Maternal Mental Health: We Can Do Better
by Ellen Notbohm
There’s always one.
In twenty years of genealogy work, I’ve seen it countless times. In every family’s tree, there’s one nobody will talk about. A disgrace best erased. The black sheep, the white raven. Bad apple, bad egg. Fallen angel.
In genealogy we call those zipped lips a brick wall. Too often, that brick wall is built with ferocious mortar and a shocking absence of context. That lack of context often comes with a ripple effect that speaks of society as a whole, and with a history that, far from buried with our ancestors, is still with us.
In my own family, the woman behind the brick wall was three generations back. Fifteen years ago, I felt a growing pull from within—I needed to know her. Only two people who might be able to tell me about her were still alive. One shut down the conversation with three curt words, “Don’t know anything.” The other politely refused, saying it had caused lifelong family strife she’d finally chosen to be done with.
Nevertheless, I persisted. Eventually a crumb of information came my way. The crumb puzzled, tantalized and tormented me, leading me down countless dead-ends. Then one otherwise unremarkable day, I stared at that crumb and saw it in a different way. Only then, through century-old public records and newspapers, did I discover the truth: my brick-wall ancestor had recurring postpartum psychosis.
Bit by bit, I learned her story. Imagine it, as I did:
A woman not yet out of her teens gives birth and falls into a long and terrifying episode of mental illness. Previously a gentle, creative and loving wife, she becomes withdrawn, angry, and violent.
There is no treatment, no compassion, no second chances, no rights as a woman or mother.
A faraway brother offers her a new home, a clean slate.
And what happens when, years later, a second chance does arise, one that shines brightly but briefly, and leads to only one, unthinkable option?
Imagine it, as I did. Law enforcement, the courts, and the medical profession—all male—pass judgment on her. In the court of law and the court of public opinion, many consider what we now know as a bona fide medical condition to be character defect, a choice, a failing.
Now picture what matters most to you: partner, child, home, health, autonomy, self-determination. Then imagine that in the face of the “treatments” and socials mores of the day, your postpartum illness could cost you all of that. You could be judged insane. You could be committed to a “luny” asylum.
I chose to tell my ancestor’s story in a novel, The River by Starlight, to be published May 8 in conjunction with Maternal Mental Health Awareness Month. I called my ancestor Annie, short form of Analiese, German for “grace.” Despite twelve years of research across a dozen states and provinces, I didn’t uncover the full story, and never would. But I had learned three things—that the subject had virtually never been discussed in historical fiction, and it was yet more rare to present the story not just from the woman’s point of view, but from her husband’s, and that that point of view could be just as anguished and tragic as the woman’s. And I learned that in the face of devastating misfortune she couldn’t control, one small, fragile-yet-fierce woman pulled forth incomparable, unforgettable resilience and tenacity.
Annie was that person. I tell her story because we need to know where we came from if we are to know where to go—if we are to believe that healing can be had, and that it’s the fundamental right of every woman who carries a child, whether to term or not. Lack of health care, women’s rights, gender inequality, double standards, stigma, societal judgment—these things are still with us, reverberating around us today, as inescapable as the untreated illness and consequences Annie faced.
Today, with Annie’s century-old story on the brink of going out into the world, a woman in a modern American city went to her doctor for a postpartum checkup. She asked about postpartum depression, for advice dealing with some episodes of irritability and anger she’d experienced. She made it clear, repeatedly, that she had no thoughts of hurting herself or her baby. A nurse, citing “standard procedure,” called the police, who escorted the young mother to an emergency room, where her clothes were taken, blood and urine samples taken, and a security guard assigned to her. She remained there until midnight when a social worker finally showed up, deemed the young mother didn’t need help, and discharged her with some photocopied information. The mother never saw a doctor, wasn’t offered treatment or follow-up. She left the hospital feeling “like a criminal . . . my spirit more broken than ever.”
That her story went viral and drew forth numerous other women with similar stories tells us that, despite the hundred years since Annie, our work has barely begun.
I wrote about Annie because I didn’t think she should be the one nobody would talk about. I want her to be the one everyone talks about—what her illness so unjustly cost her, what she refused to surrender, and what we owe all women who bravely undertake the risks and unknowns of motherhood.
I tell Annie’s story because it’s about time.
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