Infanticide and Puerperal Insanity

The role of women in Victorian society was to nurture and protect their family unit. As the crime of infanticide became subject to news coverage in the emerging British media, society faced a moral problem. The Act of infanticide was prevalent during the seventeenth and eighteenth centuries. Early attempts to codify infanticide as a criminal act placed the blame solely on the women who perpetrated. This can be seen in the passing of the "Act to Prevent Destroying and Murdering of Bastard Children" in 1624. The Act established the need for mothers accused of the crime to prove, with a witness, that their child was stillborn. This Act placed guilt squarely on the shoulders of the mother, and required them to prove their innocence, shifting the burden of proof away from the courts. Legal efforts were made to reform this Act, albeit unsuccessfully, as it proved ineffective in indicting women guilty of the crime. Despite the severity of the crime, society expressed sympathy towards women whose social or economic situations galvanized them to kill their infants.

In 1803, Lord Ellenborough was successful in reforming the 1624 Act by passing the Offences Against the Person Act. The 1803 Act established a separate charge of "concealment of birth" in cases where a live birth could not be proven. This new indictment represented the legal system's attempts to comply with social sympathy for infanticidal women. It offered a legal loophole, which allowed jurists to find women guilty without sending them to be executed as the new indictment had a limited of two years imprisonment. However, if a woman were found guilty of infanticide, she would be punished with execution.

"Gruesome Facts Cartoon," Punch, 1849. Source: History Today

Historians have analyzed the trials of infanticide to understand better how the law, and broader society, understood and dealt with the issue. For example, Anne Cossins argued that the criminalization of infanticide during the nineteenth century reflected the emerging professional classes – medicine and law – aim to morally regulate the female body while asserting their authority. Married women could not be indicted with concealment of birth as the crime's definition recognized the "accepted" catalyst of shame or economic hardship that drove single women to kill their illegitimate infants.

By the 1860s, the growing coverage of infanticide trials in newspapers reached its peak. The public expressed concern over the widespread issue of infanticide as many feared that it had become so common that the legal system was desensitized to the crime. This concern underlined the community's anxiety that the legal system was not successfully punishing those who perpetrated the crime. The medical profession placed itself at the forefront of these public debates. They developed a medical answer that squashed the publics' fears while also implementing a sympathetic approach that saved mothers from the death penalty.

"A Mother-Specific Disorder for a Mother-Specific Crime": Puerperal Insanity

Initially defined in 1819 by Dr. Robert Gooch, a leading obstetric physician, puerperal insanity was defined as "the insanity occurring in women during the period of pregnancy or after delivery." The disorder became intrinsically linked with women and their reproductive system. Obstetricians continued to write and develop the disorder under their authority as they claimed expertise in women and childbirth. However, alienists – the term referring to early psychiatrists— recognized the disorder as a mental ailment and, therefore, under their authority. By the 1860s, alienists dominated in publishing papers and findings on the disorder, defining it further through their clinical access to asylums and its lunatic patients. The disorder was split into three different categories:

Insanity of Pregnancy – a rare form of insanity which occurred during the pregnant stage.

Puerperal Insanity – the most common form that could be diagnosed up to 6 weeks after childbirth.

Insanity of Lactation – a common form of insanity that could exhibit months after birth and be caused by

issues with breastfeeding.

These "sister disorders" were connected directly with each stage of the childbirth process. Through publications and clinical studies, puerperal insanity was considered the most common form of the mental disorder and was used by contemporary alienists interchangeably with the more specific diagnoses. Puerperal insanity could exhibit in two ways:

Mania

Mental symptoms: overexcited, violent, and deviant behavior.
Physical symptoms: fast pulse, high temperate, flushed complexion, uterine tenderness, abnormal lochial discharge.
It is considered the most common and curable form of mental disorder.

Melancholia

Mental symptoms: depressed, lethargic moods, and suicidal delusions.
Physical symptoms: slow pulse, clammy and cold skin, disrupted lactation, weak circulation.
Considered the deadliest form due to it being likely to become chronic and, therefore, beyond rehabilitation.

"Puerperal Mania in Four Stages," Medical Times Gazette, 1858. Source: Wellcome Library

Dovetailing the increased social anxiety surrounding infanticide by the end of the 1860s, puerperal insanity developed into an expansive and useful diagnosis. In their development of the disorder, alienists acknowledged that in both mania and melancholia forms of puerperal insanity, violence towards family members, and especially infants, was considered the most pronounced symptom. Puerperal insanity offered a medical explanation for the shifting demographics of infanticide as a substantial percentage were married women.

By the 1880s, Puerperal insanity was referenced in many infanticide trials in Britain. Its psychiatric definition explained why women were subverting the behavior expected of them as mothers and offered hope that they could be treated and welcomed back into society.