{"title":"\"I have suffered something\": traumatic childbirth in 19th-century Britain.","authors":"Jessica Cox","doi":"10.1136/medhum-2023-012883","DOIUrl":null,"url":null,"abstract":"<p><p>In 1994, the American Psychiatric Association revised its definition of trauma in relation to post-traumatic stress disorder (PTSD), enabling the recognition of childbirth as a potentially traumatic event leading to the development of symptoms of PTSD. This article considers clinical definitions of postpartum PTSD in relation to 19th-century case histories of difficult childbirth, and posits that the circumstances of some of these births-particularly in the context of higher infant and maternal mortality-mean they were likely to have been experienced as highly traumatic events, which may have led to the onset of symptoms today associated with postpartum PTSD. While resisting problematic retrospective diagnoses of postpartum PTSD, the article highlights the presence of the now widely recognised risk factors for the disorder in the experiences of these women, and demonstrates that birth in 19th-century Britain had significant potential to be experienced as a traumatic event for mothers. In doing so, it seeks to contribute to a wider conversation around-and expand our understanding of-women's (physical and emotional) experiences of childbirth at this time, as well as some of the medical practices commonly employed in the birthing room, and the ethical questions which emerge from some of these. The article begins by outlining the risk factors now associated with postpartum PTSD, before exploring these in relation to 19th-century birth narratives. It draws on medical case notes (primarily the case studies of Dr Robert Lee) and women's own accounts of childbirth, as well as advice literature for women on the subject of childbirth. The discussion focuses in particular on three issues: women's knowledge around childbirth and agency within the birthing room (including issues of consent); the use of interventions in childbirth; and infant loss. The final part of the article briefly considers 19th-century discourses around puerperal insanity, and notes an association between difficult deliveries and the onset of puerperal insanity in some cases.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Humanities","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/medhum-2023-012883","RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"0","JCRName":"HUMANITIES, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0
Abstract
In 1994, the American Psychiatric Association revised its definition of trauma in relation to post-traumatic stress disorder (PTSD), enabling the recognition of childbirth as a potentially traumatic event leading to the development of symptoms of PTSD. This article considers clinical definitions of postpartum PTSD in relation to 19th-century case histories of difficult childbirth, and posits that the circumstances of some of these births-particularly in the context of higher infant and maternal mortality-mean they were likely to have been experienced as highly traumatic events, which may have led to the onset of symptoms today associated with postpartum PTSD. While resisting problematic retrospective diagnoses of postpartum PTSD, the article highlights the presence of the now widely recognised risk factors for the disorder in the experiences of these women, and demonstrates that birth in 19th-century Britain had significant potential to be experienced as a traumatic event for mothers. In doing so, it seeks to contribute to a wider conversation around-and expand our understanding of-women's (physical and emotional) experiences of childbirth at this time, as well as some of the medical practices commonly employed in the birthing room, and the ethical questions which emerge from some of these. The article begins by outlining the risk factors now associated with postpartum PTSD, before exploring these in relation to 19th-century birth narratives. It draws on medical case notes (primarily the case studies of Dr Robert Lee) and women's own accounts of childbirth, as well as advice literature for women on the subject of childbirth. The discussion focuses in particular on three issues: women's knowledge around childbirth and agency within the birthing room (including issues of consent); the use of interventions in childbirth; and infant loss. The final part of the article briefly considers 19th-century discourses around puerperal insanity, and notes an association between difficult deliveries and the onset of puerperal insanity in some cases.
期刊介绍:
Occupational and Environmental Medicine (OEM) is an international peer reviewed journal concerned with areas of current importance in occupational medicine and environmental health issues throughout the world. Original contributions include epidemiological, physiological and psychological studies of occupational and environmental health hazards as well as toxicological studies of materials posing human health risks. A CPD/CME series aims to help visitors in continuing their professional development. A World at Work series describes workplace hazards and protetctive measures in different workplaces worldwide. A correspondence section provides a forum for debate and notification of preliminary findings.