The Book<\/h4>\n
Blue: A History of Postpartum Depression in America<\/p>\n
The Author(s)<\/h4>\n
Rachel Louise Moran<\/p>\n<\/p><\/div>\n
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When I first experienced postpartum depression and psychosis in 2013, nine months after my first child was born, a well-known psychiatrist told me that postpartum depression did not exist. I knew something was wrong with me, but I was experiencing enough stressors in my life that I did not think I had a mental illness. What was more, I was a professor\u2014I was being paid for what was in my brain even though I knew my brain was not right at the time\u2014so I could not let on that I was sick. But I had lost my appetite, a lot of weight, sleep, and focus\u2014so much so that I had to take time off of work. After seeing many specialists, a local psychiatrist told me I had a textbook case of postpartum depression. This was a relief to me. Finally, a diagnosis and a treatment plan that could address what was wrong with me. Five years after my first child, a delay because of tenure and to recover from the difficulty of a traumatic first birth and postpartum, I had a second child while under the supervision of several specialists. At nine months postpartum, I again experienced postpartum depression and psychosis even though I had followed all of the specialists\u2019 advice.<\/p>\n
This time I landed in the hospital for two weeks. A year later, I underwent a chemically-prepared biopsy to understand why I had a history of miscarriages. I again experienced a psychosis from the chemical treatment that almost hospitalized me again. The third time I experienced psychosis I had support by those closest to me, but I felt under scrutiny and judgment: how could I want more children after I had had psychosis after my first child? For some reason, those who knew me couldn\u2019t tell when I was mentally ill. I thought, \u201cI have the same illness that Brooke Shields had talked about on national television and the extreme disability that caused Andrea Yates to kill her five children that made headlines. Why didn\u2019t people understand and remember these stories?\u201d A mentor who was close to me reminded me that the judgment was simple ignorance about the condition.<\/p>\n
Rachel Louise Moran has written a magnificent, comprehensive, and long-overdue history of postpartum depression in the US called Blue<\/em> (2024) that challenges the discursive and perhaps willful ignorance about the condition. In this historiography, she introduces the book through her own personal narrative and experience with postpartum depression. The narrative style of the book is a balance between personal histories of activists and postpartum psychiatrists with postpartum depression (PPD) and breakthroughs in postpartum scientific research and activism. Moran presents us with a rich archive of research conveying the history of different postpartum support groups and companies as well as the evolution of medicine to address postpartum depression and psychosis. The main thrust of her argument is that medicine and activism for postpartum depression and psychosis evolved together and are still at work. She goes as far as to argue that scientific research for postpartum depression and psychosis can be defined as feminist activism. The chapters tellingly proceed as follows: 1. Baby Blues and the Baby Boom; 2. A Feminist Postpartum; 3. Supermoms and Support Groups; 4. A Different Kind of Women\u2019s Health Movement; 5. The Problem of Diagnosis; 6. The Postpartum Professional; 7. Talk Shows, Tell-Allas, and Postpartum Awareness; 8. A New Generation of Activism; 9. It is Not a Political Issue.<\/p>\n In Blue<\/em>, Moran traces the discursive evolution of the condition of postpartum depression and psychosis. Some of the scholarly stakes of the book include: (1) Postpartum depression and psychosis are severe medical conditions that are severe and different from other clinical depressions. (2) Medicine is a form of activism. (3) Motherhood is a divisive topic even as it is often thought of as a white topic and Black and Latina women are more susceptible to PPD than white women. (4) Postpartum distress was not named until the 1960s even though evidence of postpartum psychosis dates back to 400 BCE.[1]<\/a> Moran writes, as evidenced by Charlotte Perkins Gilman\u2019s famous short story \u201cThe Yellow Wallpaper\u201d (1892) about the author\u2019s own dealings with postpartum psychosis,<\/p>\n In the nineteenth century, a severe insanity following childbirth was called puerperal insanity, a cousin of modern postpartum psychosis. One of the most famous psychiatrists of the time, French reformer Jean-\u00c9tienne Esquirol, documented insanity in ninety-two women institutionalized in their first year postpartum. He described their outbursts, hallucinations, and nonstop talking and walking. A few other British doctors published on puerperal insanity in the first half of the nineteenth century. They debated whether the cause of the insanity was anemia, or perhaps \u2018a peculiar irritation of the uterus.\u2019[2]<\/a><\/p>\n Between the 1940s and 1960s, postpartum distress was discursively downplayed as \u201cthe baby blues\u201d\u2014even serious conditions. It was in the 1950s that tranquilizers such Miltown, Libtrium, and Valium and the ADD\/ADHD medicine Ritalin were prescribed to aid \u201cthe baby blues.\u201d It was not until the 1990s that SSRIs such as Prozac and Zoloft were specifically prescribed for postpartum depression. But even in the 1960s, feminist activists such as Betty Friedan acknowledged postpartum depression as the \u201cdepression \u2018without a name.\u2019\u201d[3]<\/a> It was not until 1984 that Carol Dix was credited for naming PPD.[4]<\/a><\/p>\n Moran also presents readers with the history of the postpartum organization and companies that were formed from the 1970s to the 2020s. Published in the 1970, the activist and self-help book, Our Bodies, Ourselves<\/em> was written by Wendy Sanford, Jane Pincus, Ruth Bell, Paula Doress, and Esther Rome and published by Boston Women\u2019s Health Book Collective. In 1973, Simon and Schuster republished the guide due to its popularity. But by the 1980s, the book was overshadowed by national and international support groups and organizations: the Pacific Postpartum Support Society (1971), Depression After Delivery started by Nancy Berchtold (1985), Postpartum Support International started by Jane Honikman (1987), Shoshana Bennett\u2019s Postpartum Assistance for Mothers (1987), later the Baby Blues Connection in Portland (1994), and Postpartum Progress (2011). Moran includes the dissolution of Postpartum Progress because of differential experiences of postpartum depression and treatment across racial lines. Moran points out that, rather than confront the racial tensions, the group folded. Its end shocked Graeme Seabrook after she had filed her complaint about the group. As I mentioned earlier, Moran also acknowledges that postpartum depression is more likely to affect Black and Latina women. The other groups still remain intact today. However, when I experienced postpartum depression and psychosis in the 2010s, none of the specialists I saw recommended these groups, so I did not know about them until reading this book.<\/p>\n That continued lack of knowledge and resource sharing exacerbates the tragedy of headline grabbing events. Moran not only includes these groups and their history but also deftly refuses to sensationalize the infanticides of Sharon Comitz, Angela Burling, and Andrea Yates. Yates was sentenced to prison but transferred to a high-security mental hospital four years after. Burling, on the other hand, was unusually acquitted of guilt for her infanticide. Moran recognizes that television wanted sensationalized stories of psychosis and infanticide but, at the same time, famously covered the postpartum depressions of Brooke Shields and Marie Osmond, which \u201copened the door for the huge number of celebrities who confessed their postpartum depression in the 2010s.\u201d[5]<\/a> Moran writes of the Yates story:<\/p>\n But overall the media coverage of Yates was not good for women. Postpartum therapist Karen Kleiman got call after call about Yates from news outlets. She would try to turn the interviews around, to be as broadly educational about the postpartum as possible. But most of what resulted \u2018scared the shit out of women,\u2019 Kleiman said. They were afraid they could hurt their children, but also afraid that it they spoke about any of their postpartum emotional problems, other people would assume they might hurt their children. Even as it made for media coverage of postpartum illness, Kleiman says, \u201cthe whole Andrea Yates piece was re-silencing moms.\u201d[6]<\/a><\/p>\n What if the discourse surrounding Yates\u2019s story could tell others of the extremity of postpartum psychosis and ways to aid a woman in leading her to heal instead of silencing them? This is the question Moran poses in her book.<\/p>\n Moran also performs the important work of reporting the legal victories of grassroots postpartum activists. House Bill 1764 was passed in the Illinois House in 2018, which was \u201cthe first criminal law in the US to center the role of postpartum mental illness in crimes committed.\u201d[7]<\/a> House Resolution 163 recognized the severity of postpartum depression and psychosis at a national level in 2000. In 2003, Virginia passed a law requiring the dissemination of information about postpartum depression to new parents. In the same year, Texas passed the \u201cAndrea Yates Bill,\u201d which mandated resources on postpartum depression. The Melanie Blocker Stokes Act was passed in 2009 for public health aid for and education about postpartum distress. Finally, the Black Maternal Health Momnibus Act of 2021 was passed to improve maternal health for vulnerable populations, including women of color and veterans. Moran acknowledges that there is still work to be done: Moran writes, \u201cPsychiatrist Margaret Spinelli has spent years campaigning to the American Psychiatric Association for the addition of postpartum psychosis to the DSM-5<\/em>.\u201d[8]<\/a><\/p>\n Because the development of postpartum activism and medicine was not linear, Blue<\/em> does not map them out in this way. However, a historical timeline of the organizations and evolution of medicine and terminology would have been a helpful appendix to the book. This book powerfully contributes to US intellectual history by demonstrating that even though discourse as power is ahistorical (for which Foucault has been heavily critiqued), discourse evolves through history, across different subjects. For example, the diminution of postpartum depression as simple baby blues in the 1950s is no longer an acceptable course of action in the 2020s. Moreover, the discourse of postpartum depression, long wielded by male physicians, is finally in the mouths of women activists who have had first-hand experience with this \u201cmonster\u201d of an illness. As Moran succinctly and memorably puts it, \u201cPPP [Postpartum Psychosis] is a monster and Lindsay needs to know she didn\u2019t take her children\u2019s lives\u2019 Berchtold explained. \u2018PPP did.\u2019\u201d[9]<\/a> She adds, \u201cPostpartum depression is not a liberal or a conservative issue, they reiterate, it is an everyone issue. It is a women\u2019s health issue and <\/em>a family issue.\u201d[10]<\/a> Those are the truths that Blue<\/em> delivers.<\/p>\n [1]<\/a> Rachel Louise Moran, Blue: A History of Postpartum Depression in America <\/em>(Chicago and London: The University of Chicago Press, 2024), 18.<\/p>\n [2]<\/a> Moran, 18.<\/p>\n [3]<\/a> Moran, 39.<\/p>\n [4]<\/a> Moran, 123.<\/p>\n [5]<\/a> Moran, 185.<\/p>\n [6]<\/a> Moran, 179.<\/p>\n [7]<\/a> Moran 161.<\/p>\n