When the bough breaks

[GorillaMumma]

Has anyone else seen this documentary about postpartum depression and psychosis? It's on Netflix. I can't help feeling angry when psychosis and infanticide are uttered in the same breath. It's so rare and I feel it increases the stigma around psychosis.

[Mims2014]

I'm sorry but I disagree. I had pp after my son and feel I was a massive risk to my son and myself and I think that risk needs to be known. I think the risk of infantcide is at least 5% and in a society when MH services are cut to the bone, this condition needs priority because of risk to mum and baby.

Listened to a story on radio 4 and it said that pp does not mean a mother is a risk to baby but that is simply not true in serious cases - A delusion could take a person down any path.

I guess it's a spectrum though, therefore some women will have never lost their mind but others of us did.

I do hate the name of the programme though, that implies we all dropped our babies, which I was so anxious of x

[Ellie_at_APP Partner]

Hi both

Thanks for your original post and reply. It's an important, but complex, issue we're discussing here isn't it?

I too find it really difficult to have postpartum psychosis and infanticide linked in such a close way, as if that's a main feature of the illness, when it is extremely rare that mum's suffering from postpartum psychosis commit infanticide.

I do personally feel that sometimes the media focus on this (infanticide), and do it more for dramatic affect, to make a good story and sell the film and papers, rather than actually give accurate information about PP, and talk about the risks in a realistic way. I haven't seen the film you mention though so I can't make judgments about that one. But as you say it can really feed into the whole stigma that we face, that mum's who suffer from postpartum psychosis are dangerous, and are unsafe to be mothers, which we all know isn't true.

However, having said that, it is true, as you say Mims, that postpartum psychosis can be a risk to the mum and baby. There is not so much risk of the mother causing deliberate harm to the baby. Most mum's who had PP, from stories I have heard, and including my own experience, their delusions seem to be often focused around trying to protect their baby from some evil, or thinking their baby was dead, rather than actively wanting to harm their baby as part of their psychotic thoughts. So harm coming to the baby would be through more unintentional neglect, or harm, due to being so unwell. The American organisation, Peer Support International, does mention some of these risks on their website: postpartum.net/learn-more/p...

I know I was so acutely unwell that I was totally unable to look after my baby safely for the first one or two weeks, until I started to respond to the anti psychotic medication. Here at APP we have some main messages about PP, which we try to promote. That PP is a psychiatric emergency, so it's essential that all parents, and professionals who are in touch with parents, are aware of the early symptoms and know they need to respond quickly if there are symptoms. We also emphasise that it's important that mum's with PP are not separated from their babies, but go to a mother and baby unit, or have intensive support at home. And lastly, that the majority of people who have PP make a full recovery, and have a normal family life, and form strong bonds and relationships with their children, so it's absolutely essential they receive the right professional support in order to do that (ideally specialised perinatal mental health support).

Sorry for the long post, but I hope it is helpful in some way, it is such a difficult and complex issue.

Ellie

[Helen_84 Volunteer]

Hello,

I think this is a really important discussion, especially when considering the stigma around mental health, and particularly maternal mental health.

Personally I agree with Ellie, and that the media can focus on this for dramatic effect and to sensationalise a story. This I feel is a real shame, as it can increase the stigma around it, and is not sensitive to the vulnerability of anyone affected by what is a serious and traumatic illness.

I personally don't know the statistics of infanticide - if it is increased and by how much when the mother has suffered PP. However given it is an extremely rare event, and that 1 to 2 in 1000 mum's experience PP, I imagine the risk of it happening is extremely low.

I always find it helpful to put mental illness in the context of physical illness too. For example if a new mum broke both her arms she too would be unable to look after her newborn and would need near constant support while she recovered. In the same way a mum who has suffered PP is also ill and will also need help looking after her baby. I agree that delusional thoughts could definitely lead to unintentional neglect of a baby - but this is the manifestation of the illness, and not the fault of the mother. You would not expect a mum who has broken both her arms to be able to pick up and feed a baby on her own and you should not expect a mum who is experiencing PP to do this either, depending on the serverity of the illness.

I agree that when comparing the funding and services of mental health to physical health there is huge amount of work to be done, and this does need to be improved so that they are on par. However things are getting better, only yesterday NHS England announced that 4 new MBUs are being commissioned. This is great news and a small step to equalising the services.

This too is a long reply! But it is a discussion worth having x