The Postpartum Effect

The Postpartum Effect contains some interesting information that might possibly be useful but it is not a book I'd recommend to pregnant women, especially those prone to depression.  The book itself is quite well-written, although parts of it are merely summaries of some recent research papers on the topic, and there's an uneven pacing to the chapters, since some are very short and others are much longer, and two are authored by medical professionals.  It's not very clear at which readership the book is aimed: much of the book seems to be for the general reader who wants information and help concerning postpartum depression, while the rest of it concerns the failure of the medical and psychological professions to adequately address this common phenomenon.  An editor who insisted on more unity in the aims and writing style would have improved the book.  But the main problem is that it strongly emphasizes the danger of mothers with postpartum depression killing their own children.  Of course, this is a serious issue, but it happens very rarely, and to highlight the problem in a general book about the common phenomenon of depression in new mothers is needlessly alarming and somewhat sensationalist.

There are various estimates of the prevalence of postpartum (also known as postnatal) depression (PPD).  The back cover says that it affects 400,000 women in the US annually.  It affects between 10 and 15 percent of new mothers, but in women over twenty-five years of age with a history of mood instability, 30 to 40 percent will be affected.  Huysman states vaguely that those with a family of mood instability, which she equates with being "genetically predisposed," are also prone to PPD.  Huysman is clearly sympathetic to a biological conception of mental illness, and places strong emphasis on the role of hormonal changes in PPD, as well as referring to bipolar disorder as a genetic illness.  She laments the fact that PPD has not been deemed a separate mental disorder in the diagnostic manual DSM-IV-TR.  Nevertheless, Huysman herself does not provide a clear definition of the disorder; rather she lists some of the "most recognizable signs" of the illness such as severe anxiety, panic attacks, spontaneous crying long after the first week after birth, lack of interest in the new baby, and insomnia.  She also lists other associated signs such as complains by the mother of not being well, of not sleeping or having nightmares, or being irritable, family conflict, thoughts of suicide, hyperactivity, and neglect or abuse of the baby.  Of course, with such a vague list, it is not surprising if this is a difficult phenomenon to identify and study scientifically. 

There are chapters on treating the condition, which go through the usual lists of forms of medication with brief mention of psychotherapy and counseling.  There is an additional chapter tagged on to the end of the book, written by Paul Goodnick, which mostly repeats information found elsewhere in the book, adding information about some of the newer medications that have become available since the first edition of the book.  Another chapter by Ilyene Barsky provides some brief information about how to get help along with a slightly dated list of books on the topic. 

In the middle of The Postpartum Effect are two chapters that seem out of place.  A chapter on "Partners" starts out telling the reader, "Research shows that a significant number of mothers who kill their children do so with the help of a partner."  This is hardly what a woman at risk of PPD or who is suffering from the condition needs to know.  The chapter goes on to list the ways in which men have colluded in child abuse or murder, giving special attention to the case of "Cheryl Stone."  The longest chapter of the book is on "Mothers Who Kill," and it goes into a great deal of detail concerning individual stories.  It is depressing reading.

The back cover claims that author Arlene Huysman as done pioneering work in mood disorders which is widely cited in the field.  However, no articles or books by her are listed in the bibliography or in the notes.  It is hard to tell what exactly she has contributed to the field of knowledge on the topic. Most of the information in the book could have been collected by a journalist.  Ultimately, The Postpartum Effect seems ill-conceived and badly edited.  I recommend readers seek out other books on the subject if they are looking for a guide to depression in new young mothers. 

© 2004 Christian Perring. All rights reserved.

Christian Perring, Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Review.  His main research is on philosophical issues in medicine, psychiatry and psychology.