ABSTRACT
Pregnancy and childbirth have an enormous combined psychological and physiological effect on a woman’s life. Historically, physicians have postulated a link between childbirth and mental illness, since Bc 5, when Hippocrates hypothesised that puerperal psychosis was a result of milk diverted from breast to brain. In the nineteenth century, the French psychiatrists Marce and Esquirol documented a series of clinical observations of women during this period (Cox, 1993). More recently, studies have shown that child-bearing is associated with a marked increase in the incidence and prevalence of psychiatric disorder but exact causal mechanisms (such as hormonal changes) remain unclear. Postnatal depression is extremely common, being consistently found in 10–15 per cent of mothers (O'Hara and Swain, 1996). Postpartum affective or schizoaffective psychosis is less common, afflicting about two in every thousand deliveries, usually requiring hospitalisation. In addition, passing through obstetric services there will also be about 2 per cent of pregnant women who have chronic mental health problems (Kumar and O'Dowd, 2000).
