How did women in New Zealand who struggled with symptoms of mental illness in the days, weeks, and months after childbirth access care or find support in the past? Such symptoms prevented women from fulfilling family obligations, and in more severe cases, women became a danger to themselves and others. Doctors long recognised that reproduction and childbirth were times of high risk for mental illness for some women. Yet, the experiences of mothers who became unwell after giving birth do not typically feature prominently in narratives about New Zealand motherhood. In addition, existing historical accounts offer only a vague picture of postpartum psychiatric illnesses (PPI).

This thesis marks the first scholarly study to analyse medical understandings of and responses to PPI in New Zealand over two centuries, addressing the work of general practitioners, obstetricians, psychiatrists, psychologists and nurses. It focuses on a range of sites of care, including psychiatric facilities, maternity hospitals, infant welfare services, family doctors’ clinics and private homes. While my focus is primarily on the New Zealand context, I also draw on international debates regarding PPI. The thesis spans from the earliest institutionalised cases of ‘puerperal insanity’ soon after intensive British settlement from the 1850s until 1980 when heightened attention from health professionals, feminists and others brought the issue more squarely into the public sphere. It explores how the recognised nineteenth-century condition of ‘puerperal insanity’ came to be overwritten by new language by the mid-twentieth century, which included ‘mental breakdown,’ ‘suburban neurosis,’ and the ‘baby blues.’ By the 1970s, ‘postpartum depression’ and ‘psychoses’ became the leading diagnoses for women’s mental health symptoms after childbirth.

While it has been presumed PPI was a ‘hidden’ illness or that women were isolated and suffered in silence, my findings illuminate that women’s experiences spanned a spectrum of severity, which influenced the level of support women received due to various social factors. In drawing attention to women’s experiences and medical efforts to understand and treat PPI across two centuries, this thesis adds to the scant historiographical body of work on the ‘problems’ in New Zealand’s maternal mental health care.