them, the infant was usually removed from the mother, and brought to the workhouse or cared for by a family member. Florence’s confinement in a padded room might have been to protect her from harming herself – she was reported to be very excited and badly bruised on admission – and it avoided the use of a strait jacket. It was commonly observed that women experiencing puerperal mania might, like Florence, be in poor physical health yet at the same time exceptionally strong, energetic, and violent. Her threatening behaviour towards her baby was common in such cases, and many women were also believed to be at risk of harming themselves. Colney Hatch Asylum was notable for its admission of large numbers of ‘alien’ patients, particularly after London County Council took the decision to concentrate Jewish patients there in 1872. Colney Hatch introduced special religious and dietary provisions for their Jewish or as they were commonly referred to ‘Hebrew’ patients.[6] Many were recent migrants to London from Eastern Europe, some of whom spoke little or no English, and almost all were impoverished and in poor physical health. Despite efforts to accommodate a growing asylum population that had reached 2,500 by 1900, the institutional experience for inmates was likely to be grim. For women already struggling with the disruptive and alienating consequences of mental illness, daily life on wards, which were reportedly decrepit, gloomy and uncomfortable, must have been frightening. The medical staff appear to have been responsive to the information given by Jewish family members, particularly if the patients were unable to communicate themselves. Usually, it was husbands who described how childbirth had prompted their wives’ mental breakdown and on occasion this led to a change in diagnosis. When Eva C., ‘Hebrew’, aged 24 and resident in Mile End, was admitted on 15 February 1905, the cause of her insanity was given as ‘a fright’. She was described in the case notes as depressed, melancholic and vacant, yet also liable to be troublesome and ‘spiteful’. She was also refusing to eat. When her husband visited, he explained that she had ‘not been right’ since the birth of her second child five months ago and had been unable to sleep; accordingly, a provisional diagnosis was recorded of ‘melancholia lactational’. Sadly, Eva’s condition worsened, and she died at the end of February, when the cause of death was given as ‘Acute Melancholia or Exhaustion. Natural Causes’.[7] This was an unusual outcome for such cases given their generally good prognosis, though lactational melancholia was regarded as particularly difficult to cure. Twenty-three-year-old Leah C., also recorded as ‘Hebrew’ and from Mile End, was admitted to Colney Hatch with a diagnosis of puerperal mania on 2 June 1900. The admission notes reported her to be ‘dazed, bewildered and wild’ and her physical health ‘impaired’. On visiting the asylum, her brother-in-law and husband explained that Leah had lost her first baby after a miscarriage; she also had a three-year-old child at home. Several weeks before her last delivery on 22 May, her husband explained that Leah had begun to ‘talk nonsense, saying she would do away with herself’. She initially refused to eat, and her recovery was slow throughout the rest of the year. However, in February 1901, Leah showed significant signs of mental improvement. She was sent out for a trial period with her family and was discharged ‘recovered’ the following month. (Photographed before discharge, it is possible in the image below to see the restraining hand of a nurse keeping Leah still while the photograph was taken.)[8] These select examples provide some insights into childbirth-related cases of mental illness treated at Colney Hatch and Claybury Asylums in the early twentieth century. Many patients were single mothers, and a future blog will describe their experiences, including, for some of these women, delivery in the asylum. Though admission to an asylum must have been a miserable experience, it provided a route to recovery for many. The women appear to have been well treated on the whole, despite the limitations of overcrowded wards, staffed by overworked doctors and nurses. These cases also provide insights into the hardships experienced by working-class women of London around this time, compounded for many by anxiety about bringing another child into the world. For some the asylum proved to be just that: a place offering shelter, food, care, and respite. __________________________________________________________________________________ NOTES [1] I am using early twentieth-century terminology in this blog. At this time the term ‘lunatic asylum’ was still in common usage to describe what after the 1930s were increasingly referred to as ‘mental hospitals’. I have also employed terms such as 'insanity' and 'mental disorder', in frequent usage during this period. [2] Redbridge Central Library, Claybury Asylum Female Casebook Nov. 1903-Aug. 1904, Florence H, admitted 17 Feb. 1904. [3] Robert Jones, ‘Puerperal Insanity’, British Medical Journal, 8 March 1902, 579-86, quote p.579. [4] Ibid. [5] Louise Hide, Gender and Class in English Asylums, 1890-1914 (Houndmills: Palgrave Macmillan, 2014), p.33. [6] Rob Ellis, London and its Asylums, 1888-1914: Politics and Madness (Basingstoke: Palgrave Macmillan, 2020), 212-13, 215; Len Smith, ‘Insanity and Ethnicity: Jews in the Mid-Victorian Lunatic Asylum’, Jewish Culture and History (1998), 1, 27-40, p.34. [7] London Metropolitan Archives (LMA), Colney Hatch Asylum/Friern Hospital, H12/CH/B/11/54, Casebook for Female Patients Admitted Dec. 1904-June 1905, Eva C. admitted 10 Feb. 1905. [8] LMA, H12/CH/B/11/47, Casebook for Female Patients Admitted Dec. 1899-Aug. 1900, Leah C.. admitted 2 June 1900.

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