Unnatural Womanhood: Moral Treatment, Puerperal Insanity and the Female Patients at the Fremantle Lunatic Asylum, 1858–1908

Puerperal insanity, or what might be understood as a form of postnatal depression, was the third most frequent diagnosis among the women of the Fremantle Lunatic Asylum from 1858 to 1908. The emphasis society placed on pregnancy and child-rearing as women’s primary function resulted in anxieties surrounding childbirth. Modern medical professionals are now aware there are several factors involved in postnatal depression. However, nineteenth-century physicians viewed it as a common issue of ‘mental derangement’ in women soon after childbirth, but unlikely to be permanent. To treat this, Fremantle Asylum physicians instituted moral treatment methods, including domestic work as rehabilitation. As this paper demonstrates, this form of rehabilitation reinforced the conventional feminine behaviours essential for functioning wives and mothers in nineteenthand early twentieth-century society. As women suffering puerperal insanity challenged the notions of domesticity and femininity, their experiences allow for an analysis of how moral treatment was implemented in Fremantle. Through the patient records and case books of the Fremantle Asylum, this paper reveals that moral treatment did not cure all patients, leaving some susceptible to readmission and continued mental illness. Lilith: A Feminist History Journal, Number 26 172 Alice Mary Anderson was a 27-year-old Roman Catholic housewife admitted to the Fremantle Lunatic Asylum on 30 December 1901 diagnosed with ‘puerperal melancholia’ caused by childbirth and with ‘general symptoms of puerperal mania’.1 One month before Alice’s admission, she had given birth to a daughter, Kathleen Maud.2 However, her husband, Charles, reported Alice had threatened to poison herself, and the day before admission ‘she attempted to get away to drown herself in the river. She also attempted to take hold of a knife. Later she took her boots off in the street in order that she might walk across broken glass.’3 In the asylum, Medical Superintendent Dr Sydney Hamilton Rowan Montgomery observed Alice was ‘very restless and excited, weeps and bemoans all days, says she is lost forever’.4 Eight days later, on 7 January 1902, Montgomery noted that Alice was ‘still very depressed’ and ‘will not speak or employ herself ’.5 However, towards the end of January, she was ‘rather better, has started to do a little sewing’ but was ‘still depressed’.6 Approximately one month later, on 14 February, Montgomery reported that Alice was ‘improving, is more cheerful and contented’.7 By the end of February, Alice was considered convalescent, and on 22 March 1902, she was ‘discharged recovered’, after three months in the asylum.8 Alice’s depressed responses after childbirth manifested as suicidal actions that resulted in her committal. Puerperal insanity was a nineteenth-century understanding of postnatal depression, although not understood or treated as it is today.9 It was not uncommon for a diagnosis to include both puerperal melancholia and 1 Thanks to my supervisor Leigh Straw for her advice and support, Deborah Gare, Joan Wardrop and the Notre Dame postgraduate crew for their encouragement and feedback, in particular, to Toni Church for her comments on this article. I would also like to acknowledge the State Records Office of Western Australia (SROWA) for their assistance in accessing records. This research has been carried out with the aid of an Australian Postgraduate Award (APA). SROWA: Case Book Female Patients, 1901–08, Folio 13, 30 December 1901. 2 Ibid.; The Births, Deaths, and Marriages Index of Western Australia (BDMWA): Certificate of Birth, Kathleen Maud Anderson (1543/1901). 3 Certificate of Birth, Kathleen Maud Anderson (1543/1901). 4 SROWA: Case Book Female Patients, Folio 14, 30 December 1901. Dr Montgomery was Medical Superintendent 1901–08. 5 Ibid., 7 January 1902. 6 SROWA: Case Book Female Patients, Folio 14, 21 January 1902. 7 Ibid., 14 February 1902. 8 Ibid., 28 February; 22 March 1902. 9 A direct comparison between puerperal insanity and postnatal depression is not overly beneficial; this paper does not intend to retrospectively diagnose the women of Fremantle.